1. Which of the following is not an advantage of marsupialisation
a) Exposure of very little bone
b) Preservation of vital structure
c) Rapid healing
d) Conserve surgical structures
✅Explanation:
Marsupialization is a conservative procedure where the cyst is opened and sutured to the oral mucosa to reduce its size gradually. It helps preserve vital structures and minimizes bone exposure. However, healing is slow, not rapid, because the cyst cavity closes gradually over time.
2. Needle aspiration of a central bone lesion is useful
a) To rule out a vascular lesion
b) To determine thickness of buccal plate
c) To diagnose traumatic bone cyst
d) To feel root surfaces
✅Explanation:
Needle aspiration is performed before surgical exploration to ensure that the lesion is not vascular (like a central hemangioma). If blood is aspirated under pressure, it indicates a vascular lesion, and surgery must be avoided to prevent severe bleeding.
3. Which of the following surgery is indicated for the removal of the 3cm ameloblastoma involving the inferior border of the mandible
a) Enucleation
b) Fulgration
c) Cryosurgery
d) Resection
✅Explanation:
Ameloblastoma is a locally aggressive tumor with high recurrence if not completely removed. A large lesion (3 cm) involving the inferior border of the mandible requires resection with a margin of healthy bone to prevent recurrence.
4. The aspirate from a keratocyst will have:
a) A low soluble protein content
b) A high soluble protein content
c) Cholesterol crystal
d) inflammatory cells
✅Explanation:
The aspirated fluid from an odontogenic keratocyst (OKC) typically has low protein content (<4 g/100 mL) and a thin, straw-colored consistency due to the keratinous nature of the cyst lining, which does not produce much exudate.
5. An empty cavity in the mandible with no lining is mostly likely to be:
a) Aneurysmal bone cyst
b) Idiopathic bone cavity
c) Dentigerous cyst
d) Keratocyst
✅Explanation:
Also known as a simple bone cyst or traumatic bone cyst, this lesion appears as an empty bone cavity without epithelial lining. It’s not a true cyst and is often discovered incidentally on radiographs.
6. A 14 year old boy has delayed eruption of the second molar. Radiography shows a dentigerous cyst surrounding the crown of the tooth. The treatment of choice is:
a) Extraction of the molar
b) Aspiration of the cyst
c) Observe
d) Expose the crown and keep it exposed
✅Explanation:
In a young patient, the goal is to preserve the developing tooth. Marsupialization or surgical exposure allows the cyst to decompress, enabling the tooth to erupt naturally rather than extracting it.
7. Expected surgical procedure most frequently indicated for odontogenic cysts is:
a) Incision and drainage
b) Sclerosing solution
c) Marsupialisation
d) Enucleation
✅Explanation:
Enucleation involves complete surgical removal of the cyst lining. It’s the most common and definitive treatment for odontogenic cysts, ensuring minimal recurrence and proper healing.
8. The cyst is ‘deroofed’ and the surrounding periosteum sutured to the margins of the cyst wall in
a) Decorrication
b) Marsupialization
c) Saucerization
d) Enucleation
✅Explanation:
In marsupialization, the cyst wall is opened (“deroofed”), and the edges of the cyst are sutured to the oral mucosa or periosteum. This creates a permanent opening, allowing the cyst to shrink and drain gradually.
9. Ameloblastoma is best managed by:
a) Chemotherapy
b) Radiotherapy
c) Gene therapy
d) Surgical excision
✅Explanation:
Ameloblastoma is resistant to radiotherapy and chemotherapy. The best and most effective treatment is surgical excision or resection with adequate margins due to its high recurrence rate after conservative approaches.
10. The most appropriate method to differentiate between a dentigerous cyst and an ameloblastoma is through:
a) Radiographic examination
b) Aspiration cytology
c) Microscopic examination
d) Clinical features
✅Explanation:
Both lesions can appear similar radiographically (as radiolucencies around an unerupted tooth). The only definitive way to distinguish them is by histopathological (microscopic) examination of the cyst lining and tumor cells.
11. Treatment of fibrous dysplasia is:
a) Radical resection of lesion
b) Radiation therapy
c) If the lesion is small, dissection is done, if lesion is large cosmetic surgery has to be carried out
d) Cryosurgery
✅Explanation:
Fibrous dysplasia is a developmental bone disorder where normal bone is replaced by fibrous tissue. Small lesions may be managed conservatively by minimal surgical contouring. Large or disfiguring lesions require cosmetic recontouring to restore function and aesthetics. Radical resection is rarely needed.
