Orthognathic, Cleft, Craniofacial

Question 1

Distraction osteogenesis consists of an osteotomy followed by distraction:
(A) in 1-3 days.
(B) in 5-7 days.
(C) in 10-12 days.
(D) after consolidation.

Answer 1

B

Question 2

n 8 year-old patient with unilateral cleft lip and palate has an unrepaired residual oronasal fistula. Your treatment plan may include:
(A) rotation of incisors prior to grafting.
(B) expanding the maxilla.
(C) maintaining the primary teeth in the cleft site.
(D) using an alloplastic bone substitute in the site.

Answer 2

B

Question 3

The most common speech alteration that might occur as a complication of LeFort I advancement in a repaired cleft palate patient is:
(A) denasality.
(B) frontal distortion.
(C) lateral distortion.
(D) hypernasality.

Answer 3

D

Question 4

Antibiotics in orthognathic surgical procedures:
(A) are contraindicated.
(B) reduce the incidence of infection.
(C) increase the risk of osseous necrosis.
(D) are most effective when started 2 days before surgery.

Answer 4

B

Question 5

The simultaneously performed genioplasty and sagittal split osteotomy:
(A) decreases the risk of inferior alveolar nerve sensory loss.
(B) should not be performed simultaneously.
(C) increases the risk of inferior alveolar nerve sensory loss.
(D) has no effect on the risk of inferior alveolar nerve sensory loss.

Answer 5

C

Question 6

Which of the following is the most stable surgical procedure?
(A) Maxillary inferior repositioning
(B) Segmental maxillary expansion
(C) Maxillary superior repositioning
(D) Mandibular advancement

Answer 6

C

Question 7

Which class of medication used for restless leg syndrome in the OSA patient has the highest incidence of rebound?
(A) Benzodiazepines
(B) Dopamine agonists
(C) Antiepileptics
(D) Opioids

Answer 7

B

Question 8

Which procedure offers the “mouth breather” decreased resistance to nasal airflow?
(A) Segmental LeFort I osteotomy
(B) Surgically assisted maxillary expansion (SAME)
(C) Mandibular narrowing
(D) Mandibular widening

Answer 8

B

Question 9

Relapse associated with mandibular distraction osteogenesis is reduced by simultaneous expansion of:
(A) muscles.
(B) ligaments.
(C) tendons.
(D) cartilage.

Answer 9

A

Question 10

Mandibular distraction has become a reliable procedure in the management of the following craniofacial deformities?
(A) Hemifacial microsomia
(B) Crouzon’s Disease
(C) Apert’s Disease
(D) Craniosynostosis

Answer 10

A

Question 11

Distraction osteogenesis consists of an osteotomy followed by distraction:
(A) in 3 days.
(B) in 7 days.
(C) in 10 days.
(D) after consolidation.

Answer 11

B

Question 12

An 8 year-old patient with unilateral cleft lip and palate has an unrepaired residual oronasal fistula. Your treatment plan may include:
(A) rotation of incisors prior to grafting.
(B) expanding the maxilla.
(C) maintaining the primary teeth in the cleft site.
(D) using an alloplastic bone substitute in the site.

Answer 12

B

Question 13

The most common speech alteration that might occur as a complication of LeFort I advancement in a repaired cleft palate patient is:
(A) denasality.
(B) frontal distortion.
(C) lateral distortion.
(D) hypernasality.

Answer 13

D

Question 14

Antibiotics in orthognathic surgical procedures:
(A) are contraindicated.
(B) reduce the incidence of infection.
(C) increase the risk of osseous necrosis.
(D) are most effective when started 2 days before surgery.

Answer 14

B

Question 15

The simultaneously performed genioplasty and sagittal split osteotomy:
(A) decreases the risk of inferior alveolar nerve sensory loss.
(B) should not be performed simultaneously.
(C) increases the risk of inferior alveolar nerve sensory loss.
(D) has no effect on the risk of inferior alveolar nerve sensory loss.

