Oral and Maxillofacial Surgery MCQs

Bhatia’s Dentogist: MCQs in Dentistry

MCQs on Maxillofacial Injuries from Bhatia’s Dentogist

Bhatia’s Dentogist: MCQs in Dentistry

Part I : Oral and Maxillofacial Surgery

Bhatia’s Dentogist: MCQs in Dentistry
Part I : Oral and Maxillofacial Surgery (maxillofacial injuries)

Maxillofacial Injuries

1. When a minimal injury as a glancing blow is struck, to what variable it is related?
A. Position of strike
B. Area of strike
C. Angulation of strike
D. Location of strike

Glancing means striking obliquely and bouncing off at an angle. Glancing blows are combat events that can occur when fighting a mob of equal or higher level.

2. Based on champy’s principle of lines of tension and compression, the angle fracture is best treated with?
A. Compression plate
B. Fixation with AO plate
C. IMF
D. External pin fixation

During mandibular fractures, masticatory forces create tension at the upper border and compression at the lower border, causing distraction of fragments at the alveolar crest. In the canine region, both tensile and compressive loads overlap, and torsional forces are also significant.

Experimental studies on models and fractured mandibles confirmed force values of about 60 DaN in the molar region and 100 DaN in the incisal region, including the effect of torsional forces. These findings led to the definition of Champy’s “ideal osteosynthesis lines”, which follow the line of tension at the base of the alveolar process.

  • In the body of the mandible, plates are fixed with monocortical self-tapping screws.
  • Behind the mental foramen, the plate is placed below the dental roots and above the inferior alveolar nerve.
  • At the mandibular angle, the plate is ideally positioned on the broad surface of the external oblique line, as high as possible.
  • In the anterior region (between the mental foramina), a second plate is added near the lower border of the mandible, parallel to the first and 4.5 mm apart, to counteract torsional forces.

For angle fractures, the plate should be on the posterior fragment, medial to the external oblique line, bent along its surface, with posterior screws inserted nearly sagittally.

Champy’s method is based on non-compression miniplate osteosynthesis, meaning compression plates are not suitable for this technique.

3. The treatment of choice in comminuted fracture mandible is?
A. 2.5 mm plate
B. 1.5 mm plate
C. Dynamic compression plate with eccentric holes
D. Reconstruction plate with central holes

The traditional reconstruction fixation plate requires perfect adaptation to the bone to prevent displacements of fracture segments. The advantage of reconstruction plate is that it is a load bearing plate. If bone loss, severe comminution, or gross instability are present across the fracture, the reconstruction plate will provide stability and support the fracture segments during function as the fracture heals.

4. In a condylar fracture and bone plate synthesis to counteract the dynamic tension and compression zones, the most acceptable place for plating is?
A. Plate fixed laterally in neck of condyle
B. Plate on anterior and posterior border
C. Plate on posterior border only
D. Plate on anterior border only

“The mandible is exposed, via a submandibular incision, which allows access to the inferior border and entire ramus. A groove is drilled in the lateral ramus to fit in the several centimeters with in the fracture line.”

5. Champy’s plates are?
A. Semirigid fixation with monocortical screws
B. Semirigid fixation with bicortical screws
C. Rigid fixation with bicortical screws.
D. Rigid fixation with monocortical screws

MONOCORTICAL MINIPLATE OSTEOSYNTHESIS
Michelet et al developed the concept of miniplate osteosynthesis in late 1960. The original goal of miniplate osteosynthesis was to provide stable mandibular fracture reduction without requiring interfragmentary compression or maxillomandibular fixation.

6. Compression osteosynthesis heals fracture mandible by?
A. Primary union without callus formation
B. Secondary union without callus formation
C. Compression union
D. All of the above

Compression Osteosynthesis
To obtain a three dimensional stability and avoid intermaxillary fixation, the procedure of using bone plates and screws has gained momentum. In compression osteosynthesis, bicortical screws are used. It is based on the concept that when the bony fragments are pressed against each other and are held in this compressed position with axial compression, the susceptibility to infection is reduced, the healing is accelerated and there is primary repair in interfragmentary compression osteosynthesis. The following points need consideration.