12. A man has 1×1.5cm pedunculated lesion on the soft palate which has a rough, “warty” surface but is the same colour as adjacent mucosa. Appropriate management of this lesion is to:
a) Perform an incisional biopsy
b) Perform excisional biopsy
c) Scrape for exfoliative cytology
d) Observe for two weeks
✅Explanation:
A small, localized lesion that is pedunculated and benign-looking should be completely excised and sent for histopathological examination. This both removes the lesion and provides a tissue diagnosis.
13. When treated with simple curettage which odontogenic tumour is most likely to recur
a) Complex odontoma
b) Compound odontoma
c) Odontogenic myxoma
d) Ameloblastic fibroma
✅Explanation:
Odontogenic myxoma is an infiltrative, locally aggressive tumor. Curettage alone often leaves microscopic remnants in surrounding bone, leading to high recurrence rates. More extensive removal with bone margins is preferred.
14. Odontoma is treated by:
a) Excision
b) Resection
c) Curettage
d) Radiotherapy
✅Explanation:
An odontoma is a hamartomatous lesion (developmental malformation) rather than a true tumor. Treatment involves simple surgical excision, as it is well-encapsulated and non-aggressive. Recurrence is extremely rare.
15. Treatment of ameloblastoma
a) Excision of tumour
b) Resection of the mandible along with the tumour
c) Incisional biopsy and marsupialisation
d) No active treatment is necessary
✅Explanation:
Ameloblastoma has a high recurrence rate if treated conservatively. Therefore, the standard treatment is segmental or marginal resection of the affected jaw portion with 1 cm margins of healthy bone to ensure complete removal.
16. Best treatment of the large cyst:
a) Enucleation
b) Marsupialisation
c) Marsupialisation followed by Enucleation
d) Enucleation followed by marsupialisation
✅Explanation:
Large cysts can damage vital structures if removed at once. Marsupialization decompresses and reduces cyst size, followed later by enucleation for complete removal once it becomes smaller and safer to excise.
17. A 5cm suspicious looking lesion of oral mucosa should be:
a) Incised and sent for biopsy
b) Excised and sent for biopsy
c) Irradiated
d) Offered palliative treatment
✅Explanation:
Large or suspicious oral lesions should be sampled by incisional biopsy—a small portion is taken for microscopic diagnosis. Complete excision is avoided initially to prevent unnecessary removal before confirming the nature of the lesion.
18. Biopsy specimens removed for examinations are immediately placed in:
a) 10% ethanol
b) 10% formalin
c) Hydrogen peroxide
d) 1% formalin
✅Explanation:
10% neutral buffered formalin is the standard fixative used to preserve tissue architecture and prevent autolysis. Other solutions (ethanol, hydrogen peroxide) do not preserve tissues adequately for histological study.
19. Protein content of <4mg/ml is seen in
a) Dentigerous
b) Periapical
c) Keratocyst
d) Periodontal cyst
✅Explanation:
Odontogenic keratocyst (OKC) fluid contains low soluble protein content (<4 mg/mL) because it has little inflammatory exudate and a keratinous lining, unlike inflammatory cysts which have higher protein content.
20. Enucleation of palatal tumor results in
a) Excessive bleeding from nasopalatine vessels
b) Tearing of nasal mucosa
c) Damage to nasopalatine nerve
d) Alteration of speech
✅Explanation:
During palatal tumor removal, the nasal mucosa lies very close to the palatal bone. When enucleating the lesion, accidental tearing of this thin mucosa is a common complication that may lead to oro-nasal communication.
21. Adeno ameloblastoma treatment
a) Enbloc resection of maxilla
b) Marsupialization
c) Enucleation
d) No treatment
✅Explanation:
Adenoameloblastoma (also called adenomatoid odontogenic tumor) is a rare variant of ameloblastoma that behaves aggressively in some cases. To prevent recurrence and ensure complete removal, en bloc resection of the affected bone is the treatment of choice, especially in the maxilla.
22. Odontogenic tumors just 1cm away from lower border
a) Enbloc resection
b) Hemi mandibulectomy
c) Enucleation
d) None
✅Explanation:
If an odontogenic tumor is located close to the lower border of the mandible, en bloc resection is indicated to ensure total removal and to preserve bone continuity. Curettage alone risks leaving tumor remnants and causing recurrence.
