Oral surgery
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
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 areasi
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
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
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
B & C
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
Parotid space
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 1980
In 2000
In 1928
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 bar
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
A focal gross thickening of the periosteum with peripheral bone formation is :
Chronic osteomyelitis
Condencing osteitis
Garre`s osteomyelitis
Periostitis
Inflammatory cells seen chiefly in acute suppurative osteomyelitis histology are :
Plasmacells
Lymphocytes
Monocytes
Neurophilic PMNL`s
After decortication of mandible in osteomyelitis,closed irrigation suction and/or placement of antibiotic is done for a period of :
5-7 days
7-10 days
10-14 days
14-20 days
Decortication of the mandible for the treatment of osteomyelitis was described by ;
Maxwell
Mowlem
Mader
Michellin
For a patient of osteomyelitis who is allergic to penicillin,all of the following drugs are recommended as 2nd and 3rd choices except :
Clindamycin
Cephalosporin
Erythromycin
Sulfa drugs
Radiographic characteristics of osteomyelitis were described by :
Wilson
Worth
Wright
Williams
Radiolucencies due to spreading infection of osteomyelitis:
Moth eaten r/lucency, I.e. irregular & poorly outline
Radiopaque sequestrae, I.e. Piece of necrotic bone
Patchy,ragget & ill define radiolucency
All of the above
All of the following are true about osteomyelitis of the mandible, except :
Symphysis is more commonly involved than angle
Ramus is more commonly involved than symphysis
Body is more commonly involved than symphysis
Angle is more commonly involved than condyle
The most common organisms isolated from primary hematogenuos osteomyelitis of long bones in adult :
Staphylococcus sp
E.coli
Salmonella typhi
Pneumococcus
Osteomyelitis of the jaws is primarily caused by :
Peptostreptococcus
Prevotella (Bacteroids)
Streptococcus sp
Vincent`s organism
What is sinusitis ?
Sinusitis is a flammation of medular bone
Sinusitis 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
Sinusitis is an inflammatory of the mucosa of the sinus
Sinusitis is an infection of sinus bone
The following are the blood supply to the mucous membrane of sinus ,except….?
External Carotid artery
Facial and maxillary arteries
Facial ,maxillary and infraorbital arteries
Facial ,maxillary , infraorbital arteries and greater palatine arteries
The following are the nerve supply to the mucous membrane of sinus , except…
Facial nerve
V1 of trigeminal nerve or Nerve ophthalmic
V2 of trigeminal nerve or superior dental nerve and the greater palatine nerve
V3 of trigeminal nerve or Inferior alveolar nerve
I health,the thickness of sinus lining from :
0,1-0,2 mm thick(on CT)
0.3 - 2 mm thick
3-4 mm thick
5-6 mm Thick
The following are the function of maxillary sinus,except…
No special function is necessary
Lighten head, phonetic resonance and auditory feedback
Insulation,air conditioning, water conservation,olfaction
Strengthen area against trauma and protect eyes and nasal cavity
Radiography for sinusitis are :
Periapical radiograph
PA injection
OPG ,Water views or CTScan
Occlusal views
Indication of Caldwell Luc procedure ?
