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Oral Surgery > MOSBY > Flashcards

MOSBY Flashcards

1
Q

Which of the following does not represent a
fascial space for the spread of infection?

A. Superficial temporal space
B. Pterygomandibular space
C. Masseteric space
D. Rhinosoteric space
E. Submental space

A

D. Rhinosoteric space

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2
Q

From the list of classifications of impacted teeth
below, which one(s) must always involve both bone removal and sectioning during the surgical
procedure?

A. Mesioangular impaction
B. Horizontal impaction
C. Vertical impaction
D. A and B only
E. A, B, and C

A

B. Horizontal impaction

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3
Q

Which of the following does not represent a
possible finding of severe infection?

A. Trismus
B. Drooling
C. Difficult or painful swallowing
D. Swelling and induration with elevation of the
tongue
E. A temperature of 99˚ F

A

E. A temperature of 99˚ F

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4
Q

You are performing a 5-year follow-up on a
43-year-old implant patient. When comparing radiographs you estimate that there has been almost 0.1 mm loss of bone height around the implant since it was placed. Which of the
following is indicated?
A. Removal of the implant and replacement with a
larger size implant.
B. Removal of the implant to allow healing before
another one can be placed 4 months later.
C. Remaking the prosthetic crown because of
tangential forces on the implant.
D. The implant is doing well; this amount of bone loss is considered acceptable

A

D. The implant is doing well; this amount of bone loss is considered acceptable

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5
Q

Upon evaluation of an immediate postoperative panoramic film of a dental implant replacing tooth #30, you measure a distance of 1.5 mm from the apex of the implant to the inferior alveolar nerve canal. This is a titanium implant in an otherwise healthy patient. Which of the
following actions is indicated?

A. You may proceed with immediate loading of the implant.
B. You should continue but only perform a two-stage procedure.
C. Back the implant out approximately 0.5 mm to ensure a safe distance from the nerve.
D. Remove the implant and plan a repeat surgery after 4 months of healing.

A

C. Back the implant out approximately 0.5 mm to ensure a safe distance from the nerve.

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6
Q

Myofascial pain dysfunction may be described as _____.

A. Masticatory pain and limited function
B. Clicking and popping of the joint
C. An infectious process
D. Dislocation of the disc

A

A. Masticatory pain and limited function

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7
Q

A 21-year-old man is referred to your oral and maxillofacial surgery practice for an orthognathic surgery consult. After your routine exam and review of radiographs, you note the following problem list: Class III skeletal facial deformity with a negative overjet of 6 mm and significant maxillary crowding; missing left mandibular first molar due to dental decay with multiple other early carious lesions; and calculus on the lingual surfaces of teeth #22 through #27 with gingival inflammation. Which of the following is the most appropriate order in which this patient’s oral health needs should be sequenced?

A. Definitive crown and bridge therapy, orthodontics to relieve crowding and to coordinate arches, caries management, surgery to correct the skeletal discrepancy, and periodontal therapy to control gingival inflammation.
B. Caries management, orthodontics to relieve crowding and to coordinate arches, definitive crown and bridge therapy, periodontal therapy to control gingival inflammation, and surgery to correct the
skeletal discrepancy.
C. Periodontal therapy to control gingival
inflammation, definitive crown and bridge therapy, orthodontics to relieve crowding and to coordinate arches, surgery to correct the skeletal discrepancy, and caries management.
D. Periodontal therapy to control gingival inflammation, caries management, orthodontics to relieve crowding and to coordinate arches, surgery to correct the skeletal discrepancy, and definitive crown and bridge therapy.

A

D. Periodontal therapy to control gingival inflammation, caries management, orthodontics to relieve crowding and to coordinate arches, surgery to correct the skeletal discrepancy, and definitive crown and bridge therapy.

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8
Q

Systemic effects of obstructive sleep apnea syndrome (OSAS) include all of the following
except _____.

A. Hypertension
B. Cor pulmonale
C. Aortic aneurysm
D. Cardiac arrhythmia

A

C. Aortic aneurysm

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9
Q

Which of the following is not a vital part of the
physical exam for patients with TMJ complaints?