7. When a mandibular fracture is transferred to an emergency room, under what is mandibular fracture treated?
A. Primary survey
B. Secondary survey
C. Primary survey with IMF
D. Resuscitation room

Primary Survey – ABCs

The primary survey is a systematic assessment used to establish treatment priorities based on the patient’s injuries, vital signs, and mechanism of trauma. Following the ATLS protocol, this stage aims to identify and manage life-threatening conditions immediately.
It proceeds sequentially as follows:

  • A: Airway maintenance with cervical spine protection
  • B: Breathing and adequate ventilation
  • C: Circulation with control of hemorrhage
  • D: Disability – neurological evaluation
  • E: Exposure / Environmental control – fully undress the patient to detect injuries while preventing hypothermia

Airway management is the top priority, particularly in head or maxillofacial trauma. Airway obstruction may result from tongue displacement, aspiration of foreign bodies, regurgitated stomach contents, or injuries to the face, mandible, trachea, or larynx.

Secondary Assessment

The secondary assessment begins after the primary survey is complete and life-threatening conditions are under control. The patient’s vital signs must be continuously monitored to evaluate treatment effects and detect any previously unnoticed life-threatening issues.
Changes in respiratory, cardiovascular, or neurological function commonly occur within the first 24 hours after trauma.

This phase starts with a subjective evaluation (a brief interview with the patient) followed by an objective examination, which includes inspection, palpation, percussion, and auscultation of the entire body:

  • Head and skull
  • Maxillofacial region
  • Neck
  • Chest
  • Abdomen
  • Extremities
  • Neurological status

These findings establish a baseline condition for the patient. At this point, additional tests like peritoneal lavage, radiographic studies, or blood tests may be performed.

Tertiary Survey

The tertiary survey involves repeated, thorough examinations and a careful review of all radiologic and laboratory results. Its purpose is to identify injuries missed during initial evaluations. Continuous and detailed reassessment significantly improves patient outcomes.
Orthopedic injuries are particularly prone to being missed early, especially those in the upper limbs, spine, or around major joints.

8. Most common cause Pulmonary embolism is?
A. Thrombophlebitis
B. End arteritis
C. Atherosclerosis
D. Lymphangitis

Pulmonary Thromboembolism – In principle, thrombi forming anywhere in the venous circulation can embolize to the lung. In practice more than 90% of clinically significant emboli arises in deep veins of the legs and thigh and are associated with venous stasis.
Thrombophlebitis Migrans – Is a clinical, but not morphologic, condition characterized by recurrent episodes of venous thrombosis of the extremities and viscera

9. A full thickness wound having length greater than depth caused by a sharp object is described as?
A. Slab wound
B. Slash wound
C. Lacerated wound
D. Incision wound

Incised wounds
Incised wounds are sharp cut-like injuries, made by knives or broken glass etc. The edges of the wound will vary according to the nature of the cutting edge of the object, in that a razor will leave regular margins, whereas an axe may leave tilted wound margins crushed and bruised, resembling a laceration.
Slash Wounds
These are wounds where the length is greater than the depth,Eg: A slice wound across the skin. If the wound involves major blood vessels, it can be life threatening, but in general, they are not as serious as stab wounds.
Stab Wounds
These are wounds where the depth of injury is greater than the length. They penetrate more deeply than slash wounds and tend to come into contact with vital organs in the chest and abdomen.

10. In lingual splaying of guardsman fracture with ORIF, which is the clinical feature?
A. Increased intercanthal distance
B. Increased interpupillary distance
C. Increased gonion – gnathion distance
D. Increased interangular distance

The type of mandibular fracture more prone for complication is Symphyseal fracture associated with condylar fractures and poor dentition. In this type of fractures muscle pull from the tongue and suprahyoids can cause lateral flaring of the mandibular angles and lingual tipping of the buccal segments. The buccal fracture line at the symphysis remains intact, but the lingual cortex is separated.
Increased flaring is seen when bilateral subcondylar fractures are also present”. Guardsman fracture is also termed as “parade ground fracture

11. In condylar fracture with greater than 5mm overlapping and greater than 37° angulation with fracture segment, what is the line of treatment?
A. Closed reduction and IMF
B. ORIF
C. Soft diet
D. No treatment

Greatly displaced and dislocated fracture (separation of fragment more than 5mm and displacement more than 30°) increasingly are being treated surgically a functional conservative treatment is worth considering in less severely dislocated fractures.

