SEFAKO MAKGATHO HEALTH SCIENCES UNIVERSITY

SCHOOL OF ORAL HEALTH SCIENCES

DEPARTMENT OF ORAL AND MAXILLOFACIAL
PATHOLOGY
FORMATIVE TEST 2
__________________________________________________
Course : BOH 1 Date : 14/08/2024
Module : ORAL BIOLOGY Time : 60 minutes

Module Code : MORB010 Marks : 50

Instructions for this test

1. Please answer all questions in the book provided.
2. The maximum number of marks for each question is indicated.
3. Please write legible.
4. Please use a black pen
5. University Rules apply.
6. Please submit your answer books together with the question paper
__________________________________________________ Results
for this test:

Q1 10

Q2 14

Q3 11

Q4 5

Q5 10

Total 50

Internal Examiners: Dr J Toyhakale

Dr HD Miniggio

MORB010 14/08/2024
Question 1
For the following multiple-choice questions, choose the most appropriate answer

1.1 Answer the following question by studying the picture below

The picture above represents an optical illusion produced by change in direction of adjacent
groups of rods seen best on longitudinal section knows as: (1)

A. Dentin bands
B. Hunter-Schreger bands
C. Enamel bands
D. Lamellae bands
1.2 Radiating lines of poor mineralization at the DEJ as branched structures are known as: (1)
A. Enamel spindle
B. Enamel lamellae
C. Enamel tufts
D. Enamel rods
1.3 These represent fine cracks on the surface of enamel and are frequent sites of
development of early caries lesions: (1)
A. Enamel spindle
B. Enamel lamellae
C. Enamel tufts
D. Enamel rods
1.4 A type of cementum seen mainly in apical and inter-radicular areas is: (1)
A. Acellular Cementum
B. Biological Cementum
C. Cellular Cementum
D. Physiological cementum

MORB010 14/08/2024
1.5 A type of cementum that is produced once tooth is in occlusion: (1)
A. Primary acellular extrinsic fibre cementum
B. Secondary cellular intrinsic fibre cementum
C. Primary cellular extrinsic fibre cementum
D. Secondary acellular extrinsic fibre cementum
1.6 A type of cementum that is derived as Sharpey’s fibres from the periodontal ligament and
is slowly developed: (1)
A. Primary acellular extrinsic fibre cementum
B. Secondary acellular extrinsic fibre cementum
C. Primary cellular extrinsic fibre cementum
D. Secondary cellular intrinsic fibre cementum
1.7 A type of dentin that is physiologic and forms after completion of root formation is: (1)
A. Primary Dentin
B. Mantle Dentin
C. Secondary Dentin
D. Circumpulpal Dentin

1.8 Odontoblasts can be observed in the following regions of the mature, fully erupted tooth:
A. Enamel dentinal junction
B. Periphery of the dental pulp
C. Inner portion of the dental pulp
D. Mineralized dentin
1.9 Changes in pulp during aging include: (1)
A. The chamber becomes smaller due to deposition of secondary dentin
B. Pulp is more sensitive due to an increase in the number of nerve fibers
C. The chamber becomes smaller due to deposition of primary dentin
D. There is an increase in cell content of the pulp
1.10 The nerves and capillary plexus are found in the following areas of dental pulp: (1)

A. Cell free zone

B. Cell rich zone
C. Pulp core
D. Pulp periphery
[10]

MORB010 14/08/2024
Question 2
2.1 The following diagram represents dentinogenesis. Answer the following questions based
on the diagram.

2.1.1 Identify D (1)

• Inner Enamel Epithelium
2.1.2 What is the effect of D ON C? (1)
• Epithelial Mesenchymal Interaction (EMI) to cause Dental Papilla to differentiate into
Odontoblasts.
2.1.3 Identify A (1)
• Undifferentiated ectomesenchymal cell/ Daughter cell not under influence of Inner
enamel epithelium and persists. (1)

2.2 List the any 1 feature of sclerotin dentin (1)

• Tubuli that have become occluded by calcified material (1) or

• When this happens in large areas: glassy, translucent appearance (1) or
• Increases with age (1) or
• Most common in apical third (1) or
• Low permeability (1)
2.2 Outline the difference between primary dentin and secondary dentin (4)
• Primary dentin - dentin formed during odontogenesis (1), Major component of the
crown and the root, consists of Mantle dentin, Globular dentin, Circumpulpal dentin (1),
Mantle dentin: deposited first, along the enamel dentinal junction, mineralized by
matrix vesicles not a mineralization front, believed to be secreted by immature
odontoblasts (1).

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 • Secondary dentin - Following tooth eruption and once the tooth reaches occlusion
(1), the continued secretion of dentin as the odontoblasts moves centripetally towards
the centre of the pulp (1), Dentin deposited at a slower pace (1).

