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ABOMS practice questions

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Question 1Oral and Maxillofacial Surgery (Qualifying Examination)

Which local anesthetic agent is contraindicated in a patient with a documented true allergy to ester-type anesthetics due to cross-reactivity concerns?

  1. Lidocaine
  2. Procaine Correct answer.
  3. Bupivacaine
  4. Articaine

Explanation

Ester anesthetics are metabolized to para-aminobenzoic acid derivatives, which are the usual allergens, and cross-reactivity occurs among esters. Amides (lidocaine, bupivacaine, articaine) do not share this metabolite and are safe alternatives. Procaine is an ester and would be avoided.

Question 2Oral and Maxillofacial Surgery (Qualifying Examination)

A patient reports numbness of the lower lip and chin following a difficult third molar extraction. Which nerve was most likely injured?

  1. Chorda tympani
  2. Inferior alveolar nerve Correct answer.
  3. Mylohyoid nerve
  4. Long buccal nerve

Explanation

The inferior alveolar nerve provides sensory innervation to the lower teeth and, via its mental branch, to the lower lip and chin. Injury during third molar surgery is the most common cause of this distribution of paresthesia. The other listed nerves supply different territories.

Question 3Oral and Maxillofacial Surgery (Qualifying Examination)

Which radiographic projection best demonstrates the relationship of impacted mandibular third molars to the inferior alveolar canal?

  1. Lateral cephalometric radiograph
  2. Cone beam computed tomography Correct answer.
  3. Panoramic radiograph
  4. Periapical radiograph

Explanation

Cone beam CT provides three-dimensional assessment of the buccolingual position of the canal relative to the roots, which two-dimensional images cannot resolve. It is used when panoramic signs suggest close proximity. Plain films only show superimposition.

Question 4Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is the most common postoperative complication following surgical removal of a mandibular third molar?

  1. Alveolar osteitis Correct answer.
  2. Fracture of the mandible
  3. Osteomyelitis
  4. Lingual nerve transection

Explanation

Alveolar osteitis (dry socket) is the most frequently reported complication after third molar removal, presenting with pain and an empty socket. It results from loss of the clot. The other listed events are far less common.

Question 5Oral and Maxillofacial Surgery (Qualifying Examination)

A patient with a mandibular angle fracture is found to have a step-off at the inferior border and malocclusion. Which treatment principle is most appropriate for a minimally displaced favorable fracture?

  1. Immediate condylectomy
  2. Open reduction and internal fixation
  3. Observation without intervention
  4. Closed reduction with maxillomandibular fixation Correct answer.

Explanation

Favorable, minimally displaced angle fractures can often be managed with closed reduction and a period of maxillomandibular fixation to restore occlusion. Open reduction is reserved for displacement or instability. Observation alone risks malunion.

Question 6Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following best describes the Le Fort I fracture pattern?

  1. Pyramidal fracture through the nasal bones and medial orbital walls
  2. Fracture of the condylar neck with displacement of the condyle
  3. Horizontal separation of the maxilla above the apices of the teeth Correct answer.
  4. Fracture extending through the zygomatic arch and lateral orbital wall

Explanation

A Le Fort I is a low transverse fracture through the maxilla above the tooth apices, separating the palate from the upper face. Le Fort II and III involve progressively higher levels. The other options describe different injuries.

Question 7Oral and Maxillofacial Surgery (Qualifying Examination)

A patient presents with sudden unilateral facial paralysis, inability to close the eye, and loss of forehead wrinkling. Which diagnosis is most consistent with these findings?

  1. Myasthenia gravis
  2. Trigeminal neuralgia
  3. Temporomandibular joint dislocation
  4. Bell palsy Correct answer.

Explanation

Involvement of the forehead indicates a peripheral facial nerve lesion, and acute unilateral peripheral palsy is characteristic of Bell palsy. Central lesions spare the upper face. The other conditions do not produce this pattern.

Question 8Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is the most appropriate initial management for a patient with a displaced mandibular condyle causing an inability to close the mouth?