23. Marsupialization is the procedure done in
a) Large cyst
b) P.D. cyst
c) Aneurismal bone cyst
d) Stafne cyst
✅Explanation:
Marsupialization is performed for large cysts where complete enucleation may cause fracture or damage to vital structures. It reduces cyst size by creating an opening that allows continuous drainage and decompression before final enucleation.
24. Treatment for fibrous dysplasia in a young 25 yrs old patient involving maxilla is best treated by
a) Enbloc resection
b) Cosmetic contouring
c) Maxillary resection
d) Radiation therapy
✅Explanation:
In adults, fibrous dysplasia tends to stabilize, and functional disturbance is minimal. Hence, cosmetic recontouring (removal of excessive bone) is preferred to improve facial symmetry rather than aggressive resection.
25. Submandibular calculus can be removed by:
a) Dilatation of the duct
b) Excision of the opening of duct
c) Removal of the gland
d) Incision of the duct and removal of calculus
✅Explanation:
A stone (calculus) within the Wharton’s duct is best removed by making a small intraoral incision over the duct and extracting the stone. The duct is then sutured, allowing normal salivary flow.
26. During surgical excision of the parotid gland the following structures may be damaged:
a) Lesser occipital nerve, hypoglossal nerve, chorda tympani
b) Facial nerve and auriculotemporal nerve
c) Submandibular duct
d) Cervical fascia
✅Explanation:
The facial nerve passes through the parotid gland and is at high risk during surgery. The auriculotemporal nerve (sensory branch of mandibular nerve) is also close to the gland and can be injured, leading to sensory loss or Frey’s syndrome.
27. Salivary calculus is more common in
a) Submandibular gland
b) Sublingual gland
c) Parotid gland
d) Minor salivary gland
✅Explanation:
The submandibular gland produces thick, mucous-rich saliva with a high calcium content. Its long, upward duct (Wharton’s duct) favors stasis, leading to stone formation more often than in other glands.
28. During removal of a parotid tumour, the auriculotemporal nerve is injured. This could result in:
a) Facial paralysis
b) Trigeminal neuralgia
c) Gustatory sweating
d) Orolingual paraesthesia
✅Explanation:
Damage to the auriculotemporal nerve can lead to Frey’s syndrome, where sweating and flushing occur in the parotid region during eating (gustatory sweating), due to misdirected nerve regeneration connecting salivary and sweat glands.
29. Submandibular duct is exposed via intraoral approach by incising the:
a) Buccinator
b) Mucous membrane
c) Masseter
d) All of the above
✅Explanation:
To expose the submandibular duct intraorally, the surgeon incises the mucosa of the floor of the mouth, parallel to the duct. The buccinator and masseter are not involved in this approach.
30. Excision of the submandibular gland for calculus or tumours is done by incision below angle of the jaw. Special care should be taken to avoid which nerve?
a) Ansa cervicalis
b) Mandibular branch of facial nerve
c) Posterior auricular nerve
d) Submandibular ganglion
✅Explanation:
The marginal mandibular branch of the facial nerve runs just below the mandible and controls the muscles of the lower lip. Injury during submandibular gland surgery can cause asymmetry or drooping of the lower lip.
31. Treatment of solitary langerhans histiocytoma of mandible is by –
a) Curettage
b) Radiotherapy
c) No treatment required
d) Chemotherapy
✅Explanation:
– Prognosis is generally excellent after curettage.
– Solitary Langerhans histiocytoma is a benign, localized lesion of the jaw.
– Treatment: simple curettage is usually sufficient.
– Radiotherapy or chemotherapy is not needed unless the disease is multifocal or aggressive.
32. Treatment of mucocele on lower lip
a) Incision
b) Excision
c) Excision with adjacent glands
d) Biopsy
✅Explanation:
A mucocele is a mucous retention cyst that forms due to rupture or obstruction of a minor salivary gland duct.
Simple incision or drainage often leads to recurrence because the underlying gland remains.
Therefore, complete surgical excision of the cyst and the adjacent minor salivary glands is essential to prevent recurrence.
Key point:
Excision with adjacent glands → curative treatment
Incision → recurrence likely
Excision alone → recurrence possible if gland remains
33. Which of the following detects salivary gland duct diverticuli
a) Ultrasonography
b) Plain radiography
c) Sialography
d) Xeroradiography
✅Explanation:
Sialography is a radiographic technique using contrast media injected into the salivary duct. It is the most sensitive method to detect ductal abnormalities like diverticuli, strictures, or sialoliths. Ultrasound and plain radiographs are less detailed for ductal mapping.
