Oral surgery

Cellulitis is a flammation of medular bone

Cellulitis is a painful swelling of the soft tissue of the mouth and face resultating from a diffuse spreading of purulent exudate along the facial planes that separate the muscle bundles

Cellulitis is an acute deep suppurative abcess of upper neck and perioral area

Cellilitis is inflammation of hair follicle from infection or trauma or Chemical irritation

What are the causes of cellulitis ?

Inflammation of hair follicles

Chronic of apical infection

Acute of apical infection

Chronic blistering disease

How to spread of pus inside the tissues space ?

By continuity through tissue spaces and planes, by way of the lymphatic system and by way of blood circulation

By way of the lymphatic system by way of the lymphatic System

By way of blood circulation

By direct skin-to-skin contact with the infected areas

Local Signs and Symptoms of cellulitis are :

Pain and swelling

Surface erythema and pus formation

Limitation of motion

All as the above

Systemical signs and symptoms of cellulitis are :

Fever and malaise

Lymphadenopathy and toxic appearance

Elevated white blood cell count

All as the above

Classification of cellulitis based by severity ?

Acute and chronic

Acute, subacute and chronic

Low severity,medium severity and high severity

Odontogenic and nonodontogenic cellulitis

Fascial planes offer anatomic highways for infection to spread superficial to deep planes are :

Surface of gingiva, palatal abscess and maxillary sinus

Surface of gingiva, palatal abscess , maxillary sinus,maxilla and mandible

Surface of gingiva, palatal abscess , maxillary sinus, maxilla and mandible, floor of the mouth

Vestibular region and palatal region

The following are low severity of cellulitis , except…

Abscess of base of upper lip and Subperiosteal abscess,

Vestibular abscess,Intraalveolar and abscess of maxilla&Mandible

Infraorbital abscess,Buccal abscess

Submandibular abscess

Submental, Submandibular,Sublingual,Masseteric,Pterygomandibular,Superficia temporal,Deep temporal are :

Low severity

Medium severity

High severity

Diffuse abscess

The following are high severity of cellulitis , except…

Diffuse cellulitis

Subcutaneous abscess

Ludwig’s angina

Lateral Pharyngeal Space Abscess, Retropharyngeal Abscess

The following are specific signs and symptoms of cellulitis , except…

Redness(erythema) and swellin(edema)

Tenderness and pain

Bleeding

Warmth

The Goals of management of odontogenic infection is/are :

Medical treatment

Incision and drainage

Aspirate the contents

Laser therapy

How many types of localized odontogenic infection ?

Periapical Infections - infection at the apex of an abscessed tooth

Periodontal Infections – soft tissue infection in the periodontal pocket from advanced periodontitis

Pericoronal Infections – soft tissue infection around the crown of the unerupted or partially erupted tooth

All of the above

Spread of pus inside tissues from the site of the initial lesion, inflammation may spread in many ways :

By continuity through tissue spaces and planes

By way of the lymphatic system

By way of blood circulation

All of the above

To drain pus from an abscess,the surgeon should :

Penetrate into abscess cavity and probe with an artery to allow for flow of pus

Cut and eclipse from the abscess surface to allow for a drain

Aspirate the contents

Cut only the mucosa and skin

To drain pus from a submental abscess,the surgeon should :

Cut and eclipse from the abscess surface to allow for a drain

Aspirate the contents

A horizontal incision should be placed 1–3 cm below the lower border of the mandible rather than the top of the swelling (abscess) to exploit gravity to encourage drainage

Cut only the mucosa and skin

To drain pus from a submandibular abscess,the surgeon should :

Cut and eclipse from the abscess surface to allow for a drain

The incision for drainage is performed on the skin, approximately 1 cm beneath and parallel to the inferior border of the mandible

Aspirate the contents

Cut only the mucosa and skin

Treatment of choice to localized infection with pus is :

Antibiotc administration

Establish drainage

Apply col to the area

Advise hot mouth washes

Among of the followinh which is treatment of choice for infection with fluctuation in an afebrile patient ?

Administration of antibiotics

Application of hot packs to the area

Incision and drainage

Antibiotics administration followed by I and D

Surgical blade used for drainage of abscess is :

Blade No 12

Blade No 15

Blade No 11

Blade No 22

What is the most important and first step to treat acute infection?

Prescribe antibiotic

Prescribe analgesics

Incision and drainage of pus

All of the above

Which type of abscess that can cause airway obstruction?

Subcutaneous abscess

Ludwig’s Angina

Buccal abscess

Orbital cellulitis

In which case do you need to refer the patient to the hospital?