  1. Manual reduction of the dislocation Correct answer.
  2. Immediate open joint surgery
  3. Long-term maxillomandibular fixation
  4. Antibiotic therapy alone

Explanation

Acute temporomandibular joint dislocation is managed by manual reduction, often with muscle relaxation or sedation, followed by supportive care. Surgery and prolonged fixation are not first-line for simple dislocation. Antibiotics have no role.

Question 9Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is a classic radiographic feature of ameloblastoma of the mandible?

  1. Sunburst periosteal reaction
  2. Cotton-wool radiopacity
  3. Ground-glass appearance
  4. Soap-bubble multilocular radiolucency Correct answer.

Explanation

Ameloblastoma commonly appears as a multilocular soap-bubble radiolucency, often in the posterior mandible. Ground-glass appearance suggests fibrous dysplasia, and sunburst reaction suggests osteosarcoma. Cotton-wool opacity is seen in Paget disease.

Question 10Oral and Maxillofacial Surgery (Qualifying Examination)

A patient has a painless, fluctuant swelling in the floor of the mouth that enlarges when the mouth is opened. Which diagnosis should be considered first?

  1. Ranula Correct answer.
  2. Fibroma of the buccal mucosa
  3. Pleomorphic adenoma of the palate
  4. Pyogenic granuloma of the gingiva

Explanation

A ranula is a mucocele arising from the sublingual gland presenting as a fluctuant floor-of-mouth swelling. It may enlarge with mouth opening. The other lesions occur in different locations and have different characteristics.

Question 11Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is the recommended first-line treatment for a patient with an acute odontogenic infection causing facial swelling but no airway compromise?

  1. Radiation therapy
  2. Incision and drainage with antibiotic therapy Correct answer.
  3. Observation until fluctuance develops
  4. Immediate tracheostomy

Explanation

Acute odontogenic infections with swelling require drainage of pus and appropriate antibiotics, along with removal of the source. Airway management is reserved for compromise. Observation risks progression.

Question 12Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is the most appropriate antibiotic choice for a patient with a penicillin allergy and an odontogenic infection requiring antibiotics?

  1. Amoxicillin-clavulanate
  2. Clindamycin Correct answer.
  3. Amoxicillin
  4. Penicillin V

Explanation

Clindamycin is an appropriate alternative for patients with penicillin allergy, though it is no longer preferred for prophylaxis due to resistance concerns. All other listed options are penicillins or penicillin derivatives.

Question 13Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is a recognized indication for extraction of a third molar?

  1. Asymptomatic fully erupted molar in good occlusion
  2. Presence of a normal follicle on radiograph
  3. Prophylactic removal of all third molars regardless of status
  4. Recurrent pericoronitis Correct answer.

Explanation

Recurrent pericoronitis is a well-accepted indication for third molar removal. Asymptomatic, disease-free molars in good occlusion do not require extraction. Routine prophylactic removal of all third molars is not supported.

Question 14Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following best describes the mechanism of action of local anesthetics?

  1. Inhibition of cyclooxygenase
  2. Agonism at opioid receptors
  3. Blockade of calcium channels in muscle
  4. Blockade of voltage-gated sodium channels Correct answer.

Explanation

Local anesthetics reversibly block voltage-gated sodium channels, preventing nerve impulse conduction. This is the basis of their effect. The other mechanisms describe analgesics or muscle relaxants.

Question 15Oral and Maxillofacial Surgery (Qualifying Examination)

A patient with a history of bisphosphonate therapy presents for extraction of a mandibular molar. Which of the following is the most important consideration?

  1. Risk of medication-related osteonecrosis of the jaw Correct answer.
  2. Risk of malignant hyperthermia
  3. Risk of local anesthetic failure
  4. Risk of hypoglycemia

Explanation

Bisphosphonate therapy is associated with medication-related osteonecrosis of the jaw, particularly after invasive procedures. Careful risk assessment and treatment planning are essential. The other risks are not directly related.

Question 16Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is the most appropriate management for a patient with a suspected malignant lesion on the lateral border of the tongue?

