Dr.
Karim El Mestekawy
karimelmestekawy@[Link]
This file is for Oral Surgery for Membership of the
Faculty of Dentistry of the Royal College of Surgeons
in Ireland Part 2 Exam.
Sources for MFD Part 2 Exam depends mainly on
candidates' feedback and there are no pictures
associated with the feedback. So, I tried to make a
more useful feedback by adding pictures that match
the questions.
Orthodontics Questions and Answers Part 1
[Link] El Mestekawy
karimelmestekawy@[Link]
Station 1
Cephalogram with tracing paper
a. Identify the following ( tell the examiner what are you doing)
Point A, Point B, Point S, Point N, Maxillary plane, Mandibular plane.
[Link] El Mestekawy
karimelmestekawy@[Link]
Point A : deepest concavity on the anterior profile of the maxilla.
[Link] El Mestekawy
karimelmestekawy@[Link]
Point B : deepest concavity on the anterior profile of the mandibule.
[Link] El Mestekawy
karimelmestekawy@[Link]
Point S : midpoint of the sella turcica (primary fossa)
[Link] El Mestekawy
karimelmestekawy@[Link]
Point N : most anterior point of the frontonasal suture.
[Link] El Mestekawy
karimelmestekawy@[Link]
Maxillary plane : Plane line joining the anterior nasal spine (ANS) and posterior nasal
spine (PNS)
Anterior nasal spine (ANS)
[Link] El Mestekawy
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Posterior nasal spine (PNS)
[Link] El Mestekawy
karimelmestekawy@[Link]
Maxillary plane
[Link] El Mestekawy
karimelmestekawy@[Link]
Mandibular plane : Plane line joining the gonion and menton.
Gonion
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Menton
[Link] El Mestekawy
karimelmestekawy@[Link]
Mandibular plane
b. Classify:
Anteroposterior relationship & Vertical relationship
Anterioposterior relationship
Class I normal occlusion
Class II malocclusion Division 1
Class II Malocclusion Division 2
Class III malocclusion
Vertical relationship
Open bite
Normal overbite
Deep bite
c. What 4 cephalometric changes will occur if the child treated with functional
appliance?
[Link]
[Link] El Mestekawy
karimelmestekawy@[Link]
2. SNB
[Link]
[Link] El Mestekawy
karimelmestekawy@[Link]
4. MMPA
[Link] El Mestekawy
karimelmestekawy@[Link]
Station 2
a. What’s the appliance?
Twin Block
[Link] El Mestekawy
karimelmestekawy@[Link]
b. What type of malocclusion is it used to treat?
Class II Malocclusion
c. What problem will arise with using it?
1. The speaking is affected initially but after 2-3 days the patient will be
accustomed to that.
2. Excessive salivary production during initial use because the brain thinks that
there is food but this will subside aferwards.
[Link] in eating during initial use but this will subside afterwards.
[Link] El Mestekawy
karimelmestekawy@[Link]
Station 3
Determine the chronological age in each radiograph.
Radiograph 1
Radiograph 2
[Link] El Mestekawy
karimelmestekawy@[Link]
Radiograph 3
Radiograph 4
Radiograph 5
[Link] El Mestekawy
karimelmestekawy@[Link]
Radiograph 6
Radiograph 1 : About 2.5 years
Radiograph 2 : About 4 years
Radiograph 3 : About 7 years
Radiograph 4 : About 7.5 years
Radiograph 5 : About 8.5 years
Radiograph 6 : About 9.5 years
[Link] El Mestekawy
karimelmestekawy@[Link]
Station 4
[Link] of malocclusion seen.
Class II Division 1 Malocclusion
[Link] is the objective of your treatment?
Reduce the skeletal class II pattern, achieve a class I skeletal and dental relation,
establish normal overjet and overbite, reduce the convex profile, and improve
the lip incompetency.
[Link] are the aims of your treatment?
1. Functional Efficiency. 2. Structural Balance. 3. Esthetic Harmony.
[Link] 4 complications of orthodontic treatment.
[Link] Demeneralization
[Link] Wear
[Link] Resorption
[Link] Reaction
[Link] El Mestekawy
karimelmestekawy@[Link]
[Link] a removable appliance to treat this case.
[Link] El Mestekawy
karimelmestekawy@[Link]
Station 5
[Link] El Mestekawy
karimelmestekawy@[Link]
[Link] tracing: Points A,B, N, S, Maxillary plane, Mandibular plane
[Link] El Mestekawy
karimelmestekawy@[Link]
Maxillay Plane
[Link] El Mestekawy
karimelmestekawy@[Link]
Mandibular Plane
[Link] El Mestekawy
karimelmestekawy@[Link]
[Link] above mentioned points.
Point A : deepest concavity on the anterior profile of the maxilla.
Point B : deepest concavity on the anterior profile of the mandibule.
Point N : most anterior point of the frontonasal suture.
Point S : Midpoint of the sella turcica (pituitary fossa)
Maxillary Plane : Plane line joining the anterior nasal spine (ANS)
and posterior nasal spine (PNS)
Mandibular Plane : Plane line joining the gonion and menton.
[Link] :
anteroposterior relationship & vertical relationship
anteroposterior relationship
Class I normal occlusion
Class II malocclusion Division 1
Class II Malocclusion Division 2
Class III malocclusion
vertical relationship
Open bite
Normal overbite
Deep bite
[Link] 4 cephalometric changes if functional appliance is used?
1. SNA
[Link]
[Link]
[Link]
[Link] El Mestekawy
karimelmestekawy@[Link]
Station 6
[Link] El Mestekawy
karimelmestekawy@[Link]
[Link]’s this appliance?
Bionator
[Link] what age is it used?
before the pubertal growth spurt
[Link] type of malocclusion is it used to treat?