12. In a patient with 15% Blood loss, the immediate management is?
A. Immediate Blood replacement
B. Blood transfusion is not required
C. Aggressive replacement of crystalloid only
D. Aggressive replacement of crystalloid and Blood

13. In mass casualty cases, the mechanism to sort out patient is?
A. Treating 1st patients with life threatening condition
B. Treating patient with higher chances of survival with least available infrastructure.
C. Treating patient with multiple organ failure and that need equipment and mobility
D. None.

Simple triage is usually used in a scene of mass casualty accident, in order to sort patients into those who need critical attention and immediate transport to the hospital and those with less serious injuries. This step can be started before transportation becomes available. The categorization of patients based on the severity of their injuries can be aided with the use of printed triage tags or coloured flagging.

14. A patient with head injuries, glass gow coma scale 8, having mid face fracture, cyanoses and decreased breathing with frequent apneea and low oxygen management, the method of airway maintenance is?
A. Oropharyngeal airway
B. Orotracheal airway
C. Nastotracheal airway
D. Cricothyrotomy

INDICATIONS FOR CRICOTHYROTOMY
– Maxillofacial trauma; obstruction of the airway from massive facial trauma is the most common indication for cricothyrotomy.
– Oropharyngeal obstruction; edema secondary to infection, allergic reaction, thermal and caustic injuries, foreign body, and mass lesions, when oral and nasal intubation is not possible
– Condition in which tracheal intubation is from above is either contraindicated or unsuccessful, such as with congenital malformation, massive haemorrhage; persistent vomiting, unremitting laryngospasm

15. Paresthesia is seen with which of the following types of fractures:
A. Subcondylar
B. Zygomaticomaxillary
C. Coronoid process
D. Symphyseal

16. Pathognomic sign of mandibular fracture:
A. Malocclusion
B. Hematoma (Sublingual)
C. Tenderness and swelling at site
D. Inability to open mouth

17. Fracture of mandible distal to last tooth, treatment of choice:
A. Closed reduction with IMF
B. Open reduction with Bone Plating
C. Open reduction with interosseous wiring
D. Closed reduction with cap splint

18. An average patient with maxillofacial trauma requires how much of daily sodium:
A. 100 mmol
B. 50-60 mmol
C. 10 mmol
D. 1000 mmol

19. With rigid internal fixation by bone plates it is expected that healing takes place by:
A. Primary healing
B. Fibrous healing
C. Scarification
D. Exuberent callus formation

20. In dislocated condylar fractures, the condyle is dislocated:-
A. Medially due to attachment of medial pterygoid
B. Laterally due to attachment of lateral pterygoid
C. Laterally due to attachment of medial pterygoid
D. Medially due to attachment of lateral pterygoid

21. Battles sign is:
A. Subconjunctival ecchymosis
B. Sublingual ecchymosis
C. Palatal ecchymosis
D. Ecchymosis in the mastoid region

22. The safe dose of adrenaline in a patient with compromised cardiac condition is:
A. 0.2 mg
B. 0.02 mg
C. 0.4 mg
D. 0.04 mg

23. The unlunited fracture of condyle with anatomical dysfunction that occurs after the development of condyle in Tempero mandibular joint abnormality is termed as?
A. Mylarthrosis
B. Dysarthrosis
C. Pseudoarthrosis
D. Ankylosis

24. A male patient of 40 years got a blow on the angle region of mandible and he is asymptomatic. The X-rays of that region shows a radiopaque line in angle region. The inferior border shows a very sharp undercut on the inferior surface. This all feature shows?
A. Sutural diastasis
B. Overlapping sign
C. Separation sign
D. Non union

25. A 25-year-old patient with Lefort-II, Lefort-III and nasoethmoidal fracture with intermaxillary fixation done is best intubated by?
A. Nasal
B. Oral
C. Submental
D. All of the above

26. Most common complication that occur in open reduction of fracture is?
A. Infection
B. Non-union
C. Fibrous union
D. Hemorrhage

27. Lefort I Fracture is characterized by?
A. Bleeding from the ear
B. Bleeding from the maxillary antrum
C. Anterior open bite
D. Angle Class II skeletal relationship on fracture site

28. Non-Union of fracture is due to?
A. Mobility of fracture site
B. Bone loss due to infection.
C. Early mobilization
D. None of above