  1. Incisional biopsy for histopathologic diagnosis Correct answer.
  2. Observation for six months
  3. Immediate wide surgical resection without biopsy
  4. Empiric antifungal therapy without biopsy

Explanation

A suspected malignancy requires tissue diagnosis before definitive treatment. Incisional biopsy provides histopathologic confirmation and guides further management. Empiric therapy or observation delays diagnosis.

Question 17Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is a common cause of a unilateral open bite following a condylar fracture?

  1. Fracture of the nasal bone
  2. Shortening of the ramus on the fractured side Correct answer.
  3. Bilateral condylar ankylosis
  4. Superior displacement of the fractured condyle

Explanation

A condylar fracture can result in shortening of the ramus on the affected side, producing an ipsilateral open bite and deviation. This reflects loss of vertical support. The other options do not explain this finding.

Question 18Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is the most appropriate initial management for a patient with a suspected deep space infection and difficulty swallowing?

  1. Topical antiseptic rinses
  2. Urgent airway assessment and surgical drainage Correct answer.
  3. Outpatient oral antibiotics
  4. Wait for spontaneous drainage

Explanation

Deep space infections with difficulty swallowing raise concern for airway compromise and require urgent assessment, airway protection, and surgical drainage. Outpatient management is inadequate. Delay risks life-threatening spread.

Question 19Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is the most likely diagnosis for a patient with a slowly enlarging, painless, firm mass in the parotid gland that is mobile and has been present for two years?

  1. Mucoepidermoid carcinoma with rapid growth
  2. Sialolithiasis of the parotid duct
  3. Pleomorphic adenoma Correct answer.
  4. Acute suppurative parotitis

Explanation

A slow-growing, painless, mobile parotid mass is characteristic of pleomorphic adenoma, the most common benign salivary tumor. Malignancy and infection typically present differently. Sialolithiasis causes obstructive symptoms.

Question 20Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is a recognized risk factor for the development of oral squamous cell carcinoma?

  1. Use of fluoride toothpaste
  2. Vegan diet
  3. Regular dental flossing
  4. Tobacco and alcohol use Correct answer.

Explanation

Tobacco and alcohol are the major established risk factors for oral squamous cell carcinoma, with a synergistic effect. The other options are not associated with increased risk.

Question 21Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is the most appropriate management for a patient with a mandibular fracture and an unstable cervical spine?

  1. Immediate tracheostomy without imaging
  2. Immediate open reduction with intubation
  3. Closed reduction without cervical precautions
  4. Immobilization of the cervical spine during airway management Correct answer.

Explanation

Cervical spine precautions must be maintained during airway management in trauma patients with suspected cervical injury. This prevents secondary spinal cord injury. Definitive fracture treatment follows stabilization.

Question 22Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following best describes the purpose of a nasogastric tube in the management of a patient with maxillomandibular fixation?

  1. Airway protection
  2. Nutritional support and gastric decompression Correct answer.
  3. Definitive fracture reduction
  4. Antibiotic delivery

Explanation

Patients in maxillomandibular fixation may require nutritional support and gastric decompression via a nasogastric tube. It does not reduce fractures or protect the airway. Antibiotics are given systemically.

Question 23Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is the most likely cause of a sudden inability to open the mouth fully after a mandibular nerve block?

  1. Fracture of the mandible
  2. Dislocation of the temporomandibular joint
  3. Trismus from muscle trauma or hematoma Correct answer.
  4. Permanent lingual nerve injury

Explanation

Trismus after an inferior alveolar nerve block is commonly due to muscle trauma or hematoma in the medial pterygoid region. It is usually self-limiting. The other options are less likely causes.

Question 24Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is the most appropriate management for a patient with a mandibular tori interfering with denture fabrication?

  1. Surgical reduction of the tori Correct answer.
  2. Extraction of all mandibular teeth
  3. Observation only
  4. Orthodontic treatment

Explanation

Mandibular tori that interfere with denture construction may require surgical reduction. Observation is appropriate only if they are asymptomatic and do not interfere. The other options do not address the tori.

Question 25Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is a characteristic finding in a patient with hemifacial microsomia?