Acute sinusitis
Subacute sinusitis
Chronic sinusitis
Treatment of chronic maxillary sinusitis not responding to conservative medications
The following are contraindication for Caldwell-luc procedure,except…
Age < 3 Yrs
Age >18 Yrs
Trauma to maxillary sinus or fracture of antral floor.Acute maxillary sinusitis untreated by antibiotics
Diagnosis of maxillary antral hematoma
Caldwell-Luc may be performed under :
Topical anesthesia only
Infiltration anesthesia only
Regional block with infiltration anesthesia or general anesthesia
Medical drug
Flap disign for antral closure of Oroantral Communication
Vestibular flap,palatal flap,bridge flap and fat pad flap
Triangula flap
Trapezoid flap
Semi-lunar flap
The volume of maxillary sinus is :
15-30 ml
10 ml
40 ml
50 ml
Maxillary sinus is also known as :
Paranasal sinus
Antrum of Highmore
Antrum of Keith
No other name
The best view for maxillary sinus is :
Town`s view
Occlusal view
PA view in waters`s position and OPG
Lateral view of skull
A small opening is made into the maxillary antrum during extraction, immediate treatment is :
Phack the socket with gauge
Allow the clot to form No special treatment is necessary
Place the patient on antibiotics
Rise a big mucoperiosteal flap and close the antrum
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
The following are the signs and symptoms of newly created oro-antral fistula,except…
Antral floor attached to roots apices of extracted tooth or teeth
Fracture of the alveolar process or the tuberosity and bubbling of blood from the socket or nostril
Dry shcket
Change in speech tone or resonance and radiographical evidence of sinus involment
When the sinus disease is caused by an oroantral communication,typically close spontaneously,if defects less than :
< 5mm
< 7 mm
< 9 mm
< 10 mm
<>procedure is done to :
Visualize the antrum from oral cavity
Visualize the antrum from nasal cavity
To establish drainage through nasal cavity
To pack the maxillary antrum
Acute maxillary sinusitis :
Results in referred pain to a single tooth
Results in referred pain to the orbit and maxillary posterior tooth
Is exacerbated by cold history
Is usually a non-infection process
Surgical treatment of sinusitis is :
Antral irrigation
Caldwell-Luc procedure
Antrostomy
Enucleation
A tooth displaced into maxillary antrum can be removed by
Caldwell-luc procedure
Transalveolar extraction
Bergers`s method
Intranasal antrostomy
The other name of maxillary sinus is :
Antrum of Highmore
Antrum of Denver
Antrum of Khnopfleer
Antrum of Wilson
The base of the maxillary sinus is formed by the :
Zygomatic bone
Orbital floor
Hard palate
Lateral wall of the nose
The shape of the adult maxillary sinus is :
Rhomboid
Trapezoid
Rectangular
Pyramidal
The incidence of oro-antral fistulae is less in :
Children and young adults
Midle aged adults
Elderly
All of the above
The apex of the maxillary sinus faces the :
Nasal bone
Floor of the orbit
Palate
Zygomatic process of the maxilla
Inflammation of most or all para nasal sinuses simultaneously is described as :
Pan sinusitis
Sinusitis
Para nasal sinusitis
Sinus thrombosis
Maxillary sinus infection of odontogenic origin is most commonly caused by :
Aerobic bacteria
Anaerobic bacteria
Fungal
Viral
Classification of maxillary fracture by location :
Close Fracture and open Fracture
Le Fort I,Le Fort II and Le Fort III Fractures
Nasal Fracture and Zygomatic Complex Fracture
Pan facial or split palate
All of the following are signs and symptoms of dento-alveolar fractures, except :
Pain ,paraesthsia ,stepped deformity alveolar bone and palpable fracture
Lacerations / bruising / haematoma of mucosa or gingiva and Visible fracture line through torn mucosa
Teeth – missing, avulsed, fractured , unusual mobility of teeth/bone
Loos of consciousness
What are components of NOE Fracture ?
Frontal bone,nasal bone, maxillary bone
Frontal bone,nasal bone, maxillary bone, lacrimal bone
Frontal bone,nasal bone, maxillary bone, lacrimal bone, ethmoid bone and sphenoid bone
Nasal bone,eth moid bone and sphenoid bone
What are components of Zygomatic complex Fracture ?
Zygomatic bone,Frontozygomatic bone and Zygomatic arch
Zygomatic bone,Frontozygomatic bone , Zygomatic arch,Orbital rim
Zygomatic bone,Frontozygomatic bone ,Zygomatic arch,Lateral orbital rim,infraorbital rim,orbital floor, anterior and lateral maxillary sinus
Zygomatic bone,Frontozygomatic bone and Zygomatic arc
What is the treatment of Zygomatic Complex Fracture ?