A. Soft-tissue symmetry
B. Joint tenderness and sounds
C. Soft-palate length
D. Range of motion of the mandible
E. Teeth

A

C. Soft-palate length

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10
Q

Which of the following is considered the highest and most severe classification of maxillary fracture?

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

A

C. LeFort III

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11
Q

Which of the following is not a relative contraindication for routine, elective oral surgery?

A. Unstable cardiac angina
B. History of head and neck radiation
C. Chronic sinusitis
D. Hemophilia

A

C. Chronic sinusitis

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12
Q

Which of the following is true regarding temporomandibular disorders?

A. The primary treatment for the majority of patients with facial pain is TMJ surgery.
B. Disc displacement without reduction can cause a decrease in interincisal opening.
C. Myofascial pain is commonly related to
parafunctional habits, but not commonly related to stress.
D. Systemic arthritic conditions do not affect the TMJ because it is not a weight-bearing joint

A

B. Disc displacement without reduction can cause a decrease in interincisal opening.

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13
Q

The following are those properties deemed most desirable for a local anesthetic, except _____.

A. It should not be irritating to the tissue to which it is applied
B. It should cause a permanent alteration of nerve structure
C. Its systemic toxicity should be low
D. It must be effective regardless of whether it is injected into the tissue or applied locally to mucous membranes

A

B. It should cause a permanent alteration of nerve structure

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14
Q

The majority of injectable local anesthetics used today are _____.

A. Tertiary amines
B. Secondary amines
C. Primary y amines
D. Esters

A

A. Tertiary amines

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15
Q

_____ has a shorter half-life than other amides because a portion of its biotransformation occurs in the blood by the enzyme plasma cholinesterase.

A. Lidocaine
B. Bupivacaine
C. Mepivacaine
D. Articaine

A

D. Articaine

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16
Q

Which of the following local anesthetics is marketed for dentistry in the United States in
more than one concentration?

A. Bupivacaine
B. Mepivacaine
C. Lidocaine
D. Articaine

A

B. Mepivacaine

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17
Q

The major factor determining whether aspiration can be reliably performed is _____.

A. The needle gauge
B. The needle length
C. The injection performed
D. The patient

A

A. The needle gauge

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18
Q

The _____ is recommended for palatal soft-tissue management from canine to canine bilaterally in the maxilla.

A. Posterior superior alveolar
B. Inferior alveolar
C. Long buccal
D. Nasopalatine

A

D. Nasopalatine

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19
Q

Which of the following local anesthetics has the highest pKa?

A. Lidocaine
B. Prilocaine
C. Mepivacaine
D. Bupivacaine

A

D. Bupivacaine

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20
Q

Three cartridges of 2% lidocaine with 1:100,000 epinephrine contain _____ lidocaine.

A. 36 mg
B. 54 mg
C. 54 μg
D. 108 mg

A

D. 108 mg

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21
Q

Which injection anesthetizes the distobuccal aspect of the mandibular first molar?

A. Posterior superior alveolar (PSA)
B. Middle superior alveolar (MSA)
C. Anterior superior alveolar (ASA)
D. Inferior alveolar (IA)

A

D. Inferior alveolar (IA)

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22
Q

Which of the following is the longest-acting local anesthetic?

A. Mepivacaine
B. Lidocaine
C. Prilocaine
D. Bupivacaine

A

D. Bupivacaine

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23
Q

If your patient has a history of liver disease,
which of the following would be the safest local anesthetic?

A. Articaine
B. Prilocaine
C. Lidocaine
D. Bupivacaine

A

A. Articaine

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24
Q

Which of the following injections has the highest degree of failure?

A. Posterior superior alveolar
B. Lingual
C. Nasopalatine
D. Inferior alveolar

A

D. Inferior alveolar

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25
Q

All of the following are possible reasons why
some local anesthetics have a longer duration of action than others, except _____.

A. The addition of a vasoconstrictor
B. Percent protein binding
C. Degree of lipid solubility
D. pKa of the drug

A

D. pKa of the drug

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26
Q

You have placed a dental implant for replacement of tooth #9. Preoperatively you obtained a panoramic and a periapical film. During the surgery, you used a crestal incision, series of drills, and paralleling pins as necessary. Upon restoration of the crown, obtaining ideal esthetics is difficult because the implant is placed too close to the labial cortex, causing the restoration to appear overcontoured. Which of the techniques below could most adequately have prevented this problem?

