Oral Surgery, Oral Diagnosis and Radiology

1. A 31-year-old female patient is 9 weeks into her first pregnancy. She reports that while biting into an
apple, her retained left primary molar tooth "fell out." There are no clinical signs of infection. She is
interested in dental implant replacement of her missing maxillary left first premolar tooth. A review of
a panorex radiograph taken 1 year ago shows an impacted left maxillary first premolar tooth apical to
a retained deciduous molar. The patient would like to know when she will undergo dental implant
replacement of her missing tooth. You tell the patient:

A. This patient can undergo dental implant treatment immediately as there is no risk to the fetus at this
time
B. Elective surgical procedures such as implantology should be delayed until after delivery
C. It is best to wait until the third trimester to undergo surgical dental implant treatment as there is less
risk to the mother during this time
D. Because of the presence of an impacted, ankylosed tooth, this patient is not a candidate for dental
implant treatment in that region

2. A 55-year-old male presents to your office with a long history of a productive cough. The patient
states that the cough has been present for 6 months during each of the last 3 years. The patient is
afebrile and chest x-ray is unremarkable.

A. Viral pneumonia
B. Chronic bronchitis
C. Emphysema
D. Asthma

3. A history of rheumatic fever, IV drug abuse, or heart murmur should alert the dentist to the possibility
of:

A. Diabetes mellitus
B. AIDS
C. Valvular disease
D. End-stage renal disease

4. A normal platelet count is

A. 15,000 -45,000/mm3
B. 75,000 -100,000/mm3
C. 150,000 -450,000/mm3
D. 450,000 - 600,000/mm3

5. A patient has a history of two block dyspnea, two pillow orthopnea, ankle edema and palpitation. The
most likely diagnosis is:

A. Congestive heart failure

B. Hepatic failure
C. Respiratory failure
D. Uremia

6. A patient presents to your office with symptoms that include stabbing, shocking pain lasting a few
seconds to minutes. He says that the pain is provoked by cold and only occurs on the left side. What
is the most likely diagnosis for this patient?

A. Myofascial pain dysfunction syndrome

B. Trigeminal neuralgia
C. Osteoarthritis
D. TMJ ankylosis

7. A tall, thin patient presents to your office with shortness of breath. On examination, you note the
patient is breathing through "pursed" lips, his expiratory phase is prolonged, and lung sounds are
distant. Which of the following is the most likely diagnosis?
 A. Asthma
B. Bronchiectasis
C. Cystic fibrosis
D. Emphysema

8. A tender swelling in the soft tissues of the submandibular triangle is most likely caused by

A. Lipoma
B. An infected thyroglossal duct cyst
C. Lymphadenopathy
D. An obstruction of Stensen's duct

9. According to Guedel's stages of anesthesia, the proper use of nitrous oxide achieves which level of
anesthesia?

A. Stage I
B. Stage II
C. Stage III
D. Stage IV

10. After your film has been processed, you notice it appears brown in color. The most likely cause is:

A. Fixing time was too long

B. Fixing time was not long enough
C. Solutions are too strong
D. Solutions are too weak

11. After your film has been processed, you notice it appears too dark in color. The least likely cause is:

A. The film is overdeveloped

B. The temperature of the solutions was too hot
C. The temperature of the solutions was too cold
D. None of the above

12. All are advantages of digital radiography except

A. Digital subtraction
B. The ability to enhance the image
C. Size of the intraoral sensor
D. Patient education

13. All of the following are cardinal signs of a localized osteitis (dry socket) EXCEPT one

A. Throbbing pain (often radiating)

B. Bilateral lymphadenopathy
C. Poorly healed extraction site
D. Bad taste

14. All of the following symptoms that suggest that your patient is dehydrated EXCEPT

A. High blood pressure

B. Pale or gray skin color
C. Dry mouth
D. Modified state of consciousness

15. An incisional biopsy is indicated for which of the following lesions?

A. A 0.5-cm papillary fibroma of the gingiva

B. A 2.0-cm exostosis of the hard palate
C. A 3.0-cm hemangioma of the tongue
D. A 3.0-cm area of leukoplakia of the soft palate
16. Anesthesia performed with general anesthetics occurs in four stages which may or may not be
observable becau+se they can occur very rapidly. Which stage is the one in which skeletal muscles
relax and the patient's breathing becomes regular?