MMF or IMF Technique
Trans osseous wiring
Trans osseous wiring and Mini bone plates
Reduction alone and reduction &fixation
Classification of mandibular fracture by type :
Close and open fracture
Simple Fx,compound Fx,comminuted Fx,greenstick Fx,Complex Fx,telescoped or impacted Fx
Dentoalveolar Fx,symphysisFx,parasymphysis Fx,body Fx,angle Fx,coronoid Fx,condyle Fx
Class I ,Class II ,Class III
Classification of mandibular fracture by location :
Close and open fracture
Simple Fx,compound Fx,comminuted Fx,greenstick Fx,Complex Fx,telescoped or impacted Fx
Dentoalveolar Fx,symphysisFx,parasymphysis Fx,body Fx,angle Fx,coronoid Fx, condyle Fx
Class I ,Class II ,Class III
All of the following are various indications of body fractures ,except:
The patient need the rehabilitation of function, esthetic and easy for reduction and fixation (24 - 48 h after accident )
The patient is stable enough to undergo the needed treatment
Hemorrahagie disturbances
To avoid of complication such as cellulitis,osteitis , malocclusion or pseudatrose
All of the following are various contra-indications of body fractures ,except:
The patient is not stable enough to undergo the needed treatment and no cooperation
Away obstruction, hemorrhagie disturbances and no soft tissue to cover fracture site
Severe comminution, stabilization not possible and bone at fracture site diffusely infected
Soft tissue injury : lacerations,abrasions and ecchymisis
All of the following are various signs and symptoms of fractures of facial bone ,except:
Facial asymmetry
Swelling,bleeding,nerve injury and trismus
Deranged occlusion
Pseudatrose
What is treatment of compound Fx ?
MMF Technique
Trans osseous wiring
Trans osseous wiring and Mini bone plates
External fixation
When we can remove MMF from the mouth of the patient ?
2 weeks
4-6 weeks
10 weeks
3 months
How we can treat simple fractures or intracapsular fracture of condyle ?
MMF Technique
Osteosynthesis
Bandage
Dental wiring
The treatment compound fractures of condyle :
MMF Technique
Osteosynthesis by ORIF
Bandage
External fixation
The treatment for Edentulous patient :
MMF Technique
Osteosynthesis
Gunning’s splint
Gunning`s splint or Osteosynthesis
The muscles that aid in displacement of maxillary fractures are :
Masseter
Temporalis
Upper part of orbicularis and lower part of orbicularis occuli
None of the above
A fracture mandible should be immobilized an everage of
3 weeks
6 weeks
9 weeks
12 weeks
Fracture of mandible all are true except :
Fractures of the mandible are common at the angle of the mandible
Fractures of the mandible are effected by the muscle pull
Fractures of the mandible are usually characterized by sublingual hematoma
C.S.F. Rhinorrhea is a common finding
The ideal treatment for fracture of the angle of mandible is :
Transosseous wiring
Intermaxillary fixation
Plating on the lateral side of the body of the mandible
Plating at the inferior border of the mandible
Most common complication of condylar injuries in children :
Pain
Ankylosis
Osteoartrhitis
Fracture of glenoid fossa
Primary healing of a mandibular fracture is seen following fixation with :
Gunning splints
Compression plates
Trans-osseous wires
Champy plates
In the maxilla,a compression plate can be safely applied along the :
Infraorbital margin
Anterolateral wall of the maxillary sinus
Frontozygomatic suture
Zygomaticomaxillary suture
To provide absolute stability of the fracture ends by a compression bone plate,the minimum number of screws that have to be placed on both side of the fracture line is :
Six
Two
Three
Four
After extraction of maxillary first molar,a communication is found between the palatal socket and a disease of free maxillary sinus which measure 0.2 cm.The best treatment is :
Allow the clot to form advice proper home care
Primary closure and antihistamine
Gold foil closure
Caldwell-Luc operation
