NBDE Diagnosis and Treatment Planning 2

Question 1

A 45-year-old patient presents with a painless, slow-growing swelling on the posterior mandible. Radiograph shows a well-defined unilocular radiolucency with scalloped borders around the crowns of impacted third molars. What is the most likely diagnosis?

Accepted Answer

Odontogenic keratocyst

Answer

Odontogenic keratocysts (OKC) characteristically show scalloped borders and a tendency to grow along the medullary space with minimal cortical expansion.

Question 2

A patient's periodontal chart shows generalized probing depths of 5-7 mm with bleeding on probing, bone loss on radiographs, and Class II furcation involvement on maxillary molars. How should this periodontitis be classified?

Accepted Answer

Stage III, Grade B

Answer

Stage III periodontitis is characterized by tooth loss potential due to severe bone loss and furcation involvement (Class II or III), without masticatory dysfunction.

Question 3

Which finding on a panoramic radiograph would most indicate the need for immediate referral to an oral surgeon before initiating orthodontic treatment?

Accepted Answer

Multilocular radiolucency in the posterior mandible

Answer

A multilocular radiolucency in the posterior mandible raises concern for ameloblastoma or other aggressive jaw lesions requiring biopsy before any elective dental treatment.

Question 4

A 60-year-old patient taking bisphosphonates for osteoporosis requires extraction of a non-restorable mandibular molar. Which is the most critical consideration in the treatment plan?

Accepted Answer

Consult with the prescribing physician regarding risk of MRONJ

Answer

Medication-related osteonecrosis of the jaw (MRONJ) risk must be assessed by consulting the prescribing physician before any dentoalveolar surgery in bisphosphonate patients.

Question 5

A 7-year-old child presents with a maxillary central incisor that was avulsed 2 hours ago and stored dry. What is the most appropriate management?

Accepted Answer

Do not reimplant; space maintenance and prosthetic replacement

Answer

Dry storage for more than 60 minutes results in non-vital periodontal ligament cells, making reimplantation of primary teeth contraindicated; in permanent teeth, reimplantation is still considered but with poor prognosis.

NBDE - National Board Dental Examination Practice Test

NBDE - National Board Dental Examination Practice Test

NBDE Diagnosis and Treatment Planning 2