Oral surgery(Hong Someth)

1. Which of the following is NOT the differential diagnosis of a soft tissue lesion?

 List all the most probable diagnosis

 Look at the characteristics of each condition/lesion

 Blood tests

 Compare & distinguish between them

 Choose on a “best-fit” basis

2. Which one of the following is NOT the investigation before extraction?

 Radiographs

 Antibiotic

 Pulp vitality tests

 Study models

3. What is the ideal treatment plan?

4. In which cases consent should be informed before starting the treatment?

 Suture removal

 Surgical removal of deep unerupted mandibular wisdom teeth

 Prescription writing for orofacial pain

 Extraction of a maxillary second molar which the root is close proximity to the sinus

 Surgical removal of deep unerupted mandibular wisdom teeth and Extraction of a maxillary second molar which the root is close proximity to the sinus

5. Which of one of the following is NOT the clinical factors predicting the difficulty of extractions?

 Extensive loss of coronal tooth structure

 Thickness of the buccal plate

 Limited access to the area of extraction

 Limited access to the tooth in the dental arch

 Severe periodontitis

6. Which of one of the following is NOT the radiographic factors predicting the difficulty of extraction?

 Severely divergent roots

 Periapial radiolucency

 Dilacerated roots

 Endodontically treated teeth with or without post and core

 Increased number of roots present

7. Which teeth are at risk for sinus exposure when doing extraction?

 Lone standing maxillary molar with pneumatized maxillary sinus

 Roots projecting into a severely pneumatized maxillary sinus and minimal coronal bone visible radiographically

 Long divergent bulbous roots with a pneumatized sinus into the trifurcation area

 Teeth with advanced periodontal disease but with no mobility; also teeth with the maxillary sinus extending into the trifurcation area

 All of the above

8. Which one of the following is NOT one of the principles of flap designs?

9. What are the factors to consider in flap design?

 Depth of the buccal sulcus

 Position & size of labial fraenum and muscle attachments

 Vital structures

 Size of lesion

 Number of teeth to be treated

 All of the above

10. Which one of the following is NOT one of the basic steps of surgical extraction?

12. Which suture creates eversion of the wound edges?

14. What is the atraumatic suturing technique?

15. Which suture is used for extraction socket of molar teeth to control bleeding?

17. Suture is selected depends on:

 Tissue to be suturing, ie. mucosa, muscle, skin

 Wound condition

 Healing process, cost, and tissue tolerance

 Patient’s availability to come for suture removal

 All of the above

18. How do you prevent aspiration of a tooth or root into the lungs when doing an extraction?

 Place a piece of sterilized gauze as a pharyngeal screen at the back of the patient's mouth

 Place a rubber dam on the tooth

 Patient stands up while extracting the tooth

 Lay the patient flat while extracting the tooth

 Use bite block or mouth prop

19. How to treat postoperative ecchymosis?

 Apply ice pack on the bruise

 Reassure the patient

 Inject steroid

 Apply warm moist pack

 Reassure the patient and Apply warm moist pack

20. How do you avoid TMJ dislocation during dental procedures?

21. What are the symptoms and signs of alveolar osteitis (dry socket)?

 Severe pain and discomfort from the extraction site

 Pain may radiate from to other parts of the head, ear, eye, and neck

 Exposed bone around the socket and Delayed healing

 Remaining food debris inside the socket

 All of the above

22. Which one of the treatment procedures of alveolar osteitis (dry socket) below is NOT always given to the patients?

 Irrigate the socket with chlorhexidine

 Prescribed antibiotic

 Apply Alvogyl in the socket

 Prescribe strong analgesics

 Take note in the patient's file

23. Which one of the following is NOT the prevention of dry socket?

 Stop smoking

 Stop oral contraceptive for several days before & a few days after surgery

 Give antibiotic before extraction/surgery

 Minimize extraction force

 Give clear oral health instruction

24. Which of the following are the local measures to control bleeding after surgical extraction?

 Use vitamin K and Blood transfusion

 Apply pressure with sterilized gauze

 Use tranexamic acide injection

 Place Gelfoam or Surgicel in the socket

 Suture across the socket

 Apply pressure with sterilized gauze, Place Gelfoam or Surgicel in the socket and Suture across the socket

25. In aggressive measure to control bleeding, which medication is commonly used?

27. How do you prevent inferior dental nerve injury during surgical removal of mandibular wisdom teeth?

 Use atraumatic surgical techniques

 Use high speed to dissect the crown

 Perform coronectomy

 Raise small flap

 Use atraumatic surgical techniques and Perform coronectomy

28. What are the contraindications for coronectomy?

 Mobile tooth (advanced periodontitis)