Answer 15

C

Question 16

Which of the following is the most stable surgical procedure?
(A) Maxillary inferior repositioning
(B) Segmental maxillary expansion
(C) Maxillary superior repositioning
(D) Mandibular advancement

Answer 16

C

Question 17

A maxillomandibular transverse discrepancy of up to \_\_\_\_\_ mm can be treated orthodontically without surgery.
(A) 5
(B) 7
(C) 9
(D) 11

Answer 17

A

Question 18

Which procedure offers the “mouth breather” decreased resistance to nasal airflow?
(A) Segmental LeFort I osteotomy
(B) Surgically assisted maxillary expansion (SAME)
(C) Mandibular narrowing
(D) Mandibular widening

Answer 18

B

Question 19

Relapse associated with mandibular distraction osteogenesis is reduced by simultaneous expansion of:
(A) muscles.
(B) ligaments.
(C) tendons.
(D) cartilage.

Answer 19

A

Question 20

Mandibular distraction has become a reliable procedure in the management of the following craniofacial deformities?
(A) Hemifacial microsomia
(B) Crouzon’s Disease
(C) Apert’s Disease
(D) Craniosynostosis

Answer 20

A

Question 21

The percentage of soft tissue to bony advancement associated with an anterior horizontal sliding osteotomy (genioplasty) of the mandible typically is:
A. 20-30
B. 40-50
C. 60-70
D. 80-90

Answer 21

ANSWER: D
RATIONALE:
While results of soft tissue advancement can vary depending on technique, a true horizontal genioplasy with a broad based soft tissue pedicle (standard technique) will result in an 80-90% soft tissue advancement.
REFERENCE:
Betts, Norman J and Fonseca, Raymond J. Soft Tissue Changes Associated with Orthognathic Surgery. In: Modern Practice in Orthognathic and Reconstructive Surgery. Ed. William H. Bell. W.B. Saunders Company. Philadelphia, PA. 1992. pp.2171-2209.

Question 22

Which of the following describes the effects of intrinsic aging of the skin that are noted histologically?
A. dermal collagen production increases
B. the epidermis thickens
C. dermal elastin production decreases
D. rete pegs are promoted and enhanced

Answer 22

ANSWER: C
RATIONALE:
Dermal elastin production decreases with age. Generalized age-related dermal atrophy incledues decreased rete peg, epidermal thinning, and decreased dermal collagen production.
REFERENCE:
Obagi, S, Bridenstine, J: Lifetime Skin Care. Oral & Maxillofacial Surgery Clinics of North America Vol 12, No 4. Nov 2000, p 533.

Question 23

The normal distance in Caucasians from the upper eyelid margin to the superior tarsal crease is usually:
A. 3 millimeters
B. 5 millimeters
C. 10 millimeters
D. 15 millimeters

Answer 23

ANSWER: C
RATIONALE:
The supratarsal crease is generally 9-10 millimeters above the lash line of the upper eyelid in Caucasians. The crease represents an area where fibers from the levator aponeurosis attach to the posterior surface of the skin.
REFERENCE:
Karesh, JW: Blepharoplasty. Atlas of Oral & Maxillofacial Surgery Clinics of North America Vol 6, No 2. Sept 1998, pp 88 & 95.

Question 24

During closed rhinoplasty, delivery of the lower lateral cartilages requires the surgeon to perform a marginal incision and which other incision?
A. intercartilaginous
B. transfixion
C. Killian
D. transcolumellar

Answer 24

ANSWER: A
RATIONALE:
During closed rhinoplasty, delivery of the lower lateral cartilages requires the use of a marginal incision and an intercartilaginous incision. The transfixion incision connects the right and left nares through the columnella and is near the caudal edge of the cartilaginous septum, not the lower lateral cartilage. The Killian incision is used to approach the septum. The transcolumnellar incision is used in open rhinoplasty.
REFERENCE:
Kennedy, BD, Cosmetic Rhinoplasty, in Oral And Maxillofacial Surgery Vol 6 , Fonseca, RJ editor WB Saunders Co, 2000. p 326.