  1. Bilateral cleft lip
  2. Generalized osteoporosis
  3. Unilateral hypoplasia of the mandible and ear anomalies Correct answer.
  4. Bilateral symmetric mandibular growth

Explanation

Hemifacial microsomia is characterized by unilateral hypoplasia of the mandible and associated ear anomalies. It is typically asymmetric. The other findings are not characteristic.

Question 26Oral and Maxillofacial Surgery (Qualifying Examination)

Which nerve is most commonly injured during surgical extraction of a mandibular third molar because of its close proximity to the roots?

  1. Long buccal nerve
  2. Mylohyoid nerve
  3. Inferior alveolar nerve Correct answer.
  4. Chorda tympani nerve

Explanation

The inferior alveolar nerve runs through the mandibular canal, which frequently lies close to the apices of third molars, making it the nerve most at risk during surgical removal. The other listed nerves are not typically in the surgical field near the roots.

Question 27Oral and Maxillofacial Surgery (Qualifying Examination)

Which local anesthetic property is primarily responsible for determining the onset of anesthesia?

  1. Protein binding percentage
  2. Vasodilator potency
  3. Lipid solubility
  4. pKa relative to tissue pH Correct answer.

Explanation

The pKa determines the proportion of anesthetic in the uncharged base form that can cross the nerve membrane, so it governs onset speed. Lipid solubility mainly affects potency, and protein binding affects duration.

Question 28Oral and Maxillofacial Surgery (Qualifying Examination)

A patient sustains a blow to the chin and presents with a bilateral fracture of the anterior mandible and a retruded chin. Which muscle group is primarily responsible for the downward and backward displacement of the anterior fragment?

  1. Suprahyoid muscles Correct answer.
  2. Masseter and medial pterygoid
  3. Temporalis
  4. Lateral pterygoid

Explanation

The suprahyoid muscles (digastric, geniohyoid, mylohyoid) attach to the anterior mandible and, when unopposed, pull the anterior fragment downward and backward. The elevator muscles generally act on posterior fragments.

Question 29Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is the most common site for an odontogenic keratocyst?

  1. Anterior mandible
  2. Anterior maxilla
  3. Posterior mandible Correct answer.
  4. Posterior maxilla

Explanation

Odontogenic keratocysts occur most frequently in the posterior mandible and ramus region. The other sites are less commonly involved.

Question 30Oral and Maxillofacial Surgery (Qualifying Examination)

A patient with a history of radiotherapy to the mandible requires a dental extraction. Which adjunct is most important to reduce the risk of osteoradionecrosis?

  1. Systemic corticosteroids
  2. Prophylactic antibiotics only
  3. Topical fluoride application
  4. Hyperbaric oxygen therapy Correct answer.

Explanation

Hyperbaric oxygen therapy is used adjunctively to improve tissue oxygenation and healing in previously irradiated bone, reducing osteoradionecrosis risk. Antibiotics and fluoride address infection and caries but not the vascular compromise.

Question 31Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following best describes the characteristic histologic finding in a pleomorphic adenoma?

  1. Keratinizing squamous cells with keratin pearls
  2. Spindle cells with Verocay bodies
  3. Epithelial and myoepithelial cells in a chondromyxoid stroma Correct answer.
  4. Sheets of clear cells with amyloid deposition

Explanation

Pleomorphic adenoma shows a mixture of epithelial and myoepithelial cells embedded in a characteristic chondromyxoid stroma. The other descriptions correspond to different neoplasms.

Question 32Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is the most appropriate management for a patient with a mandibular angle fracture and a stable, nondisplaced fracture line with normal occlusion?

  1. Resection of the fractured segment
  2. Immediate intermaxillary fixation for six weeks
  3. Open reduction with internal fixation
  4. Closed reduction with observation and soft diet Correct answer.

Explanation

Nondisplaced angle fractures with a stable occlusion can often be managed closed with observation and a soft diet. Open reduction is reserved for displaced or unstable fractures.

Question 33Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is a cardinal feature of temporomandibular joint dislocation?

