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

Acute pericoronitis is first managed with local debridement, irrigation under the operculum, and systemic antibiotics if there is fever or spreading infection; extraction is deferred until acute inflammation resolves.

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

Polyglactin (Vicryl) is a resorbable multifilament suture that undergoes hydrolysis within 60–90 days, eliminating the need for a removal appointment.

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

The lingual nerve courses just beneath the lingual periosteum in the third molar region and can be stretched, crushed, or severed when a lingual retractor or periosteal elevator is used during mandibular third molar surgery.

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

Winter's classification categorizes impacted mandibular third molars by their angulation: mesioangular, distoangular, vertical, horizontal, buccoangular, and linguoangular.

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

NSAIDs such as ibuprofen reversibly inhibit cyclooxygenase enzymes and reduce thromboxane A2-mediated platelet aggregation, which can impair post-extraction clot formation and increase risk of dry socket.

NBDE - National Board Dental Examination Practice Test

NBDE - National Board Dental Examination Practice Test

NBDE Oral Surgery 3