Prosthodontics

Question 34

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The mandible makes a PURELY rotational opening and closing movement around the:

Select one:

a. Sagital axis

b. Horzontal axis

c. Frontal axis

d. vertical axis

e. orientation axis

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Question 35

Which curing stage of the acrylic resin is ideal for packing inside the model during processing:

Select one:

a. String

b. Rubber

c. Sticky

d. wet sand

e. dough

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Question 36

Which one of the following anatomical changes is a consequences of tooth loss:

Select one:

a. The maxillary arch becomes wider than mandible arch

b. Bone loss is greater in the maxilla than the mandible

c. Bone loss is greater in the posterior than the anterior edontouls area

d. The oral mucosa becomes more keratinized

e. The thickness of the cortical bone increases.

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Question 38

Which one of the following anatomical landmarks are used to check paralleselism of the upper occlusal
wax rim on the trial denture base:

Select one:

a. Interpupillary line and ala tragus line

b. Upper lip vermillion and Frankfort horizontal plane

c. Frankfort horizontal plane and interpupillary line

d. Parotid duct and interpupillary line

e. Upper lip vermillion and ala-tragus line

Question 39

Which one of the following anatomical landmarks determine where the posterior extension of maxillary
denture should be:

Select one:

a. Tongue and superior constrictor.

b. Superior constructor only

c. Hamular notch and vibrating line.

d. Mid palatal raphe and palatine fovea

e. Palatine fovea and humular notch

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Question 40

Which one of the following gypsum products has high strenghth and high expansion value:

Select one:

a. Type II

b. Type V

c. Type III

d. Type I

e. Type IV

Question 41

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Which one of the following materials can be used to make a primary impression for
complete denture:

Select one:

a. Impression wax

b. Regular body polyether impression material

c. Regular body polysulphide impression material

d. Light body silicon impression material

e. compound

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Question 42

Which one of the following sequence is correct while adjusting an occlusal rim in patients mouth:

Select one:

a. Check parallelismadjusting labial contour  adjusting height

b. adjusting labial contour  Check parallelism  adjusting height

c. adjusting height  Check parallelism  adjusting labial contour

d. adjusting height adjusting labial contour  Check parallelism

e. adjusting labial contour (support)  adjusting height  Check parallelism

Question 43

Which physical characterstics of a complete denture prosthesis resists the vertical force of dislodgment
1
:

Select one:

a. Rigidity

b. Resistance

c. Support

d. Retention

e. Stability

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Question 44

With regards to the maximum occlusal force created by the natural dentition and different types of
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prosthesis, which one of the following in descending order from left to right is correct :

Select one:

a. Natural dentetion> Fixed > removal Partial> removal complete.

b. Natural dentetion> removal Partial > Fixed > removal complete.

c. Natural dentetion= Fixed > removal Partial= removal complete.

d. Natural dentetion> Fixed > removal prosthesis.

e. Natural dentetion= Fixed = removal prosthesis.

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 Prosthodontics
Section I – Multiple Choice Questions
(Circle the letter corresponding to the most suitable answer – 1 mark per
question)

1. Which one of the following can be assessed using a diagnostic cast:

a) Length of the roots

b) Tooth mobility
c) Inclination of the tooth
d) Attached gingiva
e) Configuration of the roots

1. Habits like clenching may result in fatigue, muscle pain and hypertrophy
of the

f) Buccinator
g) Masseter
h) Sternocleidomastoid
i) Lateral pterygoid
j) Trapezius

2. Which one of the following statements is correct about principles of tooth

preparation:

k) A small tooth with short walls provides better retention than a large
tooth with short walls
l) The recommended degree of taper for premolars is more than the
anterior teeth
m) The optimum degree of taper for anterior teeth is around 17-24 degrees
n) The recommended degree of taper for a molar is less than an anterior
tooth
o) The optimum degree of taper for a premolar is around 5- 10 degrees

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 3. Which one of the following statements is correct with regards to a crown
preparation:

p) The finish line of the preparation should be located sub-ginigivally

q) The finish line should be at least 2mm away from the alveolar bone
crest
r) The path of insertion should be always parallel to the long axis of the
prepared tooth
s) A knife edge is the choice of finish line on the lingual surface of a
buccally tilted upper molar
t) A knife edge finish line produces maximal destruction in tooth
preparation

4. The role of a seating groove in a crown preparation is to provide:

u) Resistance and retention form

v) Structural durability of the crown
w) Marginal integrity and periodontal preservation
x) Structural durability of the tooth
y) Preservation of tooth structure

5. The type of finish line for a full metal gold crown is a:

z) Knife edge
aa) Shoulder
bb) Radial shoulder
cc) Chamfer
dd) Deep chamfer

6. What are the advantages of using full crown restorations over partial
veneer restorations:

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 ee) Ease of accessibility to margins for finishing
ff) Providing better resistance form
gg) Possibility for pulp testing
hh) Less periodontal irritation
ii) Better aesthetics

