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Board Exams MCQs on Cysts and Tumors of Head and Neck – Oral and Maxillofacial Surgery

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Welcome to your Board Exams MCQs on Cysts and Tumors of Head and Neck - Oral and Maxillofacial Surgery

A large odontogenic cyst is closely related to the inferior alveolar nerve and adjacent teeth. The surgeon decides to perform marsupialization to reduce cyst size and preserve surrounding structures. Which of the following is NOT an advantage of marsupialization?

Exposure of very little bone

Preservation of vital structures

Rapid healing

Conserves surgical sutures

Reduced risk of jaw fracture in large cysts

None

A panoramic radiograph reveals a large radiolucent lesion within the mandible. Before performing a biopsy, the surgeon inserts a needle into the lesion to determine its contents and avoid catastrophic hemorrhage. Needle aspiration of a central bone lesion is primarily useful for:

Ruling out a vascular lesion

Determining thickness of the buccal plate

Diagnosing a traumatic bone cyst

Feeling root surfaces

Determining tooth vitality

None

A 35-year-old patient is diagnosed with a 3 cm ameloblastoma involving the inferior border of the mandible. Radiographic examination shows cortical involvement extending to the lower border of the jaw. Considering the locally aggressive nature and high recurrence rate of ameloblastoma, which surgical treatment is most appropriate?

Enucleation

Fulguration

Cryosurgery

Resection

Marsupialization

None

A radiolucent lesion of the posterior mandible is suspected to be an odontogenic keratocyst (OKC). Before biopsy, needle aspiration is performed. Which of the following findings is most characteristic of the aspirate from an odontogenic keratocyst?

A low soluble protein content

A high soluble protein content

Cholesterol crystals

Inflammatory cells

Frank blood aspirate

None

A 17-year-old patient presents with an incidental radiolucent lesion in the posterior mandible. During surgical exploration, the surgeon finds an empty bone cavity with little or no fluid and no epithelial lining. Histopathological examination confirms the absence of a true cystic lining. What is the most likely diagnosis?

Aneurysmal bone cyst

Idiopathic bone cavity

Dentigerous cyst

Keratocyst

Radicular cyst

None

A 14-year-old boy presents with delayed eruption of a mandibular second molar. Radiographic examination reveals a dentigerous cyst surrounding the crown of the unerupted tooth. Because of the patient's young age and the eruption potential of the tooth, what is the most appropriate treatment?

Extraction of the molar

Aspiration of the cyst

Observation only

Expose the crown and keep it exposed

Segmental resection

None

A patient is diagnosed with an odontogenic cyst of moderate size involving the posterior mandible. The surgeon plans definitive treatment to completely remove the cystic lining and minimize recurrence. Which of the following is the most commonly indicated surgical procedure for odontogenic cysts?

Incision and drainage

Sclerosing solution

Marsupialization

Enucleation

Curettage only

None

A surgeon treats a large odontogenic cyst by removing the roof of the cyst and suturing the surrounding oral mucosa/periosteum to the cyst lining, thereby creating a permanent opening into the oral cavity and reducing intracystic pressure. This procedure is known as:

Decortication

Marsupialization

Saucerization

Enucleation

Curettage

None

A 32-year-old patient is diagnosed with a conventional solid/multicystic ameloblastoma of the mandible. Histopathology confirms a benign but locally aggressive odontogenic tumor with a high recurrence rate if treated conservatively. What is the best management option?

Chemotherapy

Radiotherapy

Gene Therapy

Surgical excision

Observation only

None

10.

A radiolucent lesion associated with the crown of an impacted mandibular third molar is suspected to be either a dentigerous cyst or a unicystic ameloblastoma. Since both lesions may appear similar clinically and radiographically, which of the following is the most reliable method to differentiate between them?

Radiographic examination

Aspiration cytology

Microscopic examination

Clinical features

Pulp vitality testing

None

11.

A 16-year-old patient presents with a slowly enlarging, painless swelling of the maxilla. Radiographic examination shows a characteristic ground-glass appearance, and biopsy confirms fibrous dysplasia. What is the most appropriate treatment?

Radical resection of the lesion

Radiation therapy

If the lesion is small, dissection is done. If the lesion is large, cosmetic surgery has to be carried out.

Cryosurgery

Chemotherapy

None

12.

A man presents with a 1 × 1.5 cm pedunculated lesion on the soft palate. The lesion has a rough, warty (papillary) surface and is the same color as the adjacent mucosa. The lesion appears clinically benign and is small enough to be removed completely. What is the most appropriate management?