Localized infection

Ludwig’s Angina

Cavernous sinus thrombosis

Ludwig’s Angina & Cavernous sinus thrombosis

What is a dangerous infection with potentially serious complications ?

Buccal cellulitis

Sumandibular cellulitis

Orbital cellulitis

Sublingual cellulitis

Ludwig`s angina was first described by :

The German physician, Wilhelm Frederick von Ludwig in 1836

Maxwell

Garre in the year 1893

Rene LeFort

The most common cause of cellulitis in face is :

Dental carie

Pericoronitis and impacted teeth

Trauma trauma to the eyelid including bug bites, or a foreign object

Antral infection

A diffuse inflammation of soft tissue that is not circumscribed is an :

Abscess

Granuloma

Swelling

Cellulitis

The most common micro-organisms associated with cellulitis is :

Streptococci

Staphylococci

Actinomyces

Lactobacillus

A corne-shaped space infection involving inner canthus of eye is :

Canine space

Buccal space

Parotid space

Palatal abscess

The incision technique of submandibular cellulitis the incision for drainage is performed on the skin, approximately :

0,5 cm beneath and parallel to the inferior border of the mandible

1 cm beneath and parallel to the inferior border of the mandible

2 cm beneath and parallel to the inferior border of the mandible

3 cm beneath and parallel to the inferior border of the mandible

Surgical drainage for submental abscess is usually performed through a cutaneous Incision. A horizontal incision should be placed :

0,5–1 cm below the lower border of the mandible

1-3 cm below the lower border of the mandible

4 cm1 below the lower border of the mandible

5 cm below the lower border of the mandible

Ludwig's angina was first described by the German physician, Wilhelm Frederick von Ludwig :

In 1836

In 1928

In 1980

In 2000

What is the osteitis ?

Osteitis is an flammatory process within medullary (Trabecular) bone that involves the marrow spaces

Osteitis is a painful swelling of the soft tissue of the mouth and face resultating from a diffuse spreading of purulent exudate along the facial planes that separate the muscle bundles

Osteitis is an acute deep suppurative abcess of upper neck and perioral area

Osteitis is a rare group of blistering autoimmune diseases

The most common local causes of osteitis are :

Apical infection

Localised pathological

Trauma

All as the above

The following are general factors of osteitis , except…

Radiation and fibrous dysplasia

Osteoparosis

Apical infection

Diabetis,syphilis,tuberculosis

Classification of osteitis :

Acute and chronic osteitis

Acute, subacute and chronic osteitis

Low severity,mederate severity and high severity

Close and open osteitis

Purulent exudate ,fistula and sequestra are the signs of :

Acute osteitis

Chronic osteitis

Orbital cellulitis

Sinusitis

Treatment of chronic osteitis :

Incision and drainage

Debridement -the removal of foreign material or devitalized tissue from the vicinity of a wound

Sequestrectomy,Saucerization- an excavation of the tissue of a wound to form a shallow,saucelike depression

Medical treatment

Dry soket is also termed all except :

Localized acute alveolar osteomyelitis

Acute suppurative osteomyelitis

Alveolar osteitis

Alveolalgia

The following are frequency increases with dry socket , except…

Age and smoking

Dental carie

Use of bur

Long surgeries with flap

The following are signs and symptom of dry socket , except…

Increase in acute, throbbing pain after 48 hrs (2-5 days)

Pain may radiate to ear and analgesics ineffective

Sequestrum formation

Fetid odor

The treatment of dry socket :

Curettage the socket and Irrigation with chlorhexidine

Place Alvogyl in the socket

Prescribe strong analgesics

All of the above

Patients who are at high risk for osteomyelitis include those who are :

Poorly nourished and elderly

Obese and those with impaired immune system

Those receiving long-term corticosteroid therapy

All of the above

The following are the signs and symptoms of osteomyelitis , except…

Chill,high fever(40 C),rapid pulse,trismus and general malaise

As the infection progresses, the infected area becomes painful, mobility of teeth , swollen, and extremely tender

Pus,fistula,sequestra(4-6 weeks),fetid odor and trismus

All of the above

Radiographic imaging of osteomyelitis :

Moth eaten r/lucency, I.e. irregular, ,patchy, ragget and poorly outline

Radiopaque sequestrae, I.e. Piece of necrotic bone

Evidence of involucrum surrounding area of destruction

All of the above

The treatment of chronic suppurative osteomyelitis is :

Hyperbaric oxygen therapy

Sequestrectomy,saucerization and hyperbaric oxygen therapy

Sequestrectomy ,with hyperbaric oxygen therapy

Saucerization only

Chronic focal sclerosing osteomyelitis is also known as :

Perosteitis ossificans

Condensing osteitis

Garre`s osteomyelitis

Alveolar osteitis

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