True open bite is caused by :
Horizontal fracture of the maxilla
Unilateral fracture of mandibular angle
Fracture of the coronoid process of left side of mandible
Fracture of mandibular symphysis
In depressed zygomatic arch fracture, difficulty in opening the mouth is caused by impingement of:
Condyles
Ramus
Petrous temporal
Coronoid process
Which is the immediate danger to a patient with severe facial injuries :
Bleeding
Associated fracture spine
Infection
Respiratory obstruction
Le fort 1 fracture is characterized by:
Bleeding from the ear
Bleeding from the antrum
Angle class 2 skeletal relationship
None of above
Suturing in facial wound injuries should be done with in:
2 hours
6 hours
4 hours
8 hours
Paresthesia is seen with which of the following types of fractures:
Subcondylar
Zygomatico maxillary
Coronoid process
Symphyseal
Forceps used for maxillary fracture disimpaction
Rowe's
Bristows
Ashs
Walshams
A patient is in shock with gross comminuted fracture, immediate treatment is to give :
Normal saline
Ringer's lactate solution
Whole blood
Plasma expanders
Walsham's forceps are used to :
Remove teeth
Remove root
Clamp blood vessels
Reduce nasal bone fractures
"Panda facies" is commonly seen after
Le fort I fractures
Le fort II fractures
Mandible fractures
None of the above
CSF rhinorrhea is not found in
Lefort 1
Lefort II
Lefort III
Ethmidol
Gillis approach for reduction of zygomatic fractures is done through :
Temporal fossa
Intra temporal fossa
Infra orbital fossa
All of the above
Which of the following is not a feature of Le Fort II fracture :
Enophthalmos
Malocclusion
Paraesthesia
CSF rhinorrhea
The first step in management of head injury is :
Secure airway
I.V. mannitol
I.V. dexamethasone
Blood transfusion
CSF rhinorrhea is found in :
Frontal bone structure
Zygomatico maxillary fracture
Naso ethmoidal fracture
Condylar fracture
Le Fort III fracture is the same as :
Craniofacial dysjunction
Guerrin's fracture
Pyramidal fracture
None of the above
Fixation with pack in maxillary sinus is :
To support comminuted fracture of the body of zygomatic complex
To support and reconstitute comminuted orbital floor fracture
To protect mucosal covering of maxillary sinus
A) and (B) are correct
Floating maxilla is typically found in :
Le Fort I or guerin fractures
Le Fort II or pyramidal fractures
Craniomandibular dysjunction
All of the above
In a patient of head injury which is more important to note first:
Pupillary light reflex
Pupillary size
Corneal reflex
Ability to open eye
Which of the following always indicates obstruction to the airway?
Slow pounding pulse
Stertoreous breathing
Increase in pulse rate
Decrease in blood pressure
Moon face is seen in
Le Fort I
Le Fort II
Le Fort III
Orbital fractures
In blow out fractures which of the following is seen
Enophthalmos
Exophtholmos
Bulbar hemorrhage
None
Diplopia after fracture results from entrapment of
Inferior rectus
Inferior oblique
Lateral rectus
Superior oblique
In Le Fort III fracture all are seen except
Crack pot sound on tapping teeth
CSF rhinorrhea
Fracture at frontozygomatic suture
Whole face is mobile
None of the above
The muscle that aids in displacement of maxillary fractures are
Masseter
Temporalis
Orbicularis oculi and orbicularis oris
None of the above
What is the name of the fracture that is clinically detected by tugging on the maxilla/hard palate causing the nose to move.
Le fort 1
Le fort 2
Le fort 3
Le fort 4
Which facial view x-ray is the best for examining the orbits and midface?
OPG
Waters or occipitomental
Caldwell or PA view
Submental vertex
Towne
A tripod fracture involves what?
It is another word for le fort fracture
Zygomaticotemperal and zygomatico frontal suture diastasis and inferiororbital rim fracture
Fracture through maxilla, zygomatic arch and nasal bones
Fracture through neck angle and body of the mandible
What is nonrigit fixation ?
