NBDE Oral Surgery 3

Question 1

A patient presents with acute pericoronitis around an impacted mandibular third molar. What is the correct initial management?

Accepted Answer

Irrigation under the operculum, debridement, and antibiotics only if systemic signs are present

Answer

Immediate surgical extraction of the impacted tooth

Answer

Occlusal reduction of the opposing tooth only

Answer

Prescribe antibiotics and defer all local treatment

Question 2

Which suture material is most appropriate for intraoral closure when the patient cannot return for suture removal?

Accepted Answer

4-0 polyglactin (Vicryl)

Answer

3-0 black silk

Answer

2-0 nylon monofilament

Answer

4-0 stainless steel wire

Question 3

The lingual nerve is at greatest risk of injury during which surgical procedure?

Accepted Answer

Extraction of mandibular third molars with lingual flap reflection

Answer

Extraction of maxillary third molars

Answer

Standard inferior alveolar nerve block injection

Answer

Anterior mandibular implant placement

Question 4

Winter's classification of impacted mandibular third molars describes which characteristic of the tooth?

Accepted Answer

Angulation of the impacted tooth relative to the long axis of the second molar

Answer

Depth of impaction relative to the occlusal plane

Answer

Degree of overlying soft tissue coverage

Answer

Radiographic root morphology and curvature

Question 5

Which common analgesic should be used with caution post-extraction due to its platelet-inhibiting effect that may impair clot stability?

Accepted Answer

Ibuprofen (NSAIDs)

Answer

Acetaminophen (paracetamol)

Answer

Amoxicillin

Answer

Chlorhexidine gluconate mouth rinse

Question 6

A patient reports numbness of the lower lip and chin persisting 6 months after mandibular third molar extraction. This finding most likely represents:

Accepted Answer

Permanent injury (axonotmesis or neurotmesis) to the inferior alveolar nerve

Answer

Neuropraxia of the inferior alveolar nerve that will still resolve

Answer

Damage to the facial nerve during extraction

Answer

Injury to the lingual nerve

Question 7

What do current evidence-based guidelines recommend regarding routine antibiotic prophylaxis for third molar extraction in healthy, immunocompetent patients?

Accepted Answer

Routine prophylactic antibiotics are not strongly supported and may contribute to antibiotic resistance

Answer

Metronidazole 500 mg TID for 7 days is the standard of care

Answer

Penicillin VK 500 mg QID for 5 days is universally recommended

Answer

Clindamycin 300 mg BID for 7 days is preferred due to anaerobic coverage