Perform an incisional biopsy

Perform excisional biopsy

Scrape for exfoliative cytology

Observe for two weeks

Radiation therapy

None

13.

A patient is diagnosed with an odontogenic tumor and is treated by simple curettage. During follow-up, the lesion recurs because tumor cells had infiltrated beyond the apparent radiographic margins. Which of the following odontogenic tumors is most likely to recur after simple curettage?

Complex odontoma

Compound odontoma

Odontogenic myxoma

Ameloblastic fibroma

Cementoblastoma

None

14.

A 12-year-old patient presents with delayed eruption of a permanent tooth. Radiographic examination reveals a well-circumscribed radiopaque lesion composed of dental hard tissues. Histopathology confirms an odontoma. What is the treatment of choice?

Excision

Resection

Curettage

Radiotherapy

Chemotherapy

None

15.

A 40-year-old patient is diagnosed with a solid multicystic ameloblastoma of the mandible. Because of its locally aggressive behavior and tendency to infiltrate cancellous bone beyond radiographic margins, what is the treatment of choice?

Excision of tumor

Resection of the mandible along with the tumor

Incisional biopsy and marsupialization

No active treatment is necessary

Radiotherapy alone

None

16.

A patient presents with a large odontogenic cyst causing significant bone expansion and lying close to important anatomical structures. The surgeon wishes to reduce the size of the cyst first and then remove the residual lesion definitively. What is the best treatment?

Enucleation

Marsupialization

Marsupialization followed by Enucleation

Enucleation followed by Marsupialization

Observation only

None

17.

A patient presents with a 5 cm suspicious lesion of the oral mucosa with irregular borders and features suggestive of malignancy. The lesion is too large to remove completely without a definitive diagnosis. What is the most appropriate management?

Incise and send for biopsy

Excise and send for biopsy

Irradiate

Offer palliative treatment

Observe for 2 weeks

None

18.

A surgeon removes a soft tissue lesion from the oral cavity and sends it for histopathological examination. To prevent autolysis and preserve cellular architecture, the biopsy specimen should be immediately placed in:

10% Ethanol

10% Formalin

Hydrogen peroxide

1% Formalin

Normal saline (for routine histopathology)

None

19.

A radiolucent lesion of the posterior mandible is aspirated before biopsy. Laboratory analysis shows that the cystic fluid contains less than 4 mg/mL (or

Dentigerous cyst

Periapical abscess

Keratocyst

Periodontal cyst

Radicular cyst

None

20.

A benign tumor of the hard palate is surgically removed by enucleation. Because the palatal bone is often thin and lies directly beneath the floor of the nasal cavity, a common intraoperative complication is:

Excessive bleeding from nasopalatine vessels

Tearing of nasal mucosa

Damage to nasopalatine nerve

Alteration of speech

Injury to greater palatine artery

None

21.

A 16-year-old female presents with a slowly enlarging radiolucency associated with an unerupted maxillary canine. Histopathological examination reveals an Adenomatoid Odontogenic Tumor (AOT), historically referred to as adenoameloblastoma. What is the treatment of choice?

En bloc resection of maxilla

Marsupialization

Enucleation

No treatment

Segmental resection

None

22.

A patient presents with an odontogenic tumor located only 1 cm above the inferior border of the mandible. Because the lesion is very close to the lower border, conservative surgery may leave inadequate bone and increase the risk of recurrence. What is the treatment of choice?

En bloc resection

Hemimandibulectomy

Enucleation

No treatment

Marsupialization

None

23.

A patient presents with a large odontogenic cyst causing significant bone expansion and displacement of adjacent structures. To reduce the size of the lesion and preserve vital structures before definitive treatment, the surgeon plans a conservative decompression procedure. Marsupialization is most commonly indicated in:

Large cyst

Periodontal cyst

Aneurysmal bone cyst

Stafne cyst

Small residual cyst

None

24.

A 25-year-old patient presents with a slowly enlarging, painless swelling of the maxilla. Radiographic examination reveals a classic ground-glass appearance, and biopsy confirms fibrous dysplasia. The lesion is causing facial asymmetry but no major functional impairment. What is the best treatment?

En bloc resection

Cosmetic contouring

Maxillary resection

Radiation therapy

Hemimaxillectomy

None

25.

A patient presents with pain and swelling during meals. Examination and radiographs reveal a sialolith (salivary stone) located within Wharton's duct of the submandibular gland. What is the most appropriate treatment?

Dilatation of the duct

Excision of the opening of the duct

Removal of the gland

Incision of the duct and removal of the calculus

Radiotherapy

None

26.