Open reduction and fixation of fractures using plates and screws
Open reduction and fixation of fractures using wires
Close reduction and fixation of fracture using ligature Ivy
Close reduction and fixation of fracture using Arch Bars & wire
What is rigit fixation ?
Open reduction and fixation of fractures using plates and screws
Open reduction and fixation of fractures using wires
Close reduction and fixation of fracture using ligature Ivy
Close reduction and fixation of fracture using Arch Bars & wire
Which part of the mandible is fractured the most frequently in trauma?
Condyle
Ramus
Body
Symphysis
Maxillary sinus is usually involved in fractures:
Le fort 1
Zygomatic arch fracture
Le fort 3
Nasoethmoidal fracture
If a fracture of jaw bone is communicated to external environment ,it is called :
Comminuted fracture
Compound fracture
Simple fracture
Transverse fracture
Le fort 3 fracture is also called :
Horizontal fracture
Pyramidal fracture
Transverse fracture
Green stick fracture
Goals of Maxillomandibular Fixation (MMF) :
Restore occlusion
Reduction of fracture segments
Stabilization of fracture segments
All of the above
Facial fractures are diagnosed from :
History
Physical examination
Radiographs
All of the above
During the Gillies approach,the structure of anatomic significance is :
Superficial temporal artery
Marginal mandibular nerve
Internal jugular vein
Inferior alveolar nerve
An unfavorable displaced fracture of the mandibular angle is difficult to treat because of :
Muscle pull causes distraction
Malocclusion secondary to the injury
Injury to nerves and vessels
Bone in that region is very thick
Among the following which may produce respiratory obstruction ?
Bilateral condylar fracture
Symphysis fracture of the mandible
Bilateral fracture of mandible in the second premolar area
Fracture of the angle of the mandible
In a patient with bilateral dislocated fractures of the neck of the mandibular condyles one can expect the following clinical signs :
Anterior open bite
Inability to protrude the mandible
Inability to bring posterior molars into contact
A & B
Of the following which facial bone is most frequently fractured ?
Mandible
Maxilla
Nasal
Zygomatic
Which of the following is complication often open fracture ?
Malunion
Nonunion
Infection
Crepitation
Principles in treatment fractures include :
Reduction of fracture
Fixation of fracture and restoration of occlusion
Immmobilisation
All of the above
Depressed fracture of the zygomatic area may be clinically recognized by :
Concavity of the overlaying tissue in the zygomatic arch area
Interference with movements of the mandible
Subluxation of condyles
A & B
Which of the following is characteristic of lefort fracture ?
CSF rhinorrhea
Bleeding from the ear
Bleeding into antrum
A & B
After a depressed fracture of zygomatic arch mandibular movement is restricted. The most probable reason is :
Disruption of TMJ
Spasm of the lateral pterygoid muscle
Mechanical impingement of the fracture fragment on the coronoid process
Splinting action of masseter and medial pterygoid muscle
Among the following which is compound fracture ?