A. Analgesia
B. excitement
C. Surgical anesthesia
D. Medullary paralysis

17. Before removing a palatal torus:

A. An intraoral picture should be taken

B. A mandibular torus, if present, should be removed
C. A stent should be fabricated
D. A biopsy should be taken)

18. Case history includes the following except:

A. Chief complaint
B. HPI
C. Past History
D. Diagnosis

19. Closed reduction is best used in the treatment of:

A. Favorable, nondisplaced fractures

B. Displaced and unstable fractures, with associated midface fractures, and when MMF is
contraindicated
C. Either of the above
D. None of the above

20. Copper is used to house the anode because:

A. It is a good thermal conductor

B. It dissipates heat from the tungsten target
C. It reduces the risk of melting the target
D. All of the above

21. Digital x-rays require less radiation than conventional x-rays because

A. The sensor is larger

B. The exposure time is increased
C. The sensor is more sensitive to x-rays
D. The pixels sense transmitted light quickly

22. During extraction of a maxillary third molar, you realize the tuberosity has also been extracted. What
is the proper treatment in this case?

A. Remove the tuberosity from the tooth and reimplant the tuberosity
B. No special treatment is necessary
C. Smooth the sharp edges of the remaining bone and suture the remaining soft tissue
D. None of the above

23. Elongation (the most common error) can be caused by

A. Too little vertical angulation

B. The film is not parallel to the long axis
C. The occlusal plane is not parallel to the floor
D. All of the above

24. For maxillary extractions, the upper jaw of the patient should be:
 A. Below the height of the operator's shoulder
B. Above the height of the operator's shoulder
C. At the same height of the operator's shoulder
D. It makes no difference where the patient's upper jaw is in relation to the operator's shoulder

25. Foreshorting where the teeth appear too short is caused by:

A. Too much vertical angulation

B. Too little vertical angulation
C. Incorrect horizontal angulation
D. Beam not aimed at the center of the fifilm

26. How long should one wait before obtaining a biopsy of an oral ulcer?

A. 4 days
B. 7 days
C. 14 days
D. 30 days

27. If a subcondylar fracture occurs, which of the following muscles will displace the condyle both
anteriorly and medially?

A. Digastric muscle
B. Temporalis muscle
C. Lateral pterygoid muscle
D. Medial pterygoid muscle

28. Image magnification may be minimized by

A. Using a short cone

B. Placing the film as far from the tooth as possible
C. Using a long cone
D. Shortening the exposure time

29. In SLOB rule, also known as the cone shift technique, "O " stands for:

A. Oral
B. Occlusal
C. Operative
D. Opposite

30. In the emergency type of examination, history taking includes the following except:

A. Physical examination
B. Time of occurrence
C. Manner of the accident
D. Presence of associated signs and symptoms

31. It is the measurement of the measurement of electric energy through the xray tube

A. Voltage
B. Ohm
C. Milliamperage
D. Distance

32. Local control of hemorrhage

A. Gelfoam
B. Direct pressure
C. Vitamin K
D. Traxenemic acid
33. Nitrous oxide works on the

A. Peripheral nervous system (PNS)

B. Central nervous system (CNS)
C. Autonomic nervous system (ANS)
D. None of the above

34. Regardless of the flap design used, certain principles should be followed while incising and reflecting
the gingiva. With this in mind, the termination of a vertical incision at the gingival crest must be:

A. Midbuccal of the tooth

B. At the line angle of the tooth
C. Midlingual of the tooth
D. Beyond the depth of the mucobuccal fold

35. Removing parts of the x-ray spectrum by using absorbing materials in the x-ray beam is called:

A. Filtration
B. Elimination
C. Collimation
D. Reduction

36. Sutures placed intraorally are normally removed:

A. 1-2 days postoperatively

B. 5-7 days postoperatively
C. 9-11 days postoperatively
D. 13-15 days postoperatively

37. The Caldwell-Luc procedure eliminates blind procedures and facilitates the recovery of large root tips
or entire teeth that have been displaced into the maxillary sinus. When performing this procedure, an
opening is made into the facial wall of the antrum above the:

A. Maxillary premolar roots

B. Maxillary tuberosity
C. Maxillary lateral incisor
D. Maxillary third molar

38. The clinical presentation of acute asthma includes which of the following?

A. Hemoptysis
B. Dyspnea or tachypnea
C. Wheezing
D. Hypoxemia

39. The herringbone effect will appear on the processed film when:

A. The film is bent

B. An improper vertical angulation is used
C. The film is placed backwards in the mouth
D. An improper horizontal angulation is used

40. The ideal time to remove impacted third molars is:

A. When the root is approximately two-thirds formed

B. When the root is fully formed
C. Makes no difference how much of the root is formed
D. When the root is approximately one-third formed

41. The image of the coronoid process of the mandible often appears in periapical x-rays of:

A. The molar region of the maxilla

 B. The incisor region of the mandible
C. The molar region of the mandible
D. The incisor region of the maxilla

42. The least common site for a mandibular fracture to occur is the:

A. Body
B. Angle
C. Symphysis
D. Coronoid process

43. The maxillary sinus opens into the middle meatus of the nose through the:

A. Hiatus semilunaris
B. Frontonasal duct
C. Bulla ethmoidalis
D. Nasolacrimal duct

44. The most common pathognomonic sign of a mandibular fracture is:

A. Nasal bleeding
B. Exophthalmos
C. Malocclusion
D. Numbness in the infraorbital nerve distribution

45. The most commonly impacted teeth are the mandibular third molars, maxillary third molars, and the:

A. Maxillary lateral incisors

B. Maxillary canines
C. Mandibular first molars
D. Mandibular premolars

46. The most effective means in reducing the time of exposure, the amount of radiation reaching the
patient and the amount of radiation scattered to the dentist is

A. A lead apron
B. Ekta-speed film
C. Lead diaphragms
D. Increasing target-film distance

47. The most frequent complication associated with mandibular fracture management is

A. Hematoma
B. Wound dehiscence
C. Facial or trigeminal nerve injury
D. Infection

48. The normal value for blood urea nitrogen (BUN) is:

A. 2-5 mg/dL
B. 7-18mg/dL
C. 23-30 mg/dL
D. 33-50 mg/dL

49. The one aspect of radiography the operator cannot control is:

A. The size of the focal spot

B. The angulation of the cone beam
C. The source-fifilm distance
D. The object-fifilm distance

50. The optimum site for IV sedation for an outpatient is the:

 A. Median basilic vein
B. Median cephalic vein
C. Median antebrachial vein
D. Axillary vein

51. The pH of normal tissue is__; the pH of an inflamed area is __.

A. 9.0; 3 to 4
B. 7.4; 5 to 6
C. 3.6; 8 to 9
D. 8.0; 2 to 3

52. The primary treatment modality for ameloblastoma is:

A. Marginal or partial resection

B. Enucleation and/or curettage
C. Composite resection `
D. All of the above

53. The process of fracture healing can occur in:

A. One way: by direct or primary bone healing which occurs without callus formation
B. Two ways: by direct or primary bone healing, which occurs without callus formation, and
indirect or secondary bone healing, which occurs with a callus precursor stage
C. One way: by indirect or secondary bone healing which occurs with a callus precursor stage
D. None of the above

54. The process of obtaining a digital image similar to scanning a photograph to a computer screen is
called

A. Storage phosphor imaging

B. CMOS/APS
C. Indirect digital imaging
D. Direct digital imaging

55. The rules for producing the most accurate image formation when taking x-rays are the following
except:

A. Using the largest focal spot

B. Placing the fifilm as close as possible to the object
C. Directing the central ray as close to a right angle to the fifilm as anatomical structures will allow
D. Using the longest source-fifilm distance

56. The sublingual gland is located in the oral cavity between the mucosa of the oral cavity and the:

A. Mylohyoid muscle
B. Masseter muscle
C. Buccinator muscle
D. Temporalis muscle

57. The treatment for hematoma which developed following a PSAN injection should be

A. Incise and drain the area at once

B. Apply pressure and cold to the side of the face over the hematoma
C. Apply heat in the form of a hot pad to the area
D. Administer steroids to hasten diffusion of the trapped blood

58. The unit for measuring the absorption of x-rays is called:

A. REM
B. RAD
C. Roentgen
 D. QF

59. The use of metal plates, slots, etc., to confine and direct radiation to a specific region and/or to
discriminate against radiation from unwanted directions such as scattered radiation is called

