Important Topics and Study Guide of FCPS Part 2 in Oral and Maxillofacial Surgery
Thee Guidelines are Provided by Dr. RUQQIA JEHAN
INTRODUCTION
All praise is for Allah Almighty Who is the only source of knowledge and wisdom. I would like to express my sincere gratitude towards my supervisor, Dr. Muslim khan, whose guidance, support and insight went a long way in completion of my residency. I would like to thank all the faculty and my colleagues for their assistance. A very special mention in the end for my family, whose support will always be invaluable.
There are certain basic rules for the preparation of FCPS-II exam;
• Believe in yourself and ask Allah for blessing. Tell yourself that it’s your right to pass. Stay positive all the time.
• Keep yourself focused and organized from day one of your residency. Deal all patient with utmost care and sincerity. Well-being of patients should be the priority.
• Record the cases, sent it to others for peer review. Follow up all cases till the completion of their treatment.
• Make group with 2 or 3 of your colleagues, discuss and practice with each other on daily basis.
• Learning and practice during training tenure is crucial for your success in exams as well for attainment of fine skills as a clinician.
• Have good intentions and share your knowledge with fellow colleagues.
• Remember! An exam is not only a test of your academic knowledge it is also a test of your calmness, stability and courage.
• Put your best effort on the exam and ALLAH will surely crown you with success. May ALLAH bless you all.
PRINCIPLES OF SURGERY:
Pre-op health status evaluation & management of medical emergencies
• Contemporary OMFS Chapter 1&2
• Secret
• Laskin study guide
• Add GIK protocol and modified GIK protocol for DM
• Add Blood section from scully with coagulopathies
• Add SDCEP (Scottish dental clinical effectiveness program) guidelines and NOACs from scully with oral anticoagulation
• Blood and its products and blood transfusion from scully
➢ You must know about:
o Blood and its normal and abnormal values
o Interpretation of blood investigations
o Dental aspects of different blood pathologies and their management while doing different procedures under LA and GA
o Therapeutic anticoagulation and its Mx
Principles of surgery:
From Contemporary OMFS
Wound repair:
o Soft tissues and epithelium
o Bones healing
o Nerves healing
o Implant osteointegration (diff b/w tooth and implant)
o Graft healing
o Healing of free flaps
Infection control in surgery
From contemporary+ net
You must know:
o Sterilization and disinfections and their types
o Post exposure prophylaxis of HIV, HCV & HBS
o Tetanus prophylaxis
o Rabies prophylaxis
o COVID 19 dental concerns and preventive measures
o Different antibiotics used in OMFS and their Mechanism
of action
Pain and anxiety control:
From contemporary, secrets, laskin study guide and net
o Analgesics used in OMFS
o Local anesthetics: types, constituents of LA, mechanism of action, dosage calculations and block techniques from Malamad (IAN, GP, MENTAL, INCISIVE, VAZIRANI AKINOSI AND GOW GATES)
o Iv sedation
o GA (ASA grading, phases, drugs, GA in diff comorbidities, diff
o Different intubation methods and complications especially MH)
EXODONTIA:
Impaction:
o difference between imp and unerupted tooth
o different theories of impaction
o classification of 3rd molars (maxillary 3rd do archer classification and article of ZZ yurdobakan et al) and canine imp from current
o Difficulty indices (Pederson scale, WAR lines, Rood & Shahab criteria, WARFES assessment and their significance)
o Coronectomy from current chapter 15
o Post extraction complications from
o Pulp testing for vitality and sensitivity from net
Preprosthetic surgery:
From contemporary OMFS and Neelma
Implants
From contemporary, Misch, secret, FRCS viva book and laskin study guide)
o Definition, types, osteointegration
o Pt evaluation and selection
o Ridge classification cawood and mish
o Ridge augmentation and ridge manipulation procedures from neelma
o Blood products PRP &PRF and their uses in dentistry
o GTR (from article or fonsica)
o Periimplantitis from current (CYST therapy)
o Technique contemporary
o Options for partially and completely edentulous pts (all in 4 concept)
Infections:
From contemporary, laskin study guide and secret
You must know:
o Involved bacteria, basic anatomy, principles of infections, different spaces and boundaries, incisions and Management.
o Principles of prophylaxis, prophylaxis for inf endocarditis and prosthetic joint)
o NF, cavernous sinus thrombosis (Medscape article), actinomycosis, Ludwig angina from current, sinusitis (contmp)
o Osteomyelitis from fonsica (chap 25) and navellie
Pt on chemo and Radiotherapy:
ORN: Contemporary
Current (chap 59)
Fonsica
Challenging concepts +FRCS viva book
MRONJ: Current chap 65
Contemporary
Stages and Mx from fonsica chapter 21 (tables only)
FRCS viva book
Salivary glands:
▪ Contemporary
▪ Wb whole section
▪ Navellie (Sjogren’s’ s syndrome, sialorrhea and tumors)
▪ NCCN guidelines for TNM and Tx planning’
▪ Parotid duct injury and Mx from fonsica trauma
Different biopsies in OMFS:
➢ From contemporary and net (search for techniques and watch
videos of each)
o Cytology
o FNAC
o FNAB (core biopsy)
o SLNB
o Incisional and excisional biopsy
o Diagnostic adjuncts from contemporary
o Cryotherapy
o Cornoy’s solution: use and application method
o Biopsy first vs CT/MRI first
Orthognathic surgery:
o Pt evaluation from WB chp74 up to combined tmj and ortho sx planning
o Surgical Techniques (watch videos of each sx technique)
• BSSO, VRO, LEFORT 1 do it from WB & fonsica
• Inverted L, genioplasty from fonsica
• SARPE from current
• Clear your concepts in lefort 2,3 & kufner modification of lefort 3
• Complications from WB/fonsica (if time)
• Pre and post-surgical orthodontics
• Surgical first in orthognathic (net)
• Sequencing of maxilla vs mandible ist in bi jaw surgery (article by Daniel parez. et al)
• For Tx planning clear your concept in different ceph values so that you are able to make dx and make Tx plan
• Follow up from fonsica
• Add secret, FRCS viva book, challenging concepts and laskin study guide
Distraction osteogenesis:
From Peterson chapter 63
• Principles, types, techniques and vector angle calculation
• Dancing distraction
• Surgery first vs DO first
• Add laskin study guide & secret
Obstructive sleep apnea:
From Peterson chapter 64
• Types, AHI, RDI, dx, treatment & complications
• Add laskin study guide, FRCS viva book and secret
Nerve injuries:
• Micronuerosurgery from Peterson chp 42
• Wb chap 50
• Fonsica CN 5& 7 injuries
• Secret
• Watch videos for sx repair
Clear concepts in following topics regarding nerve injuries
o Facial nerve anatomy, examination, house-Brackmann classification, bell’s palsy static & dynamic procedures & their timings.
o Trigeminal nerve anatomy, injuries classification (suddan &
Sunderland)
o Sural and Greater auricular nerve anatomy and grafting technique
o Frey and crocodile tear syndrome
o Consideration