  1. Limited mouth opening with deviation to the affected side
  2. Unilateral swelling anterior to the tragus with fever
  3. Inability to close the mouth with the mandible locked in protrusion Correct answer.
  4. Crepitus on opening with joint space narrowing

Explanation

In dislocation, the condyle is displaced anterior to the articular eminence, leaving the patient unable to close the mouth and locked in protrusion. Limited opening with deviation suggests internal derangement rather than dislocation.

Question 34Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following describes the appropriate initial management for a patient with an avulsed permanent maxillary central incisor that has been out of the socket for 30 minutes and stored in milk?

  1. Replant after root canal treatment and rigid splinting
  2. Discard the tooth and plan an implant
  3. Replant the tooth and apply a flexible splint Correct answer.
  4. Soak the tooth in saline for 24 hours before replanting

Explanation

An avulsed permanent tooth with a short extraoral time and appropriate storage should be replanted promptly and splinted flexibly. Rigid splinting and immediate root canal treatment are not indicated initially for a tooth with an open apex.

Question 35Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is the most likely cause of a unilateral widened periodontal ligament space and a step in the occlusal plane after a mandibular fracture?

  1. Fracture through the alveolar process Correct answer.
  2. Bruxism
  3. Condylar hyperplasia
  4. Periodontal abscess

Explanation

A step in the occlusion with a widened PDL space indicates a fracture involving the alveolar process or tooth-bearing segment. Condylar hyperplasia and bruxism do not produce acute occlusal steps.

Question 36Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is the most appropriate initial step in the management of a patient with a suspected airway obstruction after a maxillofacial injury?

  1. Obtain a panoramic radiograph
  2. Repair facial lacerations
  3. Assess and secure the airway Correct answer.
  4. Administer intravenous antibiotics

Explanation

Airway assessment and stabilization take priority over all other diagnostic and therapeutic steps in trauma. Imaging and soft tissue repair follow once the airway is secure.

Question 37Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is a recognized feature of Sturge-Weber syndrome in the oral and maxillofacial region?

  1. Generalized gingival fibromatosis
  2. Port-wine stain in the trigeminal distribution Correct answer.
  3. Bilateral condylar aplasia
  4. Multiple odontomas

Explanation

Sturge-Weber syndrome is characterized by a facial port-wine stain in the distribution of the trigeminal nerve, along with leptomeningeal angiomatosis. The other findings are not characteristic of the syndrome.

Question 38Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is the most appropriate management for a patient with a small, well-defined, asymptomatic radiolucency at the apex of a nonvital tooth with no swelling?

  1. Conventional endodontic treatment with follow-up Correct answer.
  2. Systemic antibiotics alone
  3. Immediate extraction
  4. Incisional biopsy

Explanation

A small periapical radiolucency associated with a nonvital tooth typically represents a periapical granuloma or cyst that responds to endodontic therapy. Extraction or biopsy is reserved for lesions that do not respond or have concerning features.

Question 39Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following best describes the primary advantage of using a submental intubation in a patient with panfacial fractures?

  1. It avoids interference with nasal and oral surgical fields Correct answer.
  2. It provides better access for tracheostomy
  3. It eliminates the need for postoperative monitoring
  4. It allows immediate oral intake

Explanation

Submental intubation keeps the airway secure while freeing the nasal and oral regions for surgical reconstruction. It does not replace the need for postoperative monitoring or provide alimentary benefit.

Question 40Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is the most likely diagnosis for a patient with a painless, slowly enlarging, bluish, compressible swelling of the lower lip?

  1. Fibroma
  2. Mucocele Correct answer.
  3. Squamous cell carcinoma
  4. Hemangioma

Explanation

A mucocele results from retention or extravasation of saliva and typically presents as a bluish, fluctuant, painless swelling of the lower lip. Fibromas are firm, and hemangiomas are vascular lesions that may blanch.

Question 41Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is the most appropriate management for a patient with a mandibular fracture and a concomitant cervical spine injury that has been cleared by the spine service?

  1. Proceed with fracture management using appropriate precautions Correct answer.
  2. Delay all treatment until the spine injury resolves
  3. Perform immediate tracheostomy
  4. Apply skeletal traction to the mandible

Explanation

Once the cervical spine has been clinically cleared, mandibular fracture treatment can proceed with appropriate precautions. Delaying treatment indefinitely is unnecessary and may worsen outcomes.