29. All of the following are present in pterygomandibular space except?
A. Nerve to mylohyoid
B. Chorda tympani
C. Long buccal nerve
D. Nerve to pterygoid

30. In ASTHMATIC patient, treatment is usually done in?
A. Morning
B. Afternoon
C. Evening
D. Not done at all

31. Which of the following can be used to stop bleeding from extraction socket?
A. Vitamin K
B. Suturing of the wound margin
C. Bone Wax
D. None

32. In which mandibular fracture the tongue fall backwards?
A. Symphysis Fracture
B. Bilateral Mandibular Body Fracture
C. Bilateral Parasymphysis Fracture
D. Bilateral Angle Fracture

33. A patient with Condylar Fracture, the occlusion is normal with normal mouth opening. The best treatment is?
A. IMF for 3 Weeks
B. IMF for 5-6 Weeks
C. Conservative treatment, close observation & soft diet & return to as normal function as possible.
D. Open reduction and bone plating.

34. Which of the following is a direct interdental wiring method?
A. Gilmer’s Wiring Method
B. Col stout’s Wiring Method
C. Ivy Islet Wiring Method
D. Riadon’s Wiring Method

35. The Sub-conjunctival hemorrhage remains bright red in color for a long time because?
A. Permeability of the conjunctiva to oxygen
B. Natural color of blood
C. Lack of drainage of the pooled blood
D. None

36. Which treatment plan will leads to rigid fixation of the fracture site?
A. Direct Interdental Wiring
B. Miniplate Osteosynthesis
C. Eccentric Compression Plate Osteosynthesis
D. IMF

37. In CPR, the sternum should be depressed at a rate of?
A. 1 Inch Per 1 Second
B. 2 Inch Per 1 Second
C. 1 Inch Per Second
D. 2 Inch Per 5 Second

38. In Blow-Out fracture which of the following is seen?
A. Enophthalmos
B. Exophthalmos
C. Bulbar Hemorrhage
D. Conjunctival Hemorrhage

39. Following bilateral mandibular fracture in the canine region (Parasymphysis), the following muscles will tend to pull the mandible back?
A. Anterior belly of digastric genihyoid and geniglossus
B. Genihyoid geniglossus and mylohyoid
C. Mylohyoid, hyoglossus and sternohyoid
D. Hyoglossus, mylohyoid and geniglossus

40. All of the following are features of mandibular fracture except?
A. Malocclusion and gagging of occlusion
B. Paresthesia lip
C. Fractured ends are prevented from dislocations by muscles
D. Are usually compound

41. Patient with unfavorable fracture of the angle of mandible is best treated by?
A. Closed reduction with IMF
B. Closed reduction with cap splint
C. Circumnandibular wiring
D. Open reduction with bone plate fixation

42. Incision in hair line at 45 degree to zygomatic arch best describe as?
A. Gilli’s incision
B. Alkymat-Bramly incision
C. Risdon’s incision
D. Moore’s incision

43. Hemorrhage secondary to heparin administration can be corrected by administration of?
A. Vitamin K
B. Whole blood
C. Protamine
D. Ascorbic acid

44. Which of the following is correct reason of facial nerve injury during forceps delivery in labour?
A. The mastoid process is absent at birth
B. The parotid gland is in developing stage
C. The beak of the forceps engages the main trunk of facial nerve
D. The sublingual hematoma during delivery causes neuropraxia

45. During CPR, the chest compression should be:
A. 2 inch/second
B. 1 inch/second
C. 2 inch/5 seconds
D. 1 inch/5 seconds

46. In case of suspected fracture, area demonstrating increase in radiopacity is described by:
A. Separation sign
B. Overlapping sign
C. Corman’s sign
D. Battle’s sign

47. The muscle, under the influence of which, the superior fragment of condyle, in a condylar neck fracture is displaced anteriorly and medially is:
A. Medial pterygoid
B. Lateral pterygoid
C. Masseter
D. Temporalis

48. The radiographic view of choice for diagnosing horizontally favourable and unfavourable fracture is:
A. OPG
B. Occlusal
C. Lateral oblique view
D. Transpharyngeal

49. The radiographic view of choice for demonstrating a nasal fracture is:
A. Reverse towne’s
B. PA view
C. True lateral
D. OPG

