ORE Part 1 Oral Surgery

Question 1

During surgical extraction of a lower third molar, the lingual nerve is most at risk at which anatomical location?

Accepted Answer

At the lingual plate of the third molar region, just below the alveolar crest

Answer

The lingual nerve runs in close proximity to the lingual plate in the third molar region, often lying at or just below the level of the alveolar crest. Studies have shown it is directly on the bone surface in approximately 15% of cases, making it vulnerable during flap elevation and bone removal.

Question 2

A patient develops numbness of the lower lip immediately following extraction of a lower premolar. Which nerve has most likely been damaged?

Accepted Answer

Mental nerve

Answer

The mental nerve exits through the mental foramen, typically located between the apices of the lower premolars. During premolar extraction, the mental nerve can be damaged by direct trauma, excessive periosteal elevation, or compression, resulting in numbness of the lower lip and chin on the affected side.

Question 3

What is the most common complication following extraction of maxillary molars?

Accepted Answer

Oroantral communication

Answer

Oroantral communication (OAC) is the most common complication of upper molar extractions due to the close relationship between the molar roots and the maxillary sinus floor. If the OAC is less than 2mm, it may close spontaneously; larger communications require surgical closure with a buccal advancement flap.

Question 4

A patient presents 3 days post-extraction with severe throbbing pain, a foul taste, and an empty socket with exposed bone. What is the diagnosis?

Accepted Answer

Alveolar osteitis (dry socket)

Answer

Alveolar osteitis (dry socket) typically presents 2–5 days after extraction with severe pain, halitosis, and an empty socket where the blood clot has been lost or lysed. Risk factors include smoking, oral contraceptive use, and traumatic extraction. Management involves irrigation and placement of an obtundent dressing.

Question 5

Which of the following is an absolute contraindication to dental extraction without specialist referral?

Accepted Answer

Patients receiving intravenous bisphosphonate therapy for bone metastases

Answer

Patients on intravenous bisphosphonates (e.g., zoledronic acid for bone metastases) have a significantly elevated risk of MRONJ compared to oral bisphosphonate users. These patients should be referred to a specialist oral surgery unit for extraction with appropriate planning and follow-up.

ORE Part 1 Practice Test

ORE Part 1 Practice Test

ORE Part 1 Oral Surgery