ORE Part 2 Oral Surgery & Extractions 3 — Questions and Answers
Question 1: What splint duration is recommended following lateral luxation of a permanent incisor?
- 4 weeks with a semi-rigid splint (Correct answer)
- 2 weeks with a rigid splint
- 8 weeks with a rigid splint
- No splinting required
Correct answer: 4 weeks with a semi-rigid splint
IADT guidelines recommend a semi-rigid splint for 4 weeks following lateral luxation to allow PDL healing while preventing ankylosis from rigid immobilisation.
Question 2: When should a post-extraction review be arranged for a straightforward lower molar extraction in a healthy adult?
- Only if the patient is symptomatic or at high risk (Correct answer)
- Routinely at 24 hours
- After 2 weeks always
- Immediately the next day for all patients
Correct answer: Only if the patient is symptomatic or at high risk
Routine post-extraction review is not always required for uncomplicated extractions in healthy patients; review should be arranged if the patient is symptomatic or has risk factors.
Question 3: What is the recommended approach if inferior alveolar nerve (IAN) injury is detected post-operatively after third molar surgery?
- Document findings, reassure patient, review at 3 months, refer to oral surgery if no recovery (Correct answer)
- Prescribe steroids immediately without follow-up
- Perform immediate re-exploration
- Offer compensation immediately
Correct answer: Document findings, reassure patient, review at 3 months, refer to oral surgery if no recovery
IAN injuries should be documented thoroughly, the patient reassured (most recover within weeks), reviewed at 3 months, and referred to an oral and maxillofacial surgeon if there is no improvement.
Question 4: Which flap design is most commonly used for surgical removal of a lower third molar?
- Ward's (envelope) incision with a distal relieving incision (Correct answer)
- Trapezoidal flap
- Semilunar flap
- Straight midcrestal incision only
Correct answer: Ward's (envelope) incision with a distal relieving incision
The most common approach involves a Ward's envelope incision along the external oblique ridge with a mesial relieving incision, providing adequate access while avoiding key anatomical structures.
Question 5: What is the clinical significance of a displaced root fragment into the maxillary sinus during upper molar extraction?
- Requires urgent referral to oral and maxillofacial surgery for removal (Correct answer)
- Can be left in situ permanently
- Always resolves without treatment
- Requires immediate GP notification only
Correct answer: Requires urgent referral to oral and maxillofacial surgery for removal
A root displaced into the maxillary sinus can cause acute or chronic sinusitis and must be removed by an oral surgeon with appropriate sinus access under specialist care.
Question 6: Which antibiotic is the drug of first choice for acute dentoalveolar abscess in a penicillin-allergic patient in the UK?
- Metronidazole (Correct answer)
- Erythromycin
- Tetracycline
- Flucloxacillin
Correct answer: Metronidazole
Metronidazole is effective against the anaerobic bacteria responsible for dentoalveolar abscesses and is the recommended first-line alternative in penicillin-allergic patients.
ORE Part 2 Oral Surgery & Extractions 3
What splint duration is recommended following lateral luxation of a permanent incisor?