A patient undergoes parotid gland excision (parotidectomy) for a benign salivary gland tumor. Because of the intimate anatomical relationship of several nerves with the parotid gland, which of the following structures are most at risk of injury during surgery?

Lesser occipital nerve, hypoglossal nerve, chorda tympani

Facial nerve and auriculotemporal nerve

Submandibular duct

Cervical fascia

. Lingual nerve and hypoglossal nerve

None

27.

A patient complains of recurrent pain and swelling in a salivary gland during meals. Investigation reveals a salivary calculus (sialolith). In which salivary gland are calculi most commonly found?

Submandibular gland

Sublingual gland

Parotid gland

Minor salivary gland

Labial salivary gland

None

28.

During surgical removal of a parotid gland tumor, the auriculotemporal nerve is inadvertently damaged. What complication may subsequently develop due to aberrant regeneration of parasympathetic fibers?

Facial paralysis

Trigeminal neuralgia

Gustatory sweating

Orolingual paresthesia

Loss of taste from anterior two-thirds of tongue

None

29.

A patient with a submandibular duct (Wharton's duct) calculus requires surgical removal through an intraoral approach. To expose the duct, the surgeon makes an incision in the floor of the mouth through the:

Buccinator muscle

Mucous membrane

Masseter muscle

Mylohyoid muscle

All of the above

None

30.

During excision of the submandibular gland for a calculus or tumor, a skin incision is typically placed below the angle of the mandible. Which nerve requires special attention because injury may result in weakness of the lower lip?

Ansa cervicalis

Marginal mandibular branch of the facial nerve

Posterior auricular nerve

Submandibular ganglion

Greater auricular nerve

None

31.

A patient presents with a solitary eosinophilic granuloma (Langerhans cell histiocytosis) involving the mandible. Radiographs show a localized osteolytic lesion without evidence of multifocal disease. What is the treatment of choice?

Curettage

Radiotherapy

No treatment needed

Chemotherapy

Segmental resection

None

32.

A patient presents with a mucocele of the lower lip, appearing as a soft, fluctuant, bluish swelling caused by rupture of a minor salivary gland duct. To minimize recurrence, what is the treatment of choice?

Incision

Excision

Excision with adjacent glands

Biopsy

Aspiration

None

33.

A patient is suspected of having salivary gland duct diverticuli (outpouchings of the salivary duct system). Which imaging modality is most useful for detecting these ductal abnormalities?

Ultrasonography

Plain radiography

Sialography

Xeroradiography

CT scan

None

34.

A patient presents with a chronic ulcer on the lateral border of the tongue suspected to be malignant. To obtain a representative tissue sample and maximize diagnostic accuracy, the biopsy specimen should be taken from:

Necrotic area

Subdermal layer

Border of an ulcerated area

Center of an ulcerated area

Slough-covered surface only

None

35.

A histopathological examination of a radicular (apical) cyst reveals that the cystic cavity maintains a direct communication with the root canal through the apical foramen. Such a cyst is termed:

Residual cyst

Bay cyst

Paradental cyst

Collateral cyst

Lateral periodontal cyst

None

36.

A patient is diagnosed with an odontogenic keratocyst (OKC). Because of the lesion's high recurrence rate, the surgeon performs enucleation followed by application of a chemical cauterizing agent to destroy residual epithelial remnants. Which condition is classically treated using Carnoy's solution?

Odontogenic keratocyst

Ameloblastoma

Dentigerous cyst

Mucocele

Radicular cyst

None

37.

A surgeon plans to remove an odontogenic tumor by excising it in one piece along with a margin of surrounding healthy bone, while preserving the continuity of the jaw. This procedure is known as:

Complete resection of the jaw bone

Resection of half of the affected jaw

Resection of the tumor only

The entire tumor removed intact with a rim of uninvolved bone while maintaining continuity of the jaw

Curettage

None

38.

After enucleation of a large jaw cyst, a residual bony cavity remains. To promote rapid bone regeneration and healing, which grafting material is considered the most suitable for filling the defect?

Hydroxyapatite

Autogenous cortical bone chips

Autogenous medullary bone chips

Allogenic bone chips

Xenograft bone chips

None

39.

A periapical radiolucency is associated with a non-vital tooth. The clinician wishes to differentiate whether the lesion is a radicular cyst or a periapical granuloma. Which of the following methods can be used for this differentiation?

Radioopaque dyes (contrast studies)

Polyacrylamide gel electrophoresis

Biopsy

All of the above

Pulp vitality testing

None

40.

