INBDE Oral Surgery & Local Anesthesia practice questions

Question 1

A 45-year-old patient requires the extraction of tooth #19. You perform a successful inferior alveolar nerve (IAN) block. However, the patient experiences sharp pain when you apply a periosteal elevator to the buccal gingiva. Which nerve likely requires a supplemental injection?

Accepted Answer

Long buccal nerve

Answer

Mylohyoid nerve

Answer

Lingual nerve

Answer

Mental nerve

Question 2

During a routine extraction, a 22-year-old patient suddenly becomes pale, diaphoretic, and loses consciousness for 15 seconds. What is the most appropriate immediate management after stopping the procedure?

Accepted Answer

Place the patient in a Trendelenburg position and monitor vitals

Answer

Administer 0.3 mg of 1:1,000 Epinephrine IM

Answer

Place the patient in an upright position to facilitate breathing

Answer

Administer high-flow oxygen via a non-rebreather mask only

Question 3

A patient returns to the office three days after the extraction of tooth #32 complaining of a dull, throbbing ache that radiates to the ear and a foul taste in the mouth. Clinical examination shows an empty socket. What is the most appropriate treatment?

Accepted Answer

Irrigation with saline and placement of a medicated sedative dressing

Answer

Aggressive curettage of the socket to induce a new blood clot

Answer

Prescription of systemic antibiotics and warm salt water rinses

Answer

Incisional biopsy of the socket walls to rule out malignancy

Question 4

A dentist is performing an IAN block. The needle is inserted too far posteriorly and enters the parotid gland. Which clinical sign would most likely be observed?

Accepted Answer

Inability to close the eyelid on the ipsilateral side

Answer

Hematoma formation in the pterygomandibular space

Answer

Sudden blanching of the skin over the infraorbital region

Answer

Instant profound anesthesia of the tongue

Question 5

A 32-year-old patient exhibits a rapidly progressing swelling of the submandibular, sublingual, and submental spaces, accompanied by fever and elevation of the tongue. What is the most critical concern in the management of this patient?

Accepted Answer

Maintenance of a patent airway

Answer

Spread of infection to the cavernous sinus

Answer

Selection of the appropriate narrow-spectrum antibiotic

Answer

Identification of the offending tooth for immediate extraction

Question 6

Which of the following is the most appropriate first-line treatment for a patient experiencing a severe anaphylactic reaction in the dental chair?

Accepted Answer

0.3 mg of 1:1,000 epinephrine administered intramuscularly

Answer

1.8 mL of 2% lidocaine with 1:100,000 epinephrine injected intraorally

Answer

25 mg of Diphenhydramine administered orally

Answer

0.3 mg of 1:10,000 epinephrine administered intravenously

Question 7

When extracting a maxillary first molar using forceps, which movement should be emphasized to expand the alveolar bone?

Accepted Answer

Strong buccal pressure

Answer

Strong palatal pressure

Answer

Continuous rotational movement

Answer

Apical pull with a sudden jerk

Question 8

An incisional biopsy is indicated for which of the following clinical scenarios?

Accepted Answer

A 2.5 cm suspected squamous cell carcinoma on the floor of the mouth

Answer

A 0.5 cm fibroma on the buccal mucosa

Answer

A small mucocele on the lower lip

Answer

A 3 mm pigmented macule that has recently changed color

Question 9

A patient requires an extraction of tooth #3. You perform a Posterior Superior Alveolar (PSA) block and a Greater Palatine block. The patient still feels pain on the mesiobuccal aspect of the tooth. Which nerve was most likely missed?

Accepted Answer

Middle Superior Alveolar nerve

Answer

Nasopalatine nerve

Answer

Anterior Superior Alveolar nerve

Answer

Long buccal nerve

Question 10

Which instrument is specifically designed to expand the socket by acting as a wedge and should be the first instrument used to luxate a tooth?

Accepted Answer

Straight elevator

Answer

Cryer elevator

Answer

#151 forceps

Answer

Curette

INBDE Oral Surgery & Local Anesthesia practice questions

A 45-year-old patient requires the extraction of tooth #19. You perform a successful inferior alveolar nerve (IAN) block. However, the patient experiences sharp pain when you apply a periosteal elevator to the buccal gingiva. Which nerve likely requires a supplemental injection?

During a routine extraction, a 22-year-old patient suddenly becomes pale, diaphoretic, and loses consciousness for 15 seconds. What is the most appropriate immediate management after stopping the procedure?

A patient returns to the office three days after the extraction of tooth #32 complaining of a dull, throbbing ache that radiates to the ear and a foul taste in the mouth. Clinical examination shows an empty socket. What is the most appropriate treatment?

A dentist is performing an IAN block. The needle is inserted too far posteriorly and enters the parotid gland. Which clinical sign would most likely be observed?

A 32-year-old patient exhibits a rapidly progressing swelling of the submandibular, sublingual, and submental spaces, accompanied by fever and elevation of the tongue. What is the most critical concern in the management of this patient?

Which of the following is the most appropriate first-line treatment for a patient experiencing a severe anaphylactic reaction in the dental chair?

When extracting a maxillary first molar using forceps, which movement should be emphasized to expand the alveolar bone?

An incisional biopsy is indicated for which of the following clinical scenarios?

A patient requires an extraction of tooth #3. You perform a Posterior Superior Alveolar (PSA) block and a Greater Palatine block. The patient still feels pain on the mesiobuccal aspect of the tooth. Which nerve was most likely missed?

Which instrument is specifically designed to expand the socket by acting as a wedge and should be the first instrument used to luxate a tooth?

The first 10 are free. 8 more below.

A 65-year-old male with a history of stable angina becomes apprehensive during a procedure and complains of chest pain. He takes one nitroglycerin tablet, but the pain persists after 5 minutes. What is the most appropriate next step?

Which Pell and Gregory classification describes a mandibular third molar where the occlusal surface is at the same level as the occlusal plane of the second molar, but the crown is partially covered by the anterior border of the ramus?

While performing an IAN block, the dentist contacts bone much earlier than expected (at roughly half the depth of the needle). What is the most likely error in technique?

A diabetic patient begins to feel shaky, cold, and confused during a long surgical appointment. The patient is conscious. What is the first-line treatment?

Which nerve is most likely to be injured during the surgical removal of a mandibular third molar, resulting in numbness of the anterior two-thirds of the tongue?

Following the extraction of a maxillary molar, the patient is asked to perform a 'Valsalva maneuver' (blow through the nose while pinching the nostrils). The dentist observes bubbles in the socket. What is the diagnosis?

Which of the following describes the 'Wheel and Axle' mechanic of an elevator?

When performing an IAN block, what is the significance of the pterygomandibular raphe?