Question 42Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is the most likely cause of a dry socket after extraction of a mandibular molar?

  1. Placement of a suture
  2. Excessive irrigation during surgery
  3. Loss of the blood clot from the socket Correct answer.
  4. Use of local anesthesia

Explanation

Alveolar osteitis (dry socket) results from premature loss or disintegration of the blood clot, exposing bare bone. Suturing and local anesthesia are not causes.

Question 43Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following best describes the mechanism by which a mandibular advancement splint improves obstructive sleep apnea?

  1. It suppresses the respiratory drive
  2. It advances the mandible and tongue to enlarge the airway Correct answer.
  3. It reduces nasal resistance
  4. It increases pharyngeal muscle tone

Explanation

Mandibular advancement devices protrude the mandible and tongue, increasing the posterior airway space. They do not alter respiratory drive or directly reduce nasal resistance.

Question 44Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is a recognized indication for a coronectomy rather than extraction of a mandibular third molar?

  1. Active pericoronitis
  2. Roots intimately associated with the inferior alveolar canal Correct answer.
  3. Complete bony impaction
  4. Root resorption of the adjacent molar

Explanation

Coronectomy is considered when the roots are intimately associated with the inferior alveolar canal and removal carries a high risk of nerve injury. Active infection or complete impaction typically warrants extraction.

Question 45Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is the most appropriate initial management for a patient with a suspected fracture of the orbital floor and entrapment of the inferior rectus muscle?

  1. Immediate orbital exenteration
  2. Systemic antibiotics alone
  3. Observation with a soft diet
  4. Urgent surgical exploration and release Correct answer.

Explanation

Entrapment of the inferior rectus with restricted gaze and diplopia is an indication for urgent surgical release to prevent ischemia and permanent restriction. Observation is appropriate only for non-entrapment fractures.

Question 46Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following best describes the radiographic appearance of an odontoma?

  1. A ground-glass radiopacity
  2. A multilocular radiolucency with cortical expansion
  3. A well-defined radiopaque mass with a radiolucent halo Correct answer.
  4. A diffuse ill-defined radiolucency

Explanation

Odontomas appear as well-defined radiopaque masses, often with a radiolucent rim representing the follicle. The other descriptions correspond to different lesions.

Question 47Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is the most appropriate management for a patient with a large mandibular tori that are asymptomatic and do not interfere with function?

  1. Reassurance and observation Correct answer.
  2. Antibiotic therapy
  3. Surgical removal
  4. Radiation therapy

Explanation

Asymptomatic tori that do not interfere with function require no treatment beyond reassurance. Surgical removal is reserved for functional interference or prosthetic needs.

Question 48Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following best explains why a patient with a mandibular fracture may develop a malocclusion after treatment?

  1. Inadequate reduction of the fractured segments Correct answer.
  2. Use of local anesthesia
  3. Prolonged soft diet
  4. Excessive antibiotic use

Explanation

Malocclusion after fracture treatment usually results from inadequate reduction or fixation, leaving the segments malpositioned. Antibiotics and diet do not alter the alignment of bone segments.

Question 49Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is the most likely diagnosis for a patient with recurrent, painful oral ulcers with a gray pseudomembrane and a history of similar episodes?

  1. Herpangina
  2. Squamous cell carcinoma
  3. Oral lichen planus
  4. Recurrent aphthous stomatitis Correct answer.

Explanation

Recurrent aphthous stomatitis presents with painful ulcers covered by a pseudomembrane and recurs over time. Lichen planus is more often reticular and chronic, and carcinoma is persistent and indurated.

Question 50Oral and Maxillofacial Surgery (Qualifying Examination)

Which of the following is the most appropriate management for a patient with a suspected malignant transformation of oral lichen planus?

  1. Systemic antibiotics
  2. Topical antifungal therapy
  3. Observation for six months
  4. Biopsy of the suspicious area Correct answer.

Explanation

Suspicious changes in oral lichen planus require biopsy to rule out malignancy. Observation delays diagnosis, and antifungal or antibiotic therapy does not address neoplastic change.