34. A specimen for a biopsy should be taken from:
a) Necrotic area
b) Subdermal layer
c) Border of an ulcerated area
d) Centre of an ulcerated area
✅Explanation:
The active pathological tissue is usually at the periphery of the lesion. Necrotic centers or subdermal areas do not yield diagnostic tissue. Taking from the border ensures adequate representation of viable disease for histopathological evaluation.
35. Apical cyst having a direct connection with apical foramen have been termed as-
a) Residual
b) Bay
c) Paradental
d) Collateral
✅Explanation:
A paradental cyst occurs adjacent to a partially erupted or vital tooth with a direct communication to the apical foramen, often associated with pericoronitis or mandibular molars.
36. Carnoys solution is used in the treatment of:
a) Odontogenic keratocyst
b) Ameloblastoma
c) Dentigerous cyst
d) Mucocele
✅Explanation:
Carnoy’s solution is a chemical cauterizing agent applied after cyst enucleation to reduce recurrence of odontogenic keratocyst. It penetrates bone and destroys residual epithelial cells while preserving surrounding structures.
37. Enbloc resection of the segment of the bone:
a) Complete resection of the jaw bone
b) Resection of half of the affected jaw
c) Resection of the tumor only
d) The entire tumor is removed intact with a rim of uninvolved bone while maintaining continuity of jaw
✅Explanation:
En bloc resection removes the tumor with a margin of healthy bone, keeping jaw continuity intact, unlike hemimandibulectomy or segmental resection which remove large segments. It is used for aggressive tumors with a lower recurrence risk.
38. Which of the following substances is filled in the bone cavity after enucleation of a cyst:
a) Hydroxyapatite
b) Autogenous cortical bone chips
c) Autogenous medullary bone chips
d) Allogenic bone chips
✅Explanation:
Cortical bone is slower to integrate, and allogenic bone carries some risk.
After cyst enucleation, the cavity may be filled to promote bone healing.
Autogenous medullary bone chips (from patient’s own cancellous bone) are preferred because they:
Integrate quickly
Promote osteogenesis
Avoid risk of disease transmission
39. A cyst can be differentiated from granuloma by
a) Radiopaque dyes
b) Polyacrylamide gel electrophoresis
c) Biopsy
d) All of the above
✅Explanation:
Hence, all listed methods can be used for differentiation.
Cysts have an epithelial lining and fluid; granulomas are solid inflamed tissue without lining.
Biopsy confirms the lining (gold standard).
Radiopaque dyes and protein analysis can also help distinguish them.
40. Chemical cauterization in odontogenic keratocyst is done by
a) Hydrogen peroxide
b) Carnoy’s solution
c) Superoxide solution
d) Betadine
✅Explanation:
Chemical cauterization using Carnoy’s solution helps destroy residual epithelial cells in the bony cavity after enucleation of an OKC, lowering recurrence risk. Other agents like hydrogen peroxide or betadine are ineffective for this purpose.
41. During surgery on the submandibular gland
a) Damage to the lingual nerve will cause loss of sensation to the posterior third of the tongue.
b) The submandibular gland is seen to wrap around the posterior border of mylohyoid.
c) The facial artery and vein are usually divided as they course through the deep part of the gland.
d) The hypoglossal nerve is seen to loop under the submandibular duct.
✅Explanation:
Anatomically, the submandibular gland has superficial and deep parts, with the deep part looping around the posterior border of mylohyoid. Knowledge of this is essential to avoid injuring adjacent structures (lingual nerve, hypoglossal nerve).
42. Following gland is removed in surgery for a ranula
a) Submandibular gland
b) Sublingual gland
c) Parotid gland
d) Lacrimal gland
✅Explanation:
A ranula originates from the sublingual gland. Treatment requires excision of the sublingual gland, often along with marsupialization or cyst removal, to prevent recurrence. The submandibular gland is usually preserved.
43. Treatment of calculus within the submandibular salivary gland is
a) Removal of sinus
b) Removal of the gland
c) Dichotomy
d) Milking of the stone
✅Explanation:
Small calculi in the duct can sometimes be expressed by milking the duct intraorally. Larger or inaccessible stones may require duct incision or gland excision. Conservative methods preserve gland function.
44. The plunging ranula is so called because of
a) Its size.
b) Lifting of tongue.
c) Extension through mylohyoid.
d) Involvement of lingual nerve
✅Explanation:
A plunging ranula extends from the floor of the mouth through or around the mylohyoid muscle into the neck. This is why it “plunges” into deeper cervical spaces.