An odontogenic keratocyst (OKC) is surgically enucleated. To reduce the risk of recurrence, the surgeon applies a chemical cauterizing agent to the bony cavity to destroy any residual epithelial remnants and daughter cysts. Which agent is used for this purpose?

Hydrogen peroxide

Carnoy's solution

Superoxide solution

Betadine

Chlorhexidine

None

41.

A 45-year-old patient undergoes surgical excision of the submandibular gland for chronic sialadenitis. During dissection, the surgeon identifies the deep lobe of the gland extending into the floor of the mouth. Which anatomical relationship of the submandibular gland is most likely to be encountered during the procedure?

Damage to the lingual nerve will cause loss of sensation to the posterior third of the tongue

The submandibular gland is seen to wrap around the posterior border of the mylohyoid

The facial artery and vein are usually divided as they course through the deep part of the gland

The hypoglossal nerve is seen to loop under the submandibular duct

The lingual nerve supplies the posterior third of the tongue

None

42.

A 19-year-old patient presents with a painless, bluish, fluctuant swelling in the floor of the mouth. Clinical examination and imaging confirm a ranula arising from mucus extravasation of the salivary glands in the floor of the mouth. To minimize the risk of recurrence, which gland is typically removed during surgical treatment?

Submandibular gland

Sublingual gland

Parotid gland

Lacrimal gland

Minor palatal salivary glands

None

43.

A 52-year-old patient presents with recurrent painful swelling of the left submandibular region during meals. Imaging reveals a large calculus located within the substance (parenchyma) of the submandibular gland, rather than in Wharton's duct. What is the most appropriate treatment?

Removal of sinus

Removal of the gland

Dichotomy

Milking of the stone

Duct incision and stone retrieval

None

44.

A 24-year-old patient presents with a soft, fluctuant swelling in the upper neck below the mandible. Intraoral examination reveals minimal swelling in the floor of the mouth. Imaging demonstrates a mucus collection originating from the sublingual gland and extending into the neck through a defect in the mylohyoid muscle. This lesion is best described as a plunging ranula. Why is it called "plunging"?

Its large size

Lifting of the tongue

Extension through the mylohyoid muscle

Involvement of the lingual nerve

Extension into the parotid gland

None

45.

A 58-year-old man is diagnosed with squamous cell carcinoma (SCC) of the lateral border of the tongue. Clinical staging is T2N0M0, with no palpable cervical lymph nodes. Because occult cervical metastasis is a concern, elective neck management is planned along with excision of the primary tumor. Which neck dissection is most appropriate?

Supraomohyoid neck dissection (Levels I–III)

Removal of lymph nodes Levels I–II

Removal of lymph nodes Levels I–V

Removal of lymph nodes Levels I–IV

Radical neck dissection

None

46.

A 62-year-old patient is diagnosed with squamous cell carcinoma of the mandibular alveolus. The surgeon plans a composite excision following the principles described by Gold, Upton, and Marx. The goal is to achieve complete tumor clearance while minimizing the risk of local recurrence. What does composite excision involve?

Resection of the tumor with the entire wound

Resection of the tumor leaving the marginal bone intact

Resection of the tumor with unaffected neighbouring tissue

Resection of the tumor with wide margin excision

Simple enucleation of the lesion

None

Time's up

High Yield MCQs on Cysts and Tumors

Cysts and tumors of the oral and maxillofacial region are among the most important and frequently tested topics in Oral Surgery and Oral Pathology examinations. Questions commonly focus on the classification, clinical features, radiographic appearance, histopathological characteristics, diagnosis, and management of odontogenic and non-odontogenic lesions.

This MCQ collection has been specially compiled for candidates preparing for:

✔ BOARD Exams
✔ FCPS Dentistry
✔ BDS Professional Examinations
✔ NBDE
✔ ORE
✔ NEET MDS
✔ AIIMS

Topics covered include:

Radicular cyst
Dentigerous cyst
Odontogenic keratocyst (OKC)
Residual cyst
Lateral periodontal cyst
Nasopalatine duct cyst
Ameloblastoma
Odontoma
Adenomatoid odontogenic tumor
Calcifying epithelial odontogenic tumor
Odontogenic myxoma
Cementoblastoma
Central giant cell granuloma
Fibro-osseous lesions
Benign and malignant jaw tumors

Attempt the quiz below and test your knowledge with high-yield examination-oriented MCQs frequently repeated in dental entrance and postgraduate examinations.

Board Exams MCQs on Cysts and Tumors of Head and Neck – Oral and Maxillofacial Surgery

High Yield MCQs on Cysts and Tumors

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