MFDS Oral Surgery

Question 1

A patient presents for extraction of a lower third molar.
The radiograph shows the roots in close proximity to the inferior alveolar canal.
Which sign on the radiograph is the MOST reliable indicator of a true intimate relationship between the tooth roots and the inferior alveolar nerve?

Accepted Answer

Loss of the lamina dura of the canal wall where the root crosses

Answer

Darkening of the root at the point of overlap with the canal

Answer

The root appearing to curve away from the canal

Answer

Widening of the periodontal ligament space

Question 2

During surgical removal of an upper first premolar, the root fractures and the apical fragment is displaced into the maxillary sinus. What is the most appropriate initial management?

Accepted Answer

Inform the patient, prescribe antibiotics and a nasal decongestant, and arrange a referral for surgical retrieval

Answer

Immediately enlarge the socket to retrieve the fragment via a Caldwell-Luc approach

Answer

Instruct the patient to blow their nose forcefully to expel the fragment

Answer

Ignore the fragment as it will be absorbed naturally

Question 3

What is the most appropriate local anaesthetic technique for extraction of a lower first molar in an adult patient?

Accepted Answer

Inferior alveolar nerve block supplemented with long buccal nerve infiltration

Answer

Infiltration anaesthesia buccally only

Answer

Mental nerve block alone

Answer

Topical anaesthesia applied to the gingiva

Question 4

A patient develops a dry socket (alveolar osteitis) three days after extraction of a lower wisdom tooth. Which of the following best describes the pathogenesis and management?

Accepted Answer

Premature loss of the blood clot with exposed bone causing severe pain, managed with irrigation and placement of a sedative dressing such as Alvogyl

Answer

Bacterial infection of the socket requiring systemic antibiotics and incision and drainage

Answer

Allergic reaction to the local anaesthetic requiring antihistamine treatment

Answer

Fracture of the alveolar bone during extraction requiring surgical fixation

Question 5

Which of the following is an absolute contraindication to dental extractions without specialist consultation?

Accepted Answer

Patient currently taking therapeutic doses of warfarin with INR of 3.8

Answer

Controlled hypertension managed with amlodipine

Answer

Patient with a history of mild asthma using a salbutamol inhaler

Answer

Patient with well-controlled type 2 diabetes on metformin

Question 6

During extraction of an upper canine, the labial plate of bone fractures and remains attached to the periosteum. What is the most appropriate management?

Accepted Answer

Leave the bone fragment attached to its periosteal blood supply, reposition it, and suture the soft tissues over it

Answer

Remove the bone fragment completely and smooth the remaining bone

Answer

Pack the socket with bone wax and leave the fragment in situ

Answer

Refer the patient for immediate bone grafting