50. In a patient with Le Fort II, Le Fort III, and naso-ethmoid fracture, what is the choice of intubation?
A. Oral
B. Oral and nasal
C. Nasal
D. Submental

51. The intercantinal distance suggestive of traumatic telecanthus is:
A. 30 mm
B. 32 mm
C. 25 mm
D. 40 mm

52. Which of the following is used for ‘Figure of eight’ wiring for stabilization of subluxated teeth in alveolar injuries:
A. 0.23 mm stainless steel wire
B. 0.35 mm stainless steel wire
C. 0.45 mm stainless steel wire
D. 0.55 mm stainless steel wire

53. Anterior open bite occurs in fracture of:
A. Symphysis
B. Bilateral angles
C. Bilateral condyles
D. Unilateral condyle

54. Zygomatic arch fractures are best seen in:
A. Submentovertext view
B. Occipitomental view
C. Lateral view of skull
D. Postero-anterior view of skull

55. Bilateral subconjunctival ecchymosis is not associated with:
A. Le Fort II fracture
B. Le Fort III fracture
C. Naso ethmoidal complex fracture
D. Le Fort I fracture

56. In Gillies temporal approach for reduction of Zygomatic arch fracture, Rows zygomatic elevator is placed between:
A. Superficial fascia and the temporal fascia
B. Between the temporal bone and the temporalis muscle
C. Between the temporal fascia and the temporalis muscle
D. Skin and superficial fascia

57. The most common site of leak in CSF rhinorrhoea is:
A. Sphenoid sinus
B. Frontal sinus
C. Cribriform plate
D. Tegmen tympani

58. A patient with maxillofacial injuries should be carried in:
A. Supine position
B. Lateral position
C. Prone position
D. Sitting position

59. A patient with maxillofacial injuries should be carried in a supine position only when there is:
A. Spinal, cervical injury
B. Bilateral parasymphysis fracture
C. Unconsciousness
D. Excessive mobility of fractured maxilla

60. Tongue-tie is indicated in:
A. Bilateral parasymphysis fracture
B. Unconscious patient
C. Chin has been destroyed in gunshot
D. All of the above

61. Immediate management of nasal bleed in facial injuries is:
A. Reduction of nasal bones manually
B. Paraffin gauze packing
C. Positioning the patient in supine position
D. Positioning the patient in prone position

62. Glasgow Cona Scale is used:
A. To ascertain motor responsiveness
B. Verbal responsiveness
C. Eye response
D. To ascertain level of consciousness

63. Examination of pupils is of paramount importance in maxillofacial injuries because it indicates:
A. Trauma to brain
B. Trauma to optic tract
C. Progress of patient after trauma
D. All of the above

64. The method commonly used to differentiate nasal discharge from CSF in fracture of middle third of face:
A. Examining level of glucose
B. Examining level of chlorides
C. Drying the discharge on a piece of cloth
D. Examining the level of proteins

65. Placing a nasal pack during nasal bleeding and CSF leak carry the danger of:
A. Fracture of ethmoidal plates
B. Redirecting the CSF to oropharynx
C. Metingitis
D. Redirecting CSF to orbit

66. A patient with maxillofacial injury complains of regurgitation, absence of gag reflex and weakening of voice, he may have:
A. Laryngeal trauma
B. Injury to middle cranial fossa
C. These symptoms are due to acute pain
D. Paralysis of IX N

67. The crystalloid which should be given first, after maxillofacial trauma:
A. Normal saline
B. 5% dextrose
C. Ringer’s lactate
D. 10% dextrose

68. Hypovolumic shock develops after loss of:
A. 10% blood
B. 20% blood
C. 30% blood
D. 40% blood

69. Facial wounds can be considered for primary closure when they report within:
A. 24 hrs
B. 72 hrs
C. 36 hrs
D. 48 hrs

70. The most important step in suturing lacerated lip:
A. Apposition of muscular layer
B. Apposition of vermilion border
C. Apposition of mucosal layer
D. All of the above

71. Failure of primary suturing occurs in facial wounds when:
A. Fine silk has not been used
B. Cagut has been used
C. Dead space develops
D. Continuous suturing is done

72. A patient presents with lateral subconjunctival haemorrhage. Infraorbital step and diplopia on right side with inability to open mouth, he can be having:
A. Fracture subcondylar right side
B. Fracture zygoma right side
C. Fracture Le Fort II right side
D. Fracture of floor of the orbit