Fracture with many small fragments
Fracture in a star shaped appearance
Fracture with communition with the oral cavity
Fracture with bleeding into the masticator space
The mini-bone plate system is a :
Compressive bone plating system
Monocortical system
Bicortical system
All of the above
The minimum number of miniplates required in fractures anterior to canine in mandible is:
No plate is required since anterior region develops less amount of tension forces than in molar region
Only one plate as in molar region
Two plates
Three plates
Minimum number of screw required for fixation of miniplate are :
One screw on each side of fracture site
Two screws on each side of fracture site
Three screws on each side of fracture site
Two screws in small fragment and three screws in large fragment
Risdom wiring is indicated for :
Body fracture
Angle fracture
Symphysis fracture
Subcondylar fracture
The most common complication of maxillofacial injuries requiring immediate attention is:
Haemorrhage
Airway obstruction
Infection
Shock
The Gillies approach is used to gain acess to the following bone :
Nasal bone
Zygomatic bone
Maxilla
Temporal bone
While doing circumferential wiring around a mandibular Gunning splint,care most be taken not to damage the :
Mandibular branch of the facial nerve
Facial artery as it crosses the anteroinferior of the masseter
The lingual nerve
The submsndibular gland and its duct
The elastic traction used commonly to reduce facial fractures,does so by overcoming :
The active mascular pull that distracts the fragments
The organized connected tussue at the fracture site
The malposion caused by the direction and force of trauma
All of the above
Panda facies is commonly seen after :
Le fort 1 fractures
Le fort 2 fractures
Zygoatic arch fractures
Orbital blow-out fractures
A subconjunctival haemorrhage remains bright red in colour for a long time because of the :
Permeability of the conjunctiva to oxygen
Natural colour of blood
Lack of drainage of the pooled blood
None of the above
The following fracture is usually pyramidal in shape :
Le firt I fracture
Le fort II fracture
Le fort III fracture
Mandibular symphysis fracture
Cranio facial disjunction commonly occurs in :
Le fort I fracture
Le fort III fracture
Mandibular symphysis fracture
Mandibular condyle
Gilli`s approach is :
Used to block inferior alveolar nerve
Used to reduce the fractured zygoma
Placed just anterior to the ear
One of the frequent approach for condylar surgery
Contraindications of close reduction are :
Alcoholic and siezure disorder
Mental retardation and nutritional concerns
Respiratory diseases(COPD) and unfavorable fractures
All of the above
Indications of close reduction are :
Nondisplaced favorable fractures
Mandibular fractures in children with developing dentition
Condylar fractures(intracapsular fracture )
All of the above
Indications of open reduction are :
Unfavorable/unstable mandibular fractres/Multiple fractures of the facial bones
Fractures of an edentulous mandibule fracture with severe displacement and malunion
Delayed treatment with interposition of soft tissue that prevents closed reduction techniques to reapproximate the fragments
All of the above
Indication of Transosseous wiring :
Control of edentulous posterior fragment and edentulous mandibular fractures
Grossly comminuted fractures
Control of lower border when upper border has been fixed by conventional methods
All of the above
The treatment goals of condylar fractures:
To restore mandibular function, occlusion, prevent growth disturbances, and maintain symmetry
Must avoid ankylosis
Use short periods of IMF (7-14 days), then jaw opening exercises; in children under 3 years, immediate function necessary to prevent ankylosis
All of the aboveI
Which methods of treatment are appropriate for reduction of a fractured mandibular angle in a dentate patient :
Intramaxillary fixation(IMF) using eyelet wires
IMF using arch bars
Mini bone plates
IMF using K-wires
Subconjunctival bleed with no posterior border indicates fracture of which bone:
Maxilla
Mandible
Zygoma
Nasal
The weakest part of mandible where fracture occurs :
Neck condyle
Angle of mandible
Canine fossa
Midline
The most common fracture of face is that of :
Mandible
Maxilla
Zygoma
Nasal bone
Sinus disease is best demonstrated by :
CTscan
Plain X-ray
Tomography
Ultrasound
Nasal pyramid consist of :
Nasal bones and Nasal septum
Frontal processes of maxilla
Lateral cartilages
All of the above
Diplopia is caused by:
Hematoma or edema arround extraoccular muscle
Neuromuscular injury