45. SCC present on lateral margin of tongue of staging T2NO, options of treatment is
a) SOHND (supraomohyoid neck dissections)
b) Remove lymph node I-II along with
c) Remove lymph node I-V along with
d) Remove lymph node I-IV along with
✅Explanation:
1. Background:
– SCC of the tongue has a high tendency for lymphatic spread even when clinically N0 (no palpable nodes).
– The lateral tongue drains primarily to levels I–III (submental, submandibular, upper jugular), but advanced or extensive lesions may involve level IV as well.
– T2 lesion: Tumor size 2–4 cm, no clinical node (N0).
2. Why not SOHND or I–II only?
– SOHND (supraomohyoid neck dissection, levels I–III) is standard for early-stage tongue SCC (T1–T2), but recent evidence suggests for lateral border lesions at T2, occult metastases may extend to level IV, so including I–IV gives better regional control.
– Removing only I–II risks leaving occult metastasis in levels III–IV.
3. Why not I–V?
– Level V is posterior triangle of the neck. Occult metastasis from lateral tongue to level V is very rare, so dissection is unnecessary and increases morbidity (spinal accessory nerve injury, shoulder dysfunction).
4. Conclusion:
– For lateral tongue T2N0 SCC, the most appropriate elective neck treatment is levels I–IV dissection to manage occult lymphatic spread while avoiding unnecessary morbidity.
Key point:
Level I–IV removal optimizes disease control and survival.
Elective neck dissection is often recommended even in N0 cases due to high risk of occult metastasis (~20–30%).
46. A 30 year old male patient reports with the swelling at the angle of the mandible with a duration of 6 months. Radiograph showed an impacted third molar with pericoronal radiolucency. (COMEDK-2013)
46A. Protein content of aspirated fluid was greater than 4.0 gms per 100 mL. The lesion is likely to be
a) Odontogenic keratocyst
b) Dentigerous cyst
c) Traumatic bone cyst
d) Stafne’s bone cyst
✅Explanation:
Dentigerous cyst fluid has high protein content (>4 g/100 mL) due to accumulation of exudate around the unerupted tooth crown. OKC fluid usually has lower protein content.
46B. Appropriate treatment option for this lesion is
a) Enucleation
b) Marginal mandibulectomy
c) Segmental resection
d) Hemimandibulectomy
✅Explanation:
Treatment of a dentigerous cyst involves enucleation along with removal of the associated tooth, preserving adjacent structures.
46C. The most likely tumor to develop from this lesion is
a) Ossifying fibroma
b) Ameloblastoma
c) Squamous cell carcinoma
d) Central giant cell granuloma
✅Explanation:
Although rare, dentigerous cysts can give rise to ameloblastoma due to neoplastic transformation of the epithelial lining.
47. In composite excision of tumor according to Gold, Upton and Marx, there is
a) Resection of tumor with entire wound
b) Resection of tumor leaving the marginal bone intact
c) Resection of tumor with unaffected neighbouring tissue
d) Resection of tumor with wide margins excision
✅Explanation:
Composite excision involves removing the tumor with a safety margin of uninvolved tissue, ensuring complete eradication and minimizing recurrence.
48. Treatment for brown tumor is
a) Curettage
b) Surgical excision
c) Intralesional steroids
d) Parathyroidectomy
✅Explanation:
Brown tumor is a bony lesion caused by hyperparathyroidism. Treating the underlying cause (parathyroid adenoma or hyperplasia) via parathyroidectomy resolves the lesion; direct excision is not curative.
49. Which of the following is not a sclerosing agent?
a) Sodium psyllate
b) Sodium morruhate
c) Sodium tetradecyl sulphate
d) Sodium bicarbonate
✅Explanation:
Sclerosing agents (sodium psyllate, sodium morrhuate, sodium tetradecyl sulfate) induce fibrosis and obliterate cystic cavities or vascular lesions. Sodium bicarbonate has no sclerosing properties.
50. The propensity of recurrence after surgical intervention is the least in
a) Ameloblastoma
b) Odontogeniomyxoma
c) Odontoma
d) Fibrocarcoma
✅Explanation:
Odontomas are hamartomas and do not recur after surgical removal. In contrast, ameloblastomas and odontogenic myxomas are aggressive and have high recurrence rates. Fibrosarcomas are malignant and may recur if margins are inadequate.