#MCQ 21 - During the Master cone fitting procedure in the endodontic treatment of a patient's tooth, the patient says he has a "sharp shooting pain in the same tooth that ached earlier". What should be your response and why?

#MCQ 21- During the Master cone fitting procedure in the endodontic treatment of a patient's tooth, the patient says he has a "sharp shooting pain in the same tooth that ached earlier". What should be your response and why?

A. Continue with obturation, the anesthetic is simply wearing off
B. Continue with obturation, this is a normal complaint during this part of the procedure
C. Consider looking for an accessory canal and re-filing, there is likely pulpal tissue that has not been properly debrided
D. Irrigate further, the Sodium Hypochlorite should take care of this problem
E. Temporize the tooth and obturate at a later date

Answer: C. Consider looking for an accessory canal and re-filing, there is likely pulpal tissue that has not been properly debrided

This indicates inadequate debridement, as a pulpless tooth should not respond to any stimuli.
The most important consideration before filling a root canal is proper cleaning (debridement)and shaping (instrumenting) of the canal. Once the canal is obturated, any organisms
that have entered the periapical tissues from the canal are eliminated by the natural defenses
of the body.

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Dentosphere Gems - Must Know Points in Oral Surgery

MOST COMMON:

1. The most common cause of anemia is iron deficiency due to decreased intake of essential compounds, viz. vitamin B1, B6, B12, iron, vitamin C.

2. The most commonly used Bard Parker Blade handle in oral surgery is no. 3.

3. Lagenbeck's retractor is the most commonly used retractor in oral surgery.

4. There are three work principles applicable to the elevators, viz. Lever principle, Wedge principle and Wheel and axle principle. Lever principle is the most commonly used principle.

5. The half circle curved needles are the most commonly used needles in oral surgical procedures.

6. Vicryl plus antibacterial suture is the world’s first and only antibacterial suture, which offers protection against bacterial colonization of the suture. It contains Triclosan which is a broad spectrum antibacterial agent and effective against the most common pathogens associated with surgical site infections.

7. Interrupted Suture is the most commonly used Suture.

8. Tetracyclines are the most common antibiotics responsible for causing superinfection, because they cause marked suppression of the normal intestinal flora.

9. The dentigerous cyst is the most common type of developmental odontogenic cyst, making up about 20 percent of all epithelium lined cysts of the jaws.

#MCQ 20 - Gingival Extension for a restoration should be:

#20 - Gingival Extension for a restoration should be:
A. At the gingival crest
B. At least 1 mm above the alveolar crest
C. At least 3 mm above the alveolar crest
D. Doesn't have any relation with the alveolar crest height

Answer: C. At least 3 mm above the alveolar crest
In a proper restoration, gingival margin of restoration should be at least 1 mm occlusal to the free marginal gingiva. Also, the free gingiva is approximately 2 mm coronal to the alveolar crest. So, margin of restoration should be 2mm (biological width) + 1 mm (distance away from free gingival margin) = 3 mm away from the alveolar crest.

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Oral Surgery Past Questions

NOTE: These are real exam questions from BPKIHS, Dharan Nepal compiled by students and handed over to juniors throughout the history. In fact these are generational gems to students. If you find any mistakes, suggest corrections and help make it errorfree. Don't be mean, share with your fellow mates too. Because, you are having access to it here because someone cared to collect these and share for you people. So, Thank the friend who shared this to you and, share with 3 of your best friends. Pay-It-Forward. :)