2.4 Briefly explain why secondary dentin is deposited more on the roof and floor of the coronal
pulp chamber than on the lateral walls? (2)

• To protect the pulpal horns as occlusal functions occurs. (1)

[14]
Question 3
3.1 A 30-year-old patient presents to your practice. Upon clinical examination, you find a
superficial carious lesion extending to the dentin.
(a) Name the type of dentin which will be formed in this scenario and explain your answer. (3)

• Reactionary Dentin (Tertiary Dentin) the carious lesion is superficial, therefore the
damage extends only to the odontoblastic processes and with no death of
odontoblasts. Reactionary Dentin is secreted by surviving primary odontoblasts
affected by mild injury.

(b) You also observe, upon radiological examination several pulp calcifications on tooth 34.
List 4 (four) microscopic zones of dental pulp and describe contents thereof in each zone. (4)

• Odontoblastic layer (0.5)- Lines the outer pulpal wall and consists of the cell bodies of
odontoblast. Secondary dentin may form in this area from the apposition of
odontoblast. (0.5)
• Cell-free zone- Fewer cells than odontoblastic layer. Nerve and capillary plexus located
here. (0.5)
• Cell-rich zone (0.5) - Increased density of cells as compared to cell-free zone and also
a more extensive vascular system. (0.5)
• Pulp-core (0.5)- Located in the center of the pulp chamber, which has many cells and
an extensive vascular supply, similar to cell-rich zone. (0.5)

3.2 A 37-year-old patient presents to your practice. Upon clinical examination, you observe
gingival recession and a cervical carious lesion on 14, which extends significantly into dentin.
Will this patient feel pain upon probing the cervical carious lesion with the dental probe?
Explain your answer by making refence to the various theories of dentinal hypersensitivity
(4)

• Yes. Exposed dentine is sensitive. Three (3) mechanisms have been proposed to
understand dentine sensitivity:
I. The dentine contains nerve endings, that responds when it is stimulated.
II. The odontoblasts serve as a receptor and are coupled to nerves in the pulp.

MORB010 14/08/2024
 III. The tubular nature of dentine permits fluid movement to occur within the tubule when
a stimulus is applied. A movement is registered by pulpal nerves. Fluid movement
through the tubule distorts the local pulpal environment and is sensed by the free
nerve endings in the plexus of Raschow. (1 mark per concept)

[11]

Question 3
3.1 Explain the difference between primary cementum (extrinsic fibre cementum) and
secondar cellular (intrinsic fibre cementum). (4)
Primary cementum (Acellular Extrinsic Fibre Cementum)

• First cementum to develop- is derived as Sharpey’s fibres from the periodontal

ligament (1)
• Slowly formed with no cells incorporated (1)
• Covers all of root (1) or
Secondary Cementum Cellular Intrinsic Fibre Cementum

• Produced once tooth is in occlusion (1)

• Overlies the acellular cementum (1)
• Fast development with entrapment of cementoblasts (Cementocytes in lacunae) (1) or
• Mainly apical and inter-radicular areas (1) or
3.2 List any 2 periodontal principle fibres and mention 1 function of each (4)

• Alveolar crest (1)- Retains tooth in the socket (1), oppose lateral forces (1), prevents
extrusion and intrusion of the tooth (1), protects deeper periodontal ligament structures
(1). Any 2 functions
• Horizontal group (1) - Restrain lateral tooth movements (1).
• Oblique group (1)- They bear the brunt of vertical masticatory stresses (1) and
transform them into tension on alveolar bone (1) and resist intrusive forces (1).
• Apical group- Prevent tooth tipping (1), resist luxation (1) and protect blood, lymph and
nerve supplies to tooth (1).
• Inter radicular group- Aid in resisting tipping (1) and luxation (1).

3.3. Name the location and function of epithelial cell rests of Malassez (ERM) (2)

• Adult periodontal ligament

• ERM maintain a constant periodontal ligament space by indirect stimulation of
osteoclast differentiation through decreasing the decoy receptor OPG and increasing
MCP-1. (1) or

MORB010 14/08/2024
 • ERM prevent formation of alveodental ankylosis by constantly secreting bone
resorptive mediators thereby preventing mineralisation of the periodontal ligament. (1)
or
• ERM participate in the process of periodontal regeneration by proving a stem cell
supply which can migrate to sites of resorption and injury and stimulate
cementogenesis. (1) or
• ERM participate in tooth movement by increasing EGF production in periodontal
tissues and helping to repair root resorption areas white stimulating cementogenesis.
(1)

[10]
Question 4
4.1 List any 2 functions of the lymphatic system (2)

• Fluid balance: Collects and returns interstitial fluid, including plasma protein to the
blood. (1) or
• Immune system: Defends the body against disease by producing lymphocytes (1) or
• Fat transport: Absorb lipids from the intestine and transport them to the blood

4.3 Where do T-Lymphocytes mature? (1)

• Thymus (1)

4.4 A 25-year-old patient presents to your practice. Upon clinical and radiological examination,
you find an infection on the tongue.

(a) Name the lymph node that will drain the anterior 2/3 (lateral region) of the tongue (1)

• Submandibular lymph node (1)

(b) Name the lymph node that will drain the anterior 2/3 (middle region) of the tongue (1)

• Inferior deep cervical lymph nodes (1)

[5]
TOTAL MARKS: 50

MORB010 14/08/2024