A. Discrimination
B. Collimation
C. Filtration
D. Coning

60. To ensure high radiographic image quality , it is important to daily

A. Check the temperature of the processing solution

B. Clean the processing equipment
C. Clean the intensifying screens
D. Calibrate the MA linearity

61. Type of examination which is a precursor to a more thorough examination is:

A. Complete
B. Screening
C. Emergency
D. Periodic Health maintenance examinations

62. What clinical sign is considered pathognomonic for the 1st stage of internal derangement of the
articular disk?

A. Ringing in the ears

B. Reciprocal clicking
C. Muscle inflammation
D. Headaches

63. What determines whether muscles will displace fractured segments from their original position?

A. Attachment of the muscle

B. Type of fracture
C. Direction of muscle fibers
D. Line of fracture

64. What is the major disadvantage of the paralleling technique?

A. The image formed on the film will not have dimensional accuracy
B. Because of the amount of distortion, periodontal bone height cannot be accurately diagnosed
C. An increase in exposure time is necessary because of the use of a long cone
D. An increase in exposure time is necessary because of the use of a short cone

65. What is the most common cause of post-extraction bleeding?

A. Not placing suture over a single extraction socket

B. Having the patient bite down on a pressure dressing for 30-60 minutes
C. Failure of the patient to follow post-extraction instructions
D. All of the above

66. What is the recommended distance (in feet) that the operator should stand from the patient while
taking radiographs?

A. 2 feet
B. 4 feet
C. 6 feet
D. 8 feet

67. When a biopsy is being performed, it is important to:

 A. Incise parallel to the long axis of any muscle fibers beneath the lesion
B. Incise perpendicular to the long axis of any muscle fibers beneath the lesion
C. Incise as deep as possible into muscle fibers beneath the lesion
D. Incise at a 45-degree angle to the long axis of any muscle fibers beneath the lesion

68. When would you place a suture over a single extraction socket?

A. Routinely
B. Never
C. If the patient requests it
D. When there is severe bleeding from the gingiva or if the gingival cuff is torn or loose

69. Whether a bone cyst or other cysts are completely enucleated or treated by marsupialization depends
on the:

A. Duration
B. Origin
C. Color
D. Size and location to vital structures

70. Which artery descends on the posterior surface of the maxilla and supplies the maxillary sinus and
the maxillary molar and premolar teeth?

A. Sphenopalatine artery
B. Greater palatine artery
C. Posterior superior alveolar artery
D. Infraorbital artery

71. Which cells are considered the most radioresistant?

A. Mature bone cells

B. Immature reproductive cells
C. Young bone cells
D. Epithelial cells

72. Which lymph nodes directly receive lymph from the anterior two-thirds of the tongue (except the tip)?

A. Parotid lymph nodes

B. Submental lymph nodes
C. Submandibular lymph nodes
D. All of the above

73. Which of the following acid-base abnormalities will develop in a patient with recurrent vomiting of
gastric contents?

A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Metabolic acidosis

74. Which of the following are ways of eliminating dead space?

A. Close the wound in layers to minimize the postoperative void

B. Apply pressure dressings
C. Use drains to remove any bleeding that accumulates
D. Allow the void to fill with blood so that a blood clot will form

75. Which of the following coagulation factors is deficient in hemophilia B?

A. VI
B. VII
C. VIII
 D. IX

76. Which of the following describes a graft material derived from genetically unrelated members of the
same species?

A. Autogenous
B. Allogeneic
C. Xenogeneic
D. Synthetic

77. Which of the following drugs would be BEST given to a patient with a history of gastric ulcers?

A. Aspirin
B. Ibuprofen
C. Acetaminophen
D. Naproxen

78. Which of the following events are correctly paired with the stages of wound healing?

A. Fibroblasts lay a bed of collagen / proliferative phase

B. Platelet aggregation / inflammatory phase
C. Contraction of the wound / remodeling phase
D. Thromboplastin makes a clot / inflammatory phase

79. Which of the following factors make 3rd molar impaction surgery less difficult?

A. Close to inferior alveolar nerve

B. Elastic bone
C. Class 3 ramus (Pell-Gregory classification)
D. Divergent, curved roots

80. Which of the following is not a disadvantage of the bisecting technique?

A. Image on x-ray fifilm may be dimensionally distorted

B. Increased exposure time
C. If using a short cone, the image may be distorted
D. May not be able to determine correct alveolar bone height