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1. What is impaction? Indication of Extraction of impacted teeth.
2. Ameloblastoma: etiopathogenesis, C/F, T/t.
3. Favourable and unfavourable #s. Principles of # T/t.
4. Trigeminal neuralgia. Etiology, C/F, T/t.
5. MPDS: predisposing factors, C/F, T/t.
6. Chronic pyogenic and suppurative osteomyelitis: Pathogenesis and treatment.
7. Dry socket: definition and causes.
8. Oroantral communication: cause, treatment.
9. Radicular cyst: Diagnosis, treatment.
10. Mx of patient on aspirin for Xn.
11. Merit/demerit of bur, chisel and mallet.
12. GowGates technique.
13. I for open extraction. Describe the flaps for the same.
14. Actinomycosis.
15. LA: classification, composition with fxn of each, MOA, complications.
16. Technique, landmark, S/S: IAN, PSA, Infraorbital.
17. Boundaries: pterygomandibular space, submandibular space.
18. Mx of anaphylaxis.
19. Ankylosis: classification, T/t, etiology.
20. Classification: Impacted canine, midface #.
21. Marsupialization of cystic lesion.



22. Oroantral fistula : etiology, complication, Mx.
23. Principles of surgery.
24. Extraction: I, CI, complication.
25. Describe areas supplied by IAN, long buccal, lingual, GP, PSA, NP, incisive, mental, infraorbital.
26. 38,48 Xn : Contarindication
27. SN: WAR line, Peterson’s difficulty index, causes of tooth impaction, heart disease needing prophylaxis, radicular cyst, nerve injury, adenocystic carcinoma, teeth and fracture lines, cavernous sinus thrombosis and its management, shift cone technique.
28. Precaution and Complication of surgery in HTN, asthmatics, diabetes.
29. GCS
30. X-ray used for mand/max #.
31. Branches of V2 and V3 and their innervation.
32. MoM, muscles attached to mandible.
33. Investigation of bleeding disorder.
34. Etiology of cleft.
35. Boundaries and content of infratemporal fossa.
36. C/F of U/L subcondylar dislocated #
37. Fracture healing.
38. Branches of external carotid, max artery, facial artery.
39. Tongue: muscles, nerve supply, lymph drainage.
40. Shock: hypovolemic, anaphylactic.
41. Space infections that cause trismus.
42. Spaces infected by lower 2nd molar.
43. Investigations and Mx of cystic lesions (also their enlargement)
44. Mandibular #: Classification and X-ray.
45. Different types of flap with design.
46. C/F, radiofeature, Mx: CGCG, ameloblastic fibroma, dry socket.
47. Etiology, C/F, Mx of pterygomandibular abscess.
48. C/F, Investigation and Mx of hemangioma.
49. Causes of non-healing fractures.
50. Possible complication of 16,26 Xn.
51. Open Vs closed reduction of mand #.
52. Define sterilization. Describe one.
53. Complication LeFort I osteotomy.
54. Methods of treating LeFort I #.
55. Superficial Vs deep temporal space.
56. Gillie’s temporal approach.
57. Branches of V.
58. Face- blood supply.
59. Facial palsy.
60. Indication of tracheostomy in OMFS.
61. CSF rhinorrhea and its Dx.
62. Complication of #.
63. Mention principles of elevators.
64. T/t options for Trigem N.
65. Classification of impacted teeth.



