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

Dumble-bell shaped swelling is characteristic of which type of odontogenic space infection:

# ‘Dumble-bell’ shaped swelling is characteristic of which type of odontogenic space infection?

A. Submandibular space infection

B. Buccal space infection

C. Submasseteric space infection

D. Temporal space infection

The correct answer is D.Temporal Space Infection.

"Dumb-bell" shaped swelling is seen in deep temporal space infection because of zygomatic arch, swelling is seen superior and inferior to zygomatic arch resulting in Dumb-bell shaped swelling.

Presence of portwine stains, gingival overgrowth and convulsive disorders

 # Which of the following is characterized by the presence of portwine stains, gingival overgrowth and convulsive disorders?

A. Sturge Weber syndrome

B. Witkop syndrome

C. Hunter syndrome

D. Fanconi syndrome

The correct answer is A. Sturge Weber Syndrome.

Encephalotrigeminal Hemangiomatosis

(Sturge-Weber syndrome)

The facial cutaneous capillary venous angiomas (or port-wine nevi) are usually the first component

of the syndrome to be observed, at birth, and are confined almost exclusively to the skin area supplied by the trigeminal nerve. Neurologic manifestations are among the most characteristic features of the disease and consist of convulsive disorders and spastic hemiplegia with or without mental retardation. Occasionally, angiomatous lesions also involve the gingiva and buccal mucosa.

Reference: Shafer’s Textbook of ORAL PATHOLOGY, 7th Edition, Page No: 149

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Undifferentiated mesenchymal cells around blood vessels are known as:

# Undifferentiated mesenchymal cells around blood vessels are known as:

A. Histiocytes

B. Pericytes

C. Fibroblast

D. Osteoblast

The correct answer is B. Pericytes.

Experimental studies have shown that a population of progenitor cells with the potential to differentiate into several distinct mesenchymal cell types can be isolated from the periodontal ligament. In cell culture, periodontal ligament stem cells can differentiate into cells that form bone, cementum, cartilage, fat, muscle, and neuron- and glial-like cells. Recent work indicates that perivascular cells (pericytes) associated with the microvasculature of alveolar bone and periodontal ligament of mice can differentiate into osteoblasts, cementoblasts, cementocytes, and periodontal ligament fibroblasts in

untreated animals, as well as after injury of the periodontium.

Reference: Fundamentals of Oral Histology and Physiology, Arthur R. Hand, 2014, Page no 128

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The protein content of a keratocyst is found to be:

# The protein content of a keratocyst is found to be:

A. less than 4 gm/dL

B. 6 mg/dL

C. Equal to serum protein

D. More than serum protein

The correct answer is A. less than 4 gm/dL.

Aspirational biopsy of odontogenic keratocysts contains a greasy fluid which is pale in colour and contains keratotic squames. Protein content of cyst fluid below 4g% is diagnostic of odontogenic keratocysts. Smaller and unilocular lesions resembling other types of cysts may require a biopsy to confirm the diagnosis. On a CT scan, the radiodensity of a keratocystic odontogenic tumour is about 30 Hounsfield units, which is about the same as ameloblastomas. However, ameloblastomas show more bone expansion and seldom show high density areas.

Reference: Wikipedia

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