73. A patient presents with bilateral infraorbital step, paraesthesia on left cheek region, with posterior gagging, and mobility of maxillary complex at nasal bones, it indicates:
A. Bilateral fracture zygoma
B. Bilateral fracture Le Fort II
C. Fracture zygoma left side with bilateral Le Fort II
D. Fracture bilateral subcondylar and fracture zygoma left side

74. Diplopia would result if fracture line around zygomatic-frontal suture passes:
A. Below the Whitnall’s tubercle
B. Above the Whitnall’s tubercle
C. Through zygomatico-frontal suture
D. Tearing the periosteum of orbital surface of zygomatic bone

75. A patient complains of diplopia following fracture zygoma, this is because of:
A. Fracture of orbital floor
B. Entrapment of medial rectus
C. Entrapment of superior oblique
D. All of the above

76. Traumatic telecanthus is associated with:
A. Bilateral Le Fort II fracture
B. Nasoethmoidal injury
C. Fracture nasal bones
D. Bilateral fracture zygoma with enophthalmos

77. Guerin sign is presence of:
A. Ecchymosis at mastoid area
B. Ecchymosis at greater palatine foramen area
C. Ecchymosis in zygomatic buttress area
D. Ecchymosis in sublingual area

78. Battle’s sign is associated with:
A. Fracture zygoma
B. Fracture anterior cranial fossa
C. Fracture middle cranial fossa
D. Fracture nasoethmoid

79. The differentiating feature of bleeding due in black eye and that due to fracture of orbit is/are:
A. Circumorbital ecchymosis in black eye develops rapidly
B. Posterior limit of subconjunctival haemorrhage cannot be seen in black eye
C. Posterior limit of subconjunctival haemorrhage can be seen in black eye
D. None of the above

80. The typical ‘cracked pot’ sound on percussion of upper teeth is indicative of fracture:
A. Le Fort I
B. Le Fort II
C. Le Fort III
D. All of the above

81. Guerin type fracture is same as fracture:
A. Le Fort I
B. Le Fort II
C. Suprazygomatic
D. Le Fort III

82. In Le Fort I fracture infraorbital rim is:
A. Bilaterally involved
B. Not involved
C. Involved medially
D. May or may not be involved

83. ‘Moon face’ appearance is not present in fracture:
A. Le Fort I
B. Le Fort II
C. Zygomatic complex
D. Le Fort III

84. Ecchymosis at zygomatic buttress would indicate fracture:
A. Le Fort I
B. Le Fort II
C. Zygoma
D. All of the above

85. ‘Dish face’ deformity commonly seen with fractures of middle third of face is because of:
A. Posterior and downward movement of maxilla
B. Anterior and forward movement of maxilla
C. Anterior and downward movement of maxilla
D. Nasal complex fracture

005E0E

87. There is tenderness at ZF suture, with hooding of eyes and step at zygomatic arches with disturbed occlusion, a possible diagnosis would be:
A. Fracture zygoma and zygomatic arch
B. Fracture zygoma with paralysis of III nerve causing hooding
C. Fracture Le Fort II and fracture zygoma
D. Fracture Le Fort III

88. On moving the maxilla bimanually, movement is felt at ZF suture area in a case of middle third fracture of face, it is indicative of fracture:
A. Le Fort I
B. Le Fort II
C. Le Fort III
D. Zygoma

89. Step and mobility at infraorbital margin and step at ZF region would indicate fracture:
A. Le Fort III and Le Fort II
B. Le Fort II and zygoma
C. Le Fort III and zygoma
D. None of the above

90. Fracture Le Fort II involves the following bones:
A. Frontal process of maxilla, nasal, lacrimal
B. Frontal process of maxilla, lacrimal ethmoidal
C. Frontal maxilla and nasal
D. Maxilla, frontal process of zygoma, nasal and lacrimal

91. A patient presents with open bite on left side and with tenderness at nasal bones, it could be fracture:
A. Unilateral Le Fort I on right side
B. Subcondylar on left side and zygoma on right side
C. Le Fort II on right side
D. Zygoma on right side and subcondylar on right side

92. In a crown-root fracture of the tooth, if fracture is not below alveolar bone and pulp is not exposed the tooth should be:
A. Endodontically restored
B. Extracted
C. Only jacket crown given
D. Observed for 3-6 weeks

93. If there is root fracture in apical third of tooth without mobility:
A. Tooth should be extracted
B. Treated endodontically
C. No treatment and periodic review
D. None of the above

94. In replanting an avulsed tooth:
A. It should be thoroughly made sterile
B. Root filling with apicocotomy should be done
C. There is failure due to external root resorption
D. All of the above

95. High rate of fractures at canine region of mandible is due to:
A. Change of direction of forces occurring here
B. Long canine root
C. Lower border is thin in this area
D. Alveolus is thin in this area

96. Fracture of coronoid process can occur due to:
A. Trauma at chin region
B. Trauma from posterior region
C. Reflex muscular contraction
D. Lateral trauma

97. Respiratory embarrassment can occur in fracture:
A. Angle
B. Parasymphysis
C. Bilateral parasymphysis
D. Bilateral subcondylar

98. A patient reported with deviation of jaw to the right side on opening and bleeding from the right ear, is a typical picture of:
A. Left-subcondylar fracture
B. Right-subcondylar fracture
C. Right-subcondylar with fracture of anterior cranial fossa
D. None of the above

99. A patient with bilateral subcondylar fracture presents with:
A. Inability to open mouth
B. On opening mandible moves forward
C. Anterior open bite
D. Closed bite

100. The term vertical in ‘vertical favourable’ fractures connotes:
A. The fracture line running in vertical direction
B. The displacement of fracture is in vertical plane
C. The direction of view of the observer is in vertical direction
D. Fracture can be reduced vertically

101. A horizontally unfavourable fracture of angle of mandible runs from:
A. Lingual plate anteriorly backward through buccal plate posteriorly
B. Upper border downward and forward
C. Upper border downward and backward
D. None of the above

102. Best radiograph for fractures of middle third of face:
A. Submentovertex
B. Reverse Towne’s view
C. OPG
D. Occipitomental view

103. To find if fracture of angle mandible is vertically favourable or unfavourable the radiograph advised:
A. PA view mandible
B. Lateral oblique 30° mandible
C. Occipitomental view
D. Lateral oblique 15° mandible

104. Submentovertex view is an ideal view for diagnosing fracture of:
A. Zygoma
B. Zygomatic arch
C. Horizontal fracture of mandible
D. Nasoethmoid region

105. There is absolute indication for extraction of a tooth which is present in the fracture line when there is:
A. Longitudinal fracture of tooth involving the root
B. Infected fracture line
C. Dislocation of tooth from its socket
D. All of the above

106. Gunning type splints are used when patient is:
A. Edentulous in one jaw
B. Edentulous in both jaws
C. When vertical relation is not known
D. All of the above

107. A 7-year old boy presented with fracture of left subcondylar region with occlusion undisturbed, the treatment would be:
A. Immobilisation for 7 days
B. Immobilisation for 14 days with intermittent active opening
C. No immobilisation with restricted mouth opening for 10 days
D. No immobilisation and active movement

108. A 32-year-old female patient reported with bilateral subcondylar fracture with anterior open bite, the treatment would constitute:
A. IMF for 6 weeks
B. Distraction with rubber stoppers and anterior traction followed by IMF for 4-6 weeks
C. IMF for 4 weeks
D. Distraction with rubber stoppers and posterior traction followed by IMF for 4-6 weeks

109. While doing circum-mandibular wiring there are chances of injuring:
A. Facial nerve
B. Facial artery, vein
C. Epiglottis
D. Lingual nerve

110. The submandibular incision for approaching angle fracture is placed one finger breadth below the lower border of mandible:
A. To keep the incision line masked
B. To prevent injury to facial vessels
C. To prevent injury to marginal mandibular nerve
D. Access becomes easy

111. If fracture angle result following extraction of mandibular impacted 3rd molar the immediate treatment should be:
A. IMF only
B. Bone plating (under GA)
C. Superior border transosseous wiring and IMF
D. Transosseous wiring at the lower border and IMF

112. In old patients, open reduction and fixation should be done with great care to:
A. Prevent iatrogenic fracture of atrophic mandible
B. Detach minimum of periosteum
C. Prevent dislocation of condyle
D. None of the above

113. Walsham’s forceps are used for:
A. Disimpaction of maxilla
B. Reduction of maxilla fractures
C. Reduction of fracture nasal bones
D. Ash septal force

114. Following are the examples of rigid fixation:
A. Lateral frontal suspension
B. Extraskeletal pin fixation
C. Bone plating
D. B and C

115. Indirect reduction of fracture zygoma can be done by:
A. Gillies approach
B. Intraoral approach
C. Percutaneous approach
D. All of the above

116. To fix a zygomatic fracture by open reduction following sites have to approached:
A. Zygomatic, frontal and infraorbital
B. Infraorbital and zygomaticotemporal
C. A and B
D. Zygomaticofrontal, zygomatic prominence and, floor of orbit

117. The mini-boneplate system is a:
A. Compressive bone plating system
B. Monocortical system
C. Bicortical system
D. None of the above

118. The best and most effective position (in mandible) of mainplate as proved by various experimental studies is:
A. Lower border of mandible
B. Buccoalveolar region
C. Linguoalveolar region
D. At a height midway between superior alveolar region and lower border of mandible

119. The minimum number of mainplates required in fractures anterior to canine in mandible is:
A. No plate is required since anterior region develops less amount of tension forces than in molar region
B. Only one plate as in molar region
C. Two plates
D. Three plates

120. Minimum number of screws required for fixation of mainplate are:
A. One screw on each side of fracture site
B. Two screws on each side of fracture site
C. Three screws on each side of fracture site
D. Two screws in smaller fragment and three screws in larger fragment

121. The optimum length of screw, for fixation of plate in mandible is:
A. 2 mm
B. 3 mm
C. 4 mm
D. 6 mm

122. In a fracture of mandible at the angle-region the placement of screws in proximal segment is in:
A. Sagittal plane
B. Horizontal plane
C. Such a close relation to teeth that injury to molar invariably occurs
D. No relation to teeth

123. To prevent injury to the apices of the teeth in mandible, the placement of mainplate is:
A. At the lower border of mandible
B. At a distance; twice the height of the clinical crown below the alveolar crest
C. Below the inferior alveolar canal
D. Not possible since alveolar bone bears the apices of the teeth

124. The most commonly injured tooth during the placement of mainplate for the fracture of mandible in anterior region may be:
A. Central incisor
B. Lateral incisor
C. Canine
D. 1st premolar

125. In a fracture of symphysis region in the mandible:
A. Subapical and lower border plates should be fixed simultaneously
B. Subapical plate should be fixed first followed by lower border plate
C. Lower border plate should be fixed first followed by subapical plate
D. None of the above

126. In fractures of mandible in elderly patients, fixation of plate is:
A. Submucosal
B. Supraperiosteal
C. Subperiosteal
D. None of the above

127. The contraindication to miniplate along the line of osteosynthesis would be:
A. A comminuted fracture
B. An infected fracture site
C. A fracture in 10-year-old
D. When more than one fracture site exists in mandible

128. Stress shielding effect is seen in:
A. Miniplating
B. Compression bone plating
C. Lag screw
D. Transosseous wiring

129. During compression bone plating which type of healing would not be observed:
A. Contact healing
B. Gap healing
C. Primary healing
D. Secondary healing

130. The spherical gliding principle is a feature of:
A. Miniplates
B. Luhr plating
C. ASIF plating
D. Lag screws

131. In Luhr system of plating, the two individual compression screws move through:
A. 1 mm
B. 1.6 mm
C. 3.2 mm
D. 4 mm

132. The whole of middle third of face can be approached by:
A. Infraorbital incisions
B. Bicoronal flap
C. Alkayat and Brumley approach
D. Transconjunctival approach

133. Epiphora results due to:
A. Blockage of lacrimal gland canaliculi
B. Blockage of nasolacrimal duct
C. Overactivity of lacrimal glands
D. Evulsion of palpebral conjunctiva

134. The most common site of mandible, which shows non union or delayed union after IMF is:
A. Angle
B. Body
C. Symphysis
D. Ramus

135. Acceptable treatment modality for fracture mandible in 8-year old is:
A. Transosseous wiring since IMF cannot be done
B. IMF for 3 weeks
C. Circum-mandibular splinting
D. AO bone plating

136. Risdon wiring is indicated for:
A. Body fracture
B. Angle fracture
C. Symphysis fracture
D. Subcondylar fracture

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