66. Three technique to block IAN.
67. Sequetrum vs involucrum.
68. Name 3 surgical approach to TMJ.
69. Normal flora of oral cavity and skin.
70. Describe line of # in LeFort # with diagram.
71. Enucleation vs marsupialization.
72. Space for 3rd molar.
73. Classify condylar #.
74. C/F and Mx of OAF..
75. Classify sutures. Describe different sutures with diagram.
76. MEQ: U/L TMJ ankylosis. – Dx and Mx. – cause, classification and pathophysiology. – Surgical Mx. – Approach to mandible. – Material used for interpositional arthroplasty and describe.
77. MEQ: LeFort I # with zygomatic complex #. –Dx. –X-ray. – Mx. Open vs closed reduction. –Gunning splint.
78. 5 lesion associated with impacted teeth. –Factors causing Xn easy and difficult.
79. Complication due to Xn of 36,46.
80. Allergic rxn, anaphylaxis due to LA: –Dx. –Mx. Prevention.
81. Ameloblastoma: histological variants, mode of t/t, radiological findings.
82. Extracranial course and branches of V3.
83. LeFort II#: GCS, C/F, X-ray.
84. Bleeding socket for 7 days: cause, investigation, Mx.
85. Case of dentigerous cyst: confirming Dx, describe enucleation and marsupialization.
86. Pt with severe pain, limited mouth opening. OPG revealed carious lesion: Primary Mx, Define Ludwig’s angina, Mx and complication Ludwig’s angina.
87. Syncope: pathophysiology, S/S, Mx.
88. 28 yrs old B/l condylar #: Investigation and Mx.
89. Zygomatic complex #: X-ray, C/F, indication for open reduction.
90. A 60 yrs old man comes in denal clinic for Xn of tooth. Previous h/o prosthetic valve replacement. 6 mnths back. List the preoperative preparation of this case. He developed intense chest pain and radiated to left shoulder : Mx.
91. Methods of treating LeFort I 3.
92. Causes of postoperative bleeding.

93. Face: blood supply.
94. Facial palsy.
95. Neuroparesis.
96. Define #. Mention causes of non-healing socket.
97. Mention the C/F of U/L subcondylar dislocated #.
98. X-ray for mand #.
99. SN: teeth and # line.
100. Define Ludwig’s angina, tt, C/F.
101. Define Xn. Flaps in open Xn with diagrams.
102. Define cyst. Mention a cyst without epithelial lining.
103. Dx of cyst, how ?
104. D/D of periapical radiolucency.
105. C/F and Mx of B/L TMJ ankylosis.
106. How to identify and manage anaphylactic rxn to LA ?
107. Buccinator muscle.
108. Osteology of midface.
109. Orthognathic surgery.
110. Ascending palatine branch of max artery.
111. Hypoglycemic shock.
112. Complications of LeFort I osteotomy.
113. Pharmacology of LA.
114. History taking. Method of drainage of submandibular and pterygomandibular space abscess.
115. Theories and MOA of LA. Describe specific receptor theory.
116. Patient on warfarin, Mx.
117. ORN : etio, C/F, Tt.
118. OKC – types, histological classification and its significance, recurrence and prevention, C/F, T/t.
119. Referred pain ?
120. Asthma Mx ?
121. Liver disease patient Mx.
122. Mx of seizures, thyroid, alcoholics.
123. PEP.
124. Indication of antimicrobials in OMFS.
125. Frey’s syndrome, etio, S/S, tt.
126. Silhoutte/PG tumor
127. Syncope vs drug overdose.
128. Central lymph nodes.
129. Inner/outer waldeyer’s ring.
130. Internal derangement.
131. CSF vs nasal secretion vs blood.
132. Birn’s hypothesis.
133. Pyogenic OM.
134. Ideal properties of LA.
135. BLS.
136. MOA of Nimesulide, Ibuprofen, Aspirin, Penicillin, cephalosporins.
137. Describe Kazanjian’s technique in vestibuloplasty.
138. Describe Caldwell-Luc operation.
139. Causes for post-traumatic diplopia.
140. Indications for sagittal split osteotomy.
141. I/CI of adrenaline.
142. Some incisions to middle third #.
143. Define dislocation.
144. Absolute/relative indications for open reduction of condylar #.
145. Mx of avulsed tooth.
146. Tt of Ellis V #.
147. Principles of suturing.
148. Tissue reaction to suture.
149. C/F of Guerin #, pyramidal #, unilateral and bilateral TMJ ankylosis.
150. Etiology of oral cancer. TNM classification and staging.



151. Define pain and methods to control pain.
152. Mention theories of pain and action of LA.
153. Local and systemic complications of LA.
154. Types of vasoconstrictors used in dentistry.
155. Indications of vestibuloplasty.
156. Classify antibiotic.
157. Complex odontoma, pleomorphic adenoma.
158. Warphe’s difficulty index.