Oral and Maxillofacial Surgery and Oral Medicine/Pathology
What the exam expects
This domain covers surgical principles, complications, and the diagnosis of oral lesions. You must know how to evaluate a swelling, a ulcer, or a radiolucency, and how to manage common surgical problems such as impacted third molars, infections, and trauma.
Concepts to master
- Surgical principles: aseptic technique, hemostasis, tension-free closure, and proper flap design. Complications include bleeding, infection, nerve injury, and dry socket.
- Odontogenic infections: spread along fascial planes; Ludwig's angina is a bilateral submandibular and sublingual space infection that threatens the airway and requires urgent drainage.
- Oral pathology: recognize common lesions such as squamous cell carcinoma, leukoplakia, erythroplakia, and odontogenic cysts and tumors. Red and white lesions that do not resolve warrant biopsy.
- Trauma: classify mandibular fractures and know the principles of reduction and fixation.
Traps
A common trap is underestimating airway risk in deep space infections. Another is assuming a white patch is benign; erythroplakia and non-healing ulcers have higher malignant potential. Questions may also test which nerve is at risk during third molar removal (lingual and inferior alveolar nerves).
Worked rule of thumb
Any oral ulcer that persists beyond two weeks without a clear cause should be biopsied or referred. For infections, assess airway first, then drainage and antibiotics.
Study strategy
Build a differential diagnosis list for swelling, ulcer, and radiolucency. Review the fascial spaces and the nerves at risk in common surgical procedures.