Class II Malocclusion
[Link] El Mestekawy
karimelmestekawy@[Link]
[Link] changes will produce?
produce considerable changes in dentoskeletal structures through a
repositioning of the lower jaw in a more forward position, establish
normal overjet and overbite, control dental eruption, and improve facial
structures
[Link]
[Link] patient cooperation
2. Treatment duartion is often prolonged
3. Not useful in adults.
[Link] El Mestekawy
karimelmestekawy@[Link]
Station 7
[Link] the cephalometry using the given radiographic view.
[Link] El Mestekawy
karimelmestekawy@[Link]
b. classify :
[Link] anteroposterior relationship and Skeletal vertical relationship
[Link] Height
[Link] relationship:
-Anteroposterior relationship:
Skeletal Class I
Skeletal Class II :
-Skeletal Class II type 1
-Skeletal Class II type 2
-Skeletal Class II type 3
Skeletal Class III
-Skeletal Class III type 1
-Skeletal Class III type 2
-Skeletal Class III type 3
[Link] El Mestekawy
karimelmestekawy@[Link]
Vertical Skeletal realtionship:
The Frankfurt plane is taken as a line through orbitale and porion (porion is often
identified by the ea post position!). Since both orbitale and porion can be difficult to
identify, the maxillay plane (ANS-PNS) is commonly used instead to represent the
inclination of the maxilla. {The Frankfurt and maxillary planes were assumed to be
approximately parallel but there is in fact a marked individual variation and the
maxillary-mandibular planes angle needs to be measured accurately each time}
[Link] El Mestekawy
karimelmestekawy@[Link]
[Link] Height :
a. Anterior Facial Height : Linear distance between Nasion (N) and Menton (M)
Anterior Facial Height is divided into:
-Upper Anterior Facial Height : Linear distance between points Nasion (N) and ANS
-Lower Anterior Facial Height : Linear distance between ANS and Menton (M)
[Link] El Mestekawy
karimelmestekawy@[Link]
b. Posterior Facial Height : Distance between articulare and gonion
[Link] El Mestekawy
karimelmestekawy@[Link]
[Link] are the skeletal changes that median opening activator can cause?
1. Growth in mandibular length.
2. Growth in ramus height.
3. Growth in corpus length.
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[Link] El Mestekawy
karimelmestekawy@[Link]
Station 8
[Link] this malocclusion?
Class III malocclusion.
[Link] is the treatment in growing child?
Face mask therapy.
[Link] is the treatment in the late teens?
Maxillary protraction with bone anchors and Class III elastics.
[Link] is the treatment after permanent dentition has established?
[Link] camouflage.
2. Orthognathic surgery
[Link] El Mestekawy
karimelmestekawy@[Link]
Station 9
[Link] cephalometric cephalometric landmarks :
(point A, B, N, maxillary plane, mandibular plane)
Point A : deepest concavity on the anterior profile of the maxilla.
Point B : deepest concavity on the anterior profile of the mandibule.
Point N : most anterior point of the frontonasal suture.
Maxillary plane : Plane line joining the anterior nasal spine (ANS) and posterior
nasal spine (PNS)
Mandibular plane : Plane line joining the gonion and menton.
[Link] El Mestekawy
karimelmestekawy@[Link]
b. Mention:
[Link] realtionship
[Link] relationship
1. Anterioposterior relationship
Class I normal occlusion
Class II malocclusion Division 1
Class II Malocclusion Division 2
Class III malocclusion
[Link] relationship
Open bite
Normal overbite
Deep bite
c. What cephalometric changes occur if functional appliances are used?
[Link]
[Link]
[Link]
[Link]
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[Link] El Mestekawy
karimelmestekawy@[Link]
References:
Phulari Basavaraj Subhashchandra. (2013). An Atlas on Cephalometric Landmarks.
Jaypee Brothers Medical Publisher (P) Ltd.
Classification of malocclusions. (2020). Retrieved 23 July 2020, from
[Link]
Mageet AO. Classification of Skeletal and Dental Malocclusion: Revisited. StomaEduJ.
2016;3(2)
Panchbhai, A. (2011). Dental radiographic indicators, a key to age
estimation. Dentomaxillofacial Radiology, 40(4), 199-212. doi: 10.1259/dmfr/19478385
El Dabbagh, D. Cephalometry [Ebook] (pp. Page 8 and Page 11). Baghdad. Retrieved
from [Link]
[Link]
Tinkler, A. Twin block appliance. Retrieved 9 August 2020, from [Link]
[Link]/Web_page/Twin_Block_Appliance.html
Dentistry and Medicine. Retrieved 9 August 2020, from
[Link]
10 Removable Appliances for the Postgraduate in Specialist Orthodontic Training.
Retrieved 9 August 2020, from [Link]
for-the-postgraduate-in-specialist-orthodontic-training/
Retrieved 9 August 2020, from [Link]
tracing-showing-the-six-cephalometric-landmarks-used-in-the-assessment-
of_fig1_12020564
Bionator I (to Open) | Accutech Orthodontic Laboratory Products. Retrieved 9 August
2020, from
[Link]
appliances/bionator-i
[Link] El Mestekawy
karimelmestekawy@[Link]
Niaki, K. Importance of facial height in Orthodontic treatment. Retrieved 9 August 2020,
from [Link]
kian-morteza/
facial height. Retrieved 9 August 2020, from
[Link]
ammar905. Orthodontic assessment. Retrieved 9 August 2020, from
[Link]
from_action=save
Azamian, Z., & Shirban, F. (2016). Treatment Options for Class III Malocclusion in
Growing Patients with Emphasis on Maxillary Protraction. Scientifica, 2016, 1-9. doi:
10.1155/2016/8105163