A. Using an anterior surgical template
B. Obtaining preoperative tomograms of the
alveolus
C. Using a tissue punch technique
D. Using a smaller size of implant

A

A. Using an anterior surgical template

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27
Q

The third molar impaction most difficult to
remove is the _____.

A. Vertical
B. Mesioangular
C. Distoangular
D. Horizontal

A

C. Distoangular

28
Q

On a panoramic radiograph of a 13-year-old
patient, there is evidence of crown formation of the third molars but no root formation yet.
These teeth fall into the category of impacted
teeth.

A. True
B. False

A

B. False

29
Q

Which of the following is not appropriate treatment for an odontogenic abscess?

A. Placing the patient on antibiotics and having
them return when the swelling resolves
B. Surgical removal of the source of the infection as early as possible
C. Drainage of the abscess with placement of
surgical drains
D. Close observance of the patient during
resolution of the infection
E. Medical management of the patient to correct any compromised states that might exist

A

A. Placing the patient on antibiotics and having
them return when the swelling resolves

30
Q

Before the exploration of any intrabony patho-
logic lesion, which type of biopsy must always
be done?

A. Cytologic smear
B. Incisional biopsy
C. Excisional biopsy
D. Aspiration biopsy

A

D. Aspiration biopsy

31
Q

You are performing a 5-year follow-up on a
43-year-old implant patient. When comparing
radiographs, you estimate that there has been
almost 0.1 mm of lost bone height around
the implant since it was placed. Which of the
following is indicated?
A. Removal of the implant and replacement with a larger-size implant.
B. Removal of the implant to allow healing before another one can be placed 4 months later.
C. Remaking the prosthetic crown because of
tangential forces on the implant.
D. The implant is doing well; this amount of bone loss is considered acceptable.

A

D. The implant is doing well; this amount of bone loss is considered acceptable.

32
Q

The major mechanisms for the destruction of
osseointegration of implants are _____.

A. Related to surgical technique
B. Similar to those of natural teeth
C. Related to implant material
D. Related to nutrition

A

D. Related to nutrition

33
Q

After completing your postoperative instructions for dental implant placement for replacement of tooth #14, your patient asks you how long it will be before she can get her new tooth. Which of the following is most correct to allow complete osseointegration?

A. 3 weeks
B. 6 weeks
C. 3 months
D. 6 months

A

D. 6 months

34
Q

The imaging evaluation of the temporoman-
dibular joint is most likely to include any of the
following except _____.

A. Panoramic radiographs
B. TMJ tomograms
C. Xeroradiography
D. Magnetic resonance imaging

A

C. Xeroradiography

35
Q

When is distraction osteogenesis preferred over a traditional osteotomy?

A. When a large advancement is needed.
B. When a small advancement is needed.
C. When exacted interdigitation of the occlusion is needed.
D. When the treatment needs to be done in a very short period of time.
E. Distraction osteogenesis is always preferred over a traditional osteotomy.

A

A. When a large advancement is needed.

36
Q

The most common mandibular surgical
osteotomy to advance the mandible is _____.

A. A LeFort I osteotomy
B. A segmental maxillary osteotomy
C. A bilateral sagittal split osteotomy
D. An intraoral vertical ramus osteotomy

A

C. A bilateral sagittal split osteotomy

37
Q

Obstructive sleep apnea syndrome (OSAS) often results in all of the following except _____.

A. Excessive daytime sleepiness
B. Aggressive behavior
C. Personality changes
D. Depression

A

B. Aggressive behavior

38
Q

Which of the following procedures would be
considered the least invasive surgical treatment for TMJ complaints?

A. Splint therapy
B. Arthrocentesis
C. Arthroscopy
D. Disc removal
E. Total joint replacement

A

C. Arthroscopy

39
Q

Your patient is a 23-year-old college student
whom you suspect may have sustained a
mandible fracture during an altercation.
Which of the following is false?
A. At least two x-rays should be obtained.
B. The most common x-ray obtained would be a panoramic radiograph.
C. The most likely area for this patient’s mandible to be fractured is the mandibular dental alveolus.
D. Point tenderness, changes in occlusion, step deformities, and gingival lacerations should all be noted on physical exam.