Disruption of attachment of inferior rectus or inferior oblique muscle
All of the above
Signs and Symptoms of LeFort I fracture :
Damaged teeth and soft tissues,swelling and bruising and deformity of alveolus
Crepitus over maxilla,ecchymosis in buccal vestibule and epistaxis
Malocclusion,maxilla mobility or Independent movement of fragments,altered sensation
All of the above
Signs and Symptoms of LeFort II fracture :
Midface crepitus,face lengthening and anterior open bite
Malocclusion, mobility of maxilla,bilateral epistaxis and infraorbital paresthesia
Ecchymoses: buccal vestibule, periorbital, subconjunctival ,orbital rim defects and paraesthesis (infra-orbital nerve)
All of the above
Signs and Symptoms of LeFort III fracture :
Bilateral periorbital edema , ecchymosis,step deformity palpated infraorbital, nasofrontal area and infraorbital paresthesia
Bilateral epistaxis,often medial canthal deformity,often unequal pupil height,face lengthening: “caved-in” or “donkey face”
Malocclusion: “open bite”,lateral orbital rim defect and ecchymoses: periorbital, subconjunctival
All of the above
LeFort Fractures were described by :
Wilson
Rene LeFort,1901
Knight and North
Williams
The coronal or bi-temporal approach is used to expose :
The anterior cranial vault
The forehead
The apper and middle regions of the facial skeleton
All of the above
Clinical sign that is always positive in fracture is
Crepitus
Tenderness
Abnormal mobility
All of the above
The most (common ) sign mandibular fracture is :
Malocclusion
Trismus
Deviation of the jaw on opening
Paraesthesia of the mental nerve
Which of them is not rigid osteosynthetic fixation
Osteosynthesis
Microplating
Screw plating
Wiring
Treatment of choice of a linear non-displaced fracture of the body of the mandible, with full compliment of teeth is
Kirschner wire
Circumferential wiring
External pin fixation
Interdental fixation
Which of the following condition is associated with anterior open bite
Unilateral condylar #
Bilateral condylar #
Maxillary fractures
Coronoid fracture
Fracture of mandible not involving dental arch is treated by :
Open reduction
Closed reduction
No treatment required
None of the above
In case of sub condylar fracture, the condyle move in
Anterior - lateral direction
Posterior - medial direction
Posterior- lateral direction
Anterior-medial direction
A 7-year-old boy presented with fracture of left subcondylar region with occlusion undisturbed, the treatment would be
Immobilization for 7 days
Immobilization for 14 days with intermittent active opening
No immobilization with restricted mouth opening for 10 days
No immobilization and active treatment
Facial fractures are diagnosed from :
The history
Physical examination
Radiographs
All of the above
Le Fort I fracture is :
Above the level of teeth
At level of nasal bones
At orbital level
At level of zygomatic bone
Le Fort II fracture is :
Transverse maxillary
Pyramidal
Craniofacial Disjunction
All of the above
Le Fort III fracture is :
Subzygomatic fracture
Subzygomatic pyramidal
Suprazygomatic
All of the above
What are the singns and symptoms of Lefort I fracture ?
Damaged teeth and soft tissues
Deformity of alveolus and altered sensation
Malocclusion and crepitus over maxilla
All as the above
What can be the signs and symptoms of le fort II fracture? Choose all that apply.
Bilateral epistaxis,open bite and face lengthening
Ecchymoses: buccal vestibule, periorbital, subconjunctival
Malocclusion, mobility of maxilla
All as the above
Which of the following is the cause of fracture of facial bone ?
Motor vehicle accidents
Assault
Sport and gunshots wounds
All are corrects
The following are the treatments of close reduction , except…
Ivy loop wiring and continuous loop wiring
Maxillo-mandibular fixation (MMF)
Inter-maxilla fixation (IMF)
Bone plating
All of the following are various surgical approaches for condylar fractures ,except:
Submandibular (Risdom`s ) approach -(Neck condyle)
Postauricular approach and endaural approch–(Excellent cosmesis)
Preauricular approach
IMF
All of the following are indication for nonsurgical treatment or close reduction of condylar process fractures ,except:
Split condylar head
Intracapsular fracture
Extracapsular fracture
Small fragments from comminuted condyle
All of the following are absolute indication for surgical treatment or open reduction of condylar process fractures ,except:
Displacement of condyle into middle cranial fossa
Intracapsular fracture
Impossibility for restoring occlusion
Lateral extracapsular displacement
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