 Caries with potential pulp involvement and Periapical abscess

 Associated with cyst which won’t resolve with the root left in place

 Nerve too close to the coronectomy cut

 All of the above

29. In coronectomy, how far from the CEJ of the crown do you need to cut?

30. Which one of the following is NOT the specific warning after coronectomy?

 Root exposure migration in the later date

 Paresthesia of the upper lip

 Later removal of roots

 Roots inadvertently removed at the time of attempted coronectomy

 All of the above

31. Which one of the following statements are NOT the treatments of acute pericoronitis?

 Extraction of opposing tooth, Prescribe potent analgesics

 Apply acid around the operculome

 Operculectomy

 Irrigation around the tooth crown with Chlorhexidine

 Apply acid around the operculome and Operculectomy

32. Which of the following statements are NOT the factors associated with surgical difficulty of mandibular wisdom teeth?

 A. Verical angulation

 B. Increased age, obesity and Body mass index

 C. Patient with no TMJ disorders

 D. Curvature of roots & dense bone

 E. Verical angulation and Patient with no TMJ disorders

33. 33. What are the radiographic signs indicative of possible inferior alveolar nerve injury during surgical removal of unerupted mandibular wisdom teeth?

 Darkening of the root and Narrowing of the roots

 Deflection of the root

 Interruption of radiopaque line

 Diversion of canal

 Darkening of the root, Deflection of the root and Interruption of radiopaque line

34. Which case the enucleation of cyst in applied?

35. Which case of cyst do you need to do marsupialization?

 Very large cyst involving vital structures

 Traumatic bone cyst

 Pocket cyst of lateral incisor

 Mucous retention cyst in the floor of the mouth (ranula)

 Very large cyst involving vital structures and Mucous retention cyst in the floor of the mouth (ranula)

36. Which flap design is best indicated for an apicectomy of maxillary incisors with ceramic crowns on?

37. Which of the following is the most recommended and affordable retrograde filling material for apicectomy?

38. How to diagnose an Oro-antral fistula?

 Squeeze patient nose & ask to strongly blow to see air bubble

 Insert a large needle into fistula & take X-ray

 Use the probe to explore the fistula

 None of the above

 All of the above

39. Which one of the following is NOT the factors influencing the course of infection?

40. What are the investigations for infection?

 Take swap of pus for microbiology & antibiotic sensitivity

 Immunoflurescence

 Blood culture

 Urine test

 Take swap of pus for microbiology & antibiotic sensitivity and Blood culture

42. Where can the infection spread from maxillary 2nd premolar spread to?

43. Where can the infection from mandibular molars spread to?

44. Which one of the following space that the infection from the mandibular 3rd molar will NOT spread to?

45. Which type of acute infection that can cause airway compromised?

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

47. What is the first line antibiotic for acute infection?

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

49. How to confirm the definitive diagnosis of a soft tissue lesion (diameter ˃2cm) on the lateral border of the tongue?

51. Which lesions are needed for fine needle aspiration?

 Vascular lesions

 Fluctuant soft tissue pathology

 Surgical emphysema

 Intraosseous pathology

 Fluctuant soft tissue pathology and Intraosseous pathology

52. What are the flap designs for frenectomy?

 Elliptical incision, Triangular flap

 Z-plasty, Semilunar flap

 V-type incision, Rectangular flap

 Elliptical incision, Z-plasty and V-type incision

 Elliptical incision, Z-plasty and V-type incision and Triangular flap

53. Which of the following statements are the clinical assessments of unerupted maxillary canines?

 Observation or visual inspection for bulging, lateral incisors’ position

 Taking radiographs, Retained deciduous canines

 Palpation on both labial & palatal sides for bone projection

 Family history of missing canines

 Probing by using a Michelle Trimmer

 Observation or visual inspection for bulging, lateral incisors’ position, Palpation on both labial & palatal sides for bone projection and Probing by using a Michelle Trimmer

54. Which one of the following is NOT the radiographic assessment of unerupted maxillary canines?

55. Which one of the following is NOT the treatment option of unerupted maxillary canines?

 Surgical removal of unerupted canine

 Interceptive removal of primary canine

 No treatment or leave in-situ

 Surgical exposure with orthodontic alignment

 Laser treatment

56. What are the criteria for surgical removal of unerupted maxillary canines?

 Patient is older than 16 years old

 Good contact between premolar & lateral incisor

 Poor prognosis for alignment

 Good aesthetic of a retained deciduous canine with a long root

 Unwilling to wear orthodontic appliance

 All of the above

57. When aspirate a cystic lesion which shows cholesterol, what type of cyst might it be?

58. When aspirate a cyst-like lesion which shows blood, what type of lesion might it be?

59. When aspirate a cyst-like lesion which shows air, what type of lesion/structure might it be?

60. Which of one the following lesions do NOT need to do excisional biopsy?