A

C. The most likely area for this patient’s mandible to be fractured is the mandibular dental alveolus.

40
Q

Which of the following is not a classification of
mandible fractures?

A. Anatomic location
B. Description of the condition of the bone
fragments at the fracture site
C. Angulation of the fracture and muscle pull
D. LeFort level

A

D. LeFort level

41
Q

Even though the state-of-the-art treatment for
facial fractures is with internal rigid fixation
using bone plates and screws, a proper
occlusal relationship must be established prior
to fixation of the bony segments if the reduction is to be satisfactory.

A. True
B. False

A

A. True

42
Q

Which of the following is true regarding possible complications resulting from dental extractions?
A. Patients with numbness lasting more than
4 weeks should be referred for microneurosurgical evaluation.
B. Infections are common, even in healthy
patients.
C. Dry socket occurs in 10% of third molar patients.
D. Teeth lost into the oropharynx are usually
swallowed, and thus do not require further
intervention.

A

A. Patients with numbness lasting more than
4 weeks should be referred for microneurosurgical evaluation.

43
Q

Which of the following is true regarding the
possibilities for reconstruction of an atrophic edentulous ridge prior to denture construction?

A. Dental implants are used only as a last resort after bone grafting attempts have failed.
B. Distraction osteogenesis is too new a technique to be applied to ridge augmentation.
C. Potential bone graft harvest sites for ridge
reconstruction include rib, hip, and chin.
D. The need for ridge augmentation is more
common in the maxilla than in the mandible.

A

C. Potential bone graft harvest sites for ridge
reconstruction include rib, hip, and chin.

44
Q

You are evaluating a patient 5 days after
extraction of tooth #17. The patient complains
of a severe throbbing pain that started yester-
day, 4 days after extraction. The patient most
likely has which of the following conditions?

A. Dry socket
B. Subperiosteal abscess
C. Periapical periodontitis in tooth #18
D. Neuropathic pain

A

A. Dry socket

45
Q

Which of the following would not be expected
to cause delayed healing of an extraction site?

A. A patient older than 60 years of age
B. A patient younger than 10 years of age
C. A patient with diabetes
D. A patient with a heavy smoking habit

A

B. A patient younger than 10 years of age

46
Q

The following are all desirable properties of an
ideal local anesthetic, except _____.

A. It should have potency sufficient to give
complete anesthesia even if harmful results
occur at therapeutic doses
B. It should be relatively free from producing
allergic reactions
C. It should be stable in solution and readily
undergo biotransformation in the body
D. It should either be sterile or capable of being sterilized by heat without deterioration

A

A. It should have potency sufficient to give
complete anesthesia even if harmful results
occur at therapeutic doses

47
Q

What is the direct effect of local anesthetics on
blood vessels in the area of injection?

A. Constriction
B. Dilation
C. Sclerosis
D. Thrombosis

A

B. Dilation

48
Q

All of the following describe lidocaine as pack-
aged in dental cartridges except _____.

A. Provided in a 2% solution
B. Provided with or without epinephrine
C. Has a pKa = 8.1
D. Has a rapid onset

A

C. Has a pKa = 8.1

49
Q

25-gauge needles are preferred to smaller-diameter ones due to all of the following reasons except _____.

A. Greater accuracy in needle insertion for
25-gauge needles
B. Increased rate of needle breakage for 25-gauge needles
C. Aspiration of blood is easier and more reliable through a larger lumen
D. There is no difference in pain of insertion

A

B. Increased rate of needle breakage for 25-gauge needles

50
Q

A 1.0-ml volume of a 2% solution contains _____.

A. 18 mg
B. 20 mg
C. 36 mg
D. 54 mg

A

B. 20 mg

51
Q

During local anesthetic administration, the
patient should be placed in a _____ position.

A. Trendelenburg
B. Supine
C. Reclined
D. Semi-supine

A

B. Supine

52
Q

According to Malamed, slow injection is
defined as the deposition of 1 ml of local anesthetic solution in not less than _____.

