5th year BDS IX Semester February 2019 - ORAL AND MAXILLOFACIAL SURGERY, BPKIHS

17th FEB 2019

B.P. Koirala Institute of Health Sciences, Dharan, Nepal

5th year BDS

IX Semester Internal Assessment, February 2019

Paper - IV 

(ORAL & MAXILLOFACIAL SURGERY)

Time - 1 Hour 20 minutes

 Total Marks: 60

SHORT ANSWER QUESTIONS

SECTION - 'A'

Maximum Marks - 30

1. Write a note on embryological aspects specific to cleft lip and palate.   (4)

2. Discuss briefly on different types of dislocation and enumerate the surgical procedures for the management of chronic recurrent temporomandibular joint dislocation. (3+3=6)

3. Mention the difference between the ridge extension and ridge augmentation procedure based on their indication. Describe any one ridge extension procedure. (1+4=5)

4. Write down the regimen for antibiotic prophylaxis for infective endocarditis and enlist the cardiac conditions requiring infective endocarditis prophylaxis. (2+4=6)

5. Write a note on the measures to be considered after exposure to a known case of HIV patient following needle-stick injury during tooth extraction. (4)

6. Describe the flap design for transalveolar extraction of impacted mandibular third molar correlating with the principles of flap design. (5)

SECTION 'B'

MODIFIED ESSAY QUESTIONS

Maximum Marks: 30

I. A 11 year-old patient reported to Maxillofacial clinic with a history of fall from a tree four days ago. There is no history of vomiting, seizure, loss of consciousness, but has a history of ear bleed from right ear. On examination, extraorally there is a sutured chin laceration with appreciable preauricular swelling present bilaterally. 

Intraoral examination reveals an anterior open bite due to premature gagging of occlusion. Maxilla appears to be normal. On opening the mouth, the midline is normal. 
Q1. State the term used to best define this fracture. (2)
Q2. Enlist two radiograph that can aid to diagnosis in this case. (2)
Q3. Enlist the indications for surgical intervention for this kind of fracture. (5)
Q4. Name two incisions that can be used to surgically approach this kind of fracture. (2)
Q5. Name the major complication that can occur if the patient is inappropriately treated with closed method and briefly discuss its etiopathophysiology. (1+3=4)

II.  A 26 year-old gentleman with a history of type -II diabetes mellitus was planned for extraction of 28 under local anesthesia. While during the procedure, the patient suddenly reports feeling uncomfortable, feeling warm, and then loses his consciousness. His wife who was accompanying him reports that he had taken his regular dose of hypoglycemic but missed his breakfast due to rush for the appointment. 
Q6. Enlist four causes for loss of consciousness. (2)
Q7. Discuss the management strategy for this patient. (4)
Q8. Discuss the management protocol to be employed for this medical condition to prevent such unwanted incidence from happening. (5)
Q9. Discuss the pathophysiology of syncope. (4)

***

5th year BDS IX Semester February 2019 - CONSERVATIVE DENTISTRY AND ENDODONTICS, BPKIHS

15th FEB 2019

B.P. Koirala Institute of Health Sciences, Dharan, Nepal

5th year BDS

IX Semester Internal Assessment, February 2019

Paper - III 

(CONSERVATIVE DENTISTRY AND ENDODONTICS)

Time - 1 Hour 20 minutes

 Total Marks: 60

SHORT ANSWER QUESTIONS

SECTION - 'A'

Maximum Marks - 30

1.  Discuss Gingival Marginal Trimmer with its number, use, and way to identify the sides.   (5)

2. Discuss the component present in 5th generation Bonding agent, Hybrid layer and ways to get a better Hybrid layer. (5)

3. Discuss the management of mercury pertaining to environmental issues using a flow chart. (5)

4. Write briefly about lateral condensation. (5)

5. What is crown down preparation of the root canal? (5)

6. What Precautions are to be taken to prevent ledging and apical transportation of root canals?
(5)

SECTION 'B'

MODIFIED ESSAY QUESTIONS

Maximum Marks: 30

I. A 42-year female patient visited dental OPD with severe spontaneous pain in the right upper back region of mouth for 5 days. Patient avoided chewing food from right side due to pain for several months.
Q1. Enlist the several causes of intraoral pain. (3)

Upon examination, there was poor oral hygiene, bleeding on probing, carious lesion in 15,16,17. IOPAR revealed dental caries in 15, deep dental caries approximating pulp in 16,17. 
Q2. Describe the investigation process to diagnose the case. (3)
Q3. Mention the diagnosis of the case. (2)
Q4. Outline the treatment plan. (2)

Prompt diagnosis and removal of the reservoir of infection are important for treatment of endodontic infections. 
Q5. Explain the crown down pressureless technique with its advantages for root canal shaping. (5)

II. Mr. Subash Limbu, 18-year male from Dharan-7, came to the Department of Conservative Dentistry and Endodontics with the chief complaint of decayed tooth on the left lower jaw region. He noticed a blackish discoloration on the chewing surface of left lower first molar yesterday evening during brushing and being a British Army aspirant, he didn't wan't to take any chances. So, today, he showed up for a checkup. After brief history, general examination was carried out. 
Q6. Outline the method for oral examination. (2)

On examination, the dentist noticed white spots over upper anterior teeth, and features associated with increased caries risk.
Q7. Mention the method for diagnosing a white spot. (2)
Q8. Describe the clinical examination findings associated with increased caries risk. (5)
Q9. Outline the treatment strategies in caries prevention program. (5)
Q10. Best measures for preventing both caries and periodontal disease are? (1)

***

#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.

CLICK HERE TO VIEW  ALL MCQS

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.