Ankylosis of the TMJ is best treated with:

 # Ankylosis of the TMJ is best treated with:

A. Exercise and massage

B. Sclerosing solutions

C. Antibiotics

D. Condylectomy

The correct answer is D. Condylectomy.

The treatment of TMJ ankylosis is always surgical. Early surgical correction of the ankylosed joint is highly desirable, if satisfactory function is to be regained. Surgical strategy adopted depends on the following:

a. Age of onset of ankylosis.

b. Extent of ankylosis.

c. Whether there is unilateral or bilateral involvement.

d. Associated facial deformity.

Surgical techniques

Number of techniques have been advocated by different surgeons. Critical analysis of all, filters only to three basic methods.

I : Condylectomy

II : Gap arthroplasty

III : Interpositional arthroplasty

Most surgical procedures can be done through a preauricular incision alone. The Popowich‘s incision is

chosen for its obvious advantages. Whenever required, additional submandibular incision can be used for fixation of the graft, etc.

Ref: Textbook of Oral and Maxillofacial Surgery, Neelima Anil Malik, 3rd Edition, Page 267

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Best treatment for pericoronitis associated with impacted mandibular third molar is:

 # Best treatment for pericoronitis associated with impacted mandibular third molar is:

A. Irrigating under the operculum

B. Antibiotic and analgesic therapy

C. Extraction of impacted third molar

D. Operculectomy

The correct answer is C. Extraction of impacted third molar. 

Patients who have severe pericoronitis around an impacted mandibular third molar should not have the tooth extracted until the pericoronitis has been treated. Nonsurgical treatment should include irrigations, antibiotics, and removal of the maxillary third molar, if necessary, to relieve impingement on the edematous soft tissue overlying the mandibular impaction. If the mandibular third molar is removed in the face of severe pericoronitis, the incidence of complications increases. If the pericoronitis is mild and the tooth can be removed easily, then immediate extraction may be performed.

Pericoronitis is most common cause for removal of impacted mandibular third molars. It is recurrent

in nature and may cause the damage of bone around the 2nd and 3rd molars. So extraction of the involved tooth is the best treatment.

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Anemia can manifest as all EXCEPT:

 # Anemia can manifest as all EXCEPT:

B. Vertigo

A. Headache

C. Delirium

D. Tinnitus

The correct answer is C. Delirium.

Headache and dizziness(vertigo) are common symptoms of anemia.

Tinnitus is the perception of sounds that occurs in the absence of external acoustic stimulus. The pathomechanism of tinnitus is thought to be complicated and therefore remains debatable. Among several risk factors, such as increased age, female gender, and hearing loss, anemia is especially related to pulsatile tinnitus due to an altered hemodynamic status although the prevalence of pulsatile tinnitus in anemia patients has not been reported in previous studies. Anemia results in decreased oxygen carrying capacity of the blood, which carries an associated risk of insufficient oxygen delivery and cellular hypoxia. The compensatory increased flow state and turbulence are perceived as tinnitus in the ear, and the recognition of a hyperdynamic circulatory state as the cause of the tinnitus avoids unnecessary diagnostic tests and is essential in determining appropriate treatment.

Ref: https://doi.org/10.1016/j.anl.2018.04.001

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Initial control of hemorrhage after tooth extraction is achieved by:

 # Initial control of hemorrhage after tooth extraction is achieved by:

A. Placing figure of eight suture around the socket

B. Placing a moisture gauze over the extraction socket

C. Application of hydrogen peroxide pack

D. Prescribe antihemorrhagic drugs

The correct answer is B. Placing a moistened gauze over the extraction socket.

Initial control of hemorrhage is achieved by use of a moistened 2 × 2 inch gauze placed over the extraction socket. The gauze should be positioned such that when the patient closes his or her teeth together, it fits into the space previously occupied by the crown of the tooth. Biting of teeth together places pressure on the gauze, and the pressure is then transmitted to the socket. This pressure results in hemostasis. If the gauze is simply placed on the occlusal table, the pressure applied to the bleeding socket is insufficient to achieve adequate hemostasis. A larger gauze sponge (4 × 4 inches) may be required if multiple teeth have been extracted or if the opposing arch is edentulous.

Reference: CONTEMPORARY ORAL AND MAXILLOFACIAL SURGERY, Sixth Edition, Page NO 118