A. 15 seconds
B. 30 seconds
C. 60 seconds
D. 2 minutes

A

B. 30 seconds

53
Q

The _____ nerve block is recommended for management of several maxillary molar teeth in one quadrant.

A. Posterior superior alveolar (PSA)
B. Inferior alveolar (IA)
C. Long buccal (LB)
D. Nasopalatine (NP)

A

A. Posterior superior alveolar (PSA)

54
Q

In an adult of normal size, penetration to a
depth of _____ mm places the needle tip in the
immediate vicinity of the foramina, through
which the posterior superior alveolar (PSA)
nerves enter the posterior surface of the maxilla.

A. 10
B. 16
C. 20
D. 30

A

B. 16

55
Q

The _____ nerve block is useful for dental procedures involving the palatal soft tissues distal to the canine.

A. Nasopalatine (NP)
B. Greater palatine (GP)
C. Long buccal (LB)
D. Inferior alveolar (IA)

A

B. Greater palatine (GP)

56
Q

Elevation of cardiovascular signs with epineph-
rine, injected in a local anesthetic solution in a
cardiovascularly compromised patient, occurs
at about what threshold?

A. 40 μg
B. 100 μg
C. 200 μg
D. 1000 μg

A

A. 40 μg

57
Q

According to Malamed, the maximum local
anesthetic dose of lidocaine (with or without
vasoconstrictor) is _____.

A. 1.5 mg/kg.
B. 2.0 mg/kg.
C. 4.4 mg/kg.
D. 7.0 mg/kg.

A

C. 4.4 mg/kg.

58
Q

Which of the following injections, when properly performed, does not lead to pulpal anesthesia?

A. Inferior alveolar (IA)
B. Lingual
C. Posterior superior alveolar (PSA)
D. Infraorbital (IO) (true anterior superior alveolar nerve block)

A

B. Lingual

59
Q

The optimal volume of local anesthetic solution delivered for a true anterior superior alveolar (ASA) nerve block is usually about _____.

A. 0.5 mL
B. 1.0 mL
C. 1.5 mL
D. 1.8 mL

A

B. 1.0 mL

60
Q

The local anesthetic agent that is most appropriate for use in most children is _____.

A. 3% mepivacaine
B. 2% mepivacaine with 1:20,000 levonordefrin
C. 2% lidocaine with 1:100,000 epinephrine
D. 0.5% bupivacaine with 1:200,000 epinephrine

A

C. 2% lidocaine with 1:100,000 epinephrine

61
Q

Which of the following local anesthetics causes
the least amount of vasodilation?

A. Lidocaine
B. Mepivacaine
C. Bupivacaine
D. Articaine

A

B. Mepivacaine

62
Q

According to Malamed, how many cartridges of 2% lidocaine can be safely administered to a child weighing 40 lb?

A. Three cartridges
B. One cartridge
C. Nine cartridges
D. Two cartridges

A

D. Two cartridges

63
Q

If a local anesthetic has a low pKa, then it will
usually have a _____.

A. Greater potency
B. Higher degree of protein binding
C. Faster onset of action
D. Greater vasodilating potential

A

C. Faster onset of action

64
Q

Anticipating correct administration of the
(long) buccal injection, what areas will be
anesthetized?

A. Soft tissues and periosteum buccal to the
mandibular molar teeth
B. Soft tissues and periosteum lingual to the
mandibular molar teeth
C. Soft tissues and periosteum lingual to the
mandibular premolar teeth
D. Soft tissues and periosteum buccal to the
mandibular premolar teeth

A

A. Soft tissues and periosteum buccal to the
mandibular molar teeth

65
Q

Which local anesthetic is most hydrophobic
and has the highest degree of protein binding?

A. Mepivacaine
B. Lidocaine
C. Bupivacaine
D. Procaine

A

C. Bupivacaine

66
Q

A portion of which cranial nerve is anesthetized when performing an infraorbital nerve block?

A. VII
B. V
C. III
D. II

A

B. V

67
Q

Which of the following local anesthetics has
the shortest half-life?

A. Lidocaine
B. Prilocaine
C. Bupivacaine
D. Articaine

A

D. Articaine

Oral Surgery (1 decks)

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