81. Which of the following is NOT a stages of hemostasis?

A. Vascular
B. Platelet
C. Leukocytic
D. Coagulation

82. Which of the following is the primary direction of luxation for extracting maxillary deciduous molars?

A. Buccal
B. Mesial
C. Distal
D. Palatal

83. Which of the following nerves exits the skull through the foramen ovale?

A. Ophthalmic nerve
B. Maxillary nerve
C. Facial nerve
D. Mandibular nerve

84. Which of the following projections is the best for evaluating the condyles?

A. Townes projection
 B. Waters projection
C. Transcranial projection
D. Submentovertex projection

85. Which of the following sites for squamous cell carcinoma has the most unfavorable prognosis?

A. Gingiva
B. Lower lip
C. Dorsum of the tongue
D. Buccal mucosa

86. Which of the following teeth could be removed without pain after administration of an inferior alveolar
and lingual nerve block?

A. All anterior teeth on the side of the injection

B. Canine and first premolar on the side of the injection
C. All teeth in that quadrant on the side of the injection

87. Which of these barbiturates can be classified as an ultra-short-acting compound?

A. Amobarbital
B. Thiopental
C. Phenobarbital
D. Pentobarbital

88. Which statement below is true regarding type 2 diabetes?

A. Was formally known as insulin-dependent diabetes

B. Patients have little or no insulin secretion capacity
C. Symptoms appear abruptly and include polyuria, polydipsia, polyphagia, and weight loss
D. Accounts for 90% of all cases of clinical diabetes

89. Which suture grading below is the thickest?

A. 2/0
B. 3/0
C. 4/0
D. 5/0

90. Which three spaces in the head and neck are bilaterally involved in ludwig's angina infection?

A. Sublingual, temporal, infratemporal

B. Submandibular, submental, sublingual
C. Submandibular, submental, masseteric
D. Pterygomandibular, masseteric, sublingual

91. Which tooth has a root that is NOT consistently innervated by the PSA nerve?

A. The maxillary first molar

B. The maxillary second molar
C. The maxillary third molar
D. All of the above

92. Which type of Le Fort fracture is often referred to as a pyramidal fracture?

A. Le Fort I
B. Le Fort II
C. Le Fort III
D. All of the above

93. While attempting to remove a grossly decayed mandibular molar, the crown fractures. What is the
recommended next step to facilitate the removal of this tooth?
 A. Separate the roots
B. Use a larger forcep and luxate remaining portion of tooth to the lingual
C. Irrigate the area and proceed to remove the rest of the tooth
D. Place a sedative filling and reschedule patient

94. While attempting to remove a grossly decayed mandibular molar, the crown fractures. What is the
recommended next step to facilitate removal of this tooth?

A. Use a large forceps and luxate remaining portion of tooth to the lingual
B. Separate the roots
C. Irrigate the area and proceed to remove rest of the tooth
D. Place a sedative filling and reschedule patient

95. While extracting a mandibular third molar, you notice that the distal root tip is missing. Where is it
most likely to be found?

A. In the infratemporal fossa

B. In the submandibular space
C. In the mandibular canal
D. In the pterygopalatine fossa

96. X-ray developer contains all of the following except:

A. A developing agent
B. An antioxidant preservative
C. A clearing agent
D. An accelerator

97. X-ray fixer contains all of the following except

A. A clearing agent
B. An antioxidant preservative
C. An accelerator
D. An acidififier

98. _______are second only to nasal fractures in frequency of involvement.

A. Le fort I
B. Le fort II
C. Le fort III
D. Zygomatic fractures

99. __________ is the least lipid soluble of the three main benzodiazepines, resulting in a slow onset of
action but a long duration of action.

A. Midazolam
B. Lorazepam
C. Diazepam
D. None of the above

100. ____________should be used cautiously in the elderly. It should never be given to patients on
monoamine oxidase inhibitors for psychiatric disease and is generally contraindicated in patients
receiving phenytoin (Dilantin) for seizure disorders.

A. Ibuprofen
B. Acetaminophen
C. Meperidine
D. Codeine