7. A full coverage crown restoration has the advantage over a partial veneer
restoration because the full crown restoration:

a) Preserves tooth structure

b) Has more cleansable margins
c) Allows for better retention
d) Is associated with less periodontal irritation
e) Results in fewer pulpal problems

8. Which one of the following statements is correct about an indirect

ONLAY restoration:

jj) It is indicated in root canal treated teeth with intact buccal and lingual
cusps
kk) The onlay preparation is more conservative than an inlay preparation
ll) It is used as a retainer for long span bridges
mm) The retention mechanism is a “sleeve”
nn) Internal buccal and lingual walls should be convergent

9. A resin bonded bridge is best suited to replace a:

oo) Missing mandibular incisor

pp) Missing mandibular canine
qq) Missing mandibular 1 s t and 2 n d premolar
rr) Missing maxillary canine
ss) Missing maxillary 1 s t and 2 n d premolar

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 Section II – Extended Matching Questions

(Insert your responses in the respective grid below – 5 marks per question)

1. Theme: Components of a Fixed Prosthesis

A. Abutment
A. Connector
B. Pontic
C. Retainer
D. Non rigid connector
E. Edentulous ridge
F. Crown

Using a lett er from A to G, choose the most appropriate response from the list
above that best matches each of the following descripti ons numbered 1 to 5
below. You may use each response A to G, once only or not at all.

A component of a bridge that permits limited movement

An artificial tooth on a bridge that replaces a missing natural tooth and restores its form and
function
A component of a bridge which is cemented to the abutment(s)
The term used to describe the tooth or teeth to which a bridge is cemented
A component of a bridge which joins the retainer to the pontic

Descripti on Response

1 E

2 C

3 D

4 A

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 5 B

Section III – Short Answer Questions

(5 marks per question)

1. You are preparing a mandibular molar FDI 36 to receive a full gold crown
restoration.

a) Explain the retention and resistance form in the crown preparation: (2

marks)

Retention prevents removal of the restoration along the path of insertion

or long axis of the tooth preparation.

Resistance prevents dislodgement of the restoration by forces directed in

an apical or oblique direction and prevents any movement of the
restoration under occlusal forces .

b) List any three features that affect the retention and resistance form: (3
marks)

Taper
Freedom of displacement
Length
Substitution of internal features
Path of insertion

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 1. a) List four possible signs and symptoms of a TMJ disorder: (2 marks)

1. Clicking
2. Crepitation
3. Pain and limitation on opening, closing and moving laterally.
4. Pain of Palpation of the joints and masticatory muscles as the patient opens and closes.
5. Deviation of mandible when open and close
6. Headache

b) Which are the six muscles that should be examined when a TMJ
disorder is suspected: (3 marks)

1. Masseter
2. Temporalis
3. Medial pterygoid
4. Lateral pterygoid
5. Trapezius and
6. Sternocleidomastoid

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 1. Saddle/Ridge lap
2. Modified ridge lap
3. Hygienic pontic
4. Conical pontic
5. Ovate pontic

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 max – distal facing / man – mesial facing

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Trouble Maker
 12mm
Protrusion Axis is

to close

>12mm
Axis is ramus

A&b. centric relation (D), protusion (A),pure hinge rotation of condyle (E)

c. Centric relation , because its REPRODUCABLE

d.methods : arbitatry hinge axis (ear axis)

2/a . bilateral balanced occlusion

Unilateral balanced occlusion

Mutually protected occlusion

2/b.Bilateral Balanced occlusion

(to prevent tipping of the denture during mastication & functioning)

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Prostho

EMQ:—
-Non functional lingualized: Maxillary and mandibular cusps doesn't play a role in occlusion 
-Monoplane: Flat plane/No excursive contacts 
-Balanced occlusion: 20-30 degree inclination 
-Christins phenomena: Mandibular protusion 
-Curve of Spee: Ant-post curve 

SAQ:-
1) Occlusal discrepancy when fitting the denture ..problem? Overheating of acrylic during
processing or packing 
How to avoid it: slow heating from zero then go up - or-slow cooling after processing.
2)Patient going through radiation complaining of instability..why? 
-Radiation induced xerostomia
-Sjogrens syndrome/Diabetes/age related changes to salivary glands 

MCQ:-
-Method of obtaining centric (Bilateral manipulation)
-Post delivery instruction (follow up after 24 hrs. Put it in water)
-Errors causing gaseous porosity(rapid heating during processing #monomer evaporation)
-Low smile line (modified ridge lap)
-High smile line (ovate)
-Tilted abutment (orthodontic repositioning)
-Preferred material of choice of tissue-pontic 
(Highly glazed porcelain-highly biocompatible)
-Preferred root configuration
(Wider-more separated- multirooted- irregular)
-Osteoradionecrosis: happens after extraction/ surgical intervention on radiating wounds.

Arcon Non arcon

Condyle analygous in the LOWER membrane Condyle analygous in the UPPER membrane
Angle of condylar Inclination Angle of condylar Inclination
Is NOT INDEPENDENT to the degree of opening Is NOT DEPENDENT to the degree of opening

inter-occlusal relation will change after removing

occlusal record : becoming slightly LESS STEEP

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 1. Rubber dam
2. High-volume vacuum
3. Saliva ejector
4. Svedopter
5. antisialagogues

1. Copper Band impressions

2. Rubber dam

healthy and inflammation free tissue

Absence of bleeding on probing
Sulcus depth less than 3mm
Presence of adequate keratinized gingiva

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No,
(remember
what we have
in the college)

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 Rotary curettage

Electrosurgery
Rubber dam

Cobber band

Retraction cord

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Prostho

Matching repeated

(Impression materials)

Compound Thermoplastic
Polysulfide Highest viscoelasticity
Alginate / condensational cured silicon ?? Only two hours waiting for pouring
Polytheres In poor moisture control (Hydrophilic)
Addition-cured silicon Highest dimensional stability

SAQ:  Fixed -fixed bridge failure: loss of retention

How you diagnose?

Pressing the bridge and looking for small bubbles in the saliva at the margins of the retainers.

Reasons for failure?

– Cementation failure

– Non retentive Preparations

– Occlusal problems

3 ways to solve the problem

– Recementation – More chemically adhesive cement

– Preparations are redone and the retainer(s) are remade – Change the design

– Additional abutments

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 Patient after a week with denture and it is loose while talking and eating? List 5 factors why it 
is loose!!!!
Decreased retentive forces

‐Dry mouth, xerostomia 

‐Air beneath the impression surface : Deficient impression, Damaged cast, Warped denture, Over
adjustment of imp surface, Undercut Residual Ridge

‐Lack of peripheral seal : Border Under Extension in Depth, Border Under Extension in Width,

Inelasticity of the cheek due to aging, submucous fibrosis, Reduction of residual ridge

-Lack of neuromuscular control: Inability to habituate to new dentures , High occlusal plane on the
lower denture, Bells palsy, Parkinsonism, Retruded tongue position

Denture borders: Over extension in depth, Over extension in width, Deep post dam on the upper
denture.
Increased retentive forces

Poor fit to supporting tissue

Denture not sited in optimal space: Lower molars set lingual to the ridge, Excessive pressure on the
lower lip on to the lower denture, Large occlusal table in poor ridge cases, Excessive pressure from the
upper lip on to the upper denture

Occlusion : Uneven Initial Contact, ICP &RCP are not coincident, Lack of occlusal balance in lateral and
protrusive movements

Support problems: Lack of ridge, Fibrous displaceable ridge

‐Short flanges

‐ fracture, perforaon  

MCQ

What is the type of strength in a crylic that prevent it from fracture in floor:

Impact strength

Flexural  strength

Compressive strength

Tensile strength

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Craze?

Small cracks in the surface of enamel or filling to relief internal stress & not causing pain.

And two others don’t remm

Occlusal interference(Max: MLBD/ Mand:DBLM )

The centric interference max – mesial facing man – distal facing

A working interference max – lingual facing man – buccal facing

A nonworking interference max – buccal facing man – lingual facing

The protrusive interference max – distal facing man – mesial facing

Position of Man from CR to CO: Anterior Superior

Movement of man in lateral side working side: Lateral And Downward 

Movement of man in lateral side non‐working side: Medial And Forward 

Type of occlusion: 

‐ Bilateral balanced occlusion

‐ Unilateral balanced occlusion

‐ Mutually protected occlusion

Questions on failure in crown design is marginal defects and (two quesons on the lecture of  failure)

– Positive ledge Excess of crown material protruding beyond the margin of the preparation - Common
with PORCELAIN - Easily correctable (– Heatless stone or diamond points – Composite finishing burs)

– Negative ledge: Marginal deficiency with no gaps – Common with METAL– Impossible to correct –
Due to poor impression, overtrimmed die- Trimming of the tooth surface

– Defect: Gap between the crown and the preparation margins. Possible causes:

 Crown or retainer did not fit before

Management : cementation

 Observe periodically
 restore the gap and observe
periodically
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 redo
  Crown or retainer did not fit after
cementation
 hydrostatic pressure of cement.
 Mobile teeth getting depressed in
socket while cementing
 Loss of cement in the margins during
the function due to erosion /
abrasion and possibly caries

Question on combination syndrome:

the characteristic features that occur when an edentulous maxilla is opposed by natural mandibular
anterior teeth, including loss of bone from the anterior portion of the maxillary ridge, overgrowth of
the tuberosity, papillary hyperplasia of the hard palate’s mucosa, extrusion of the lower anterior
teeth, and loss of alveolar bone and ridge height beneath the posterior mandibular removable dental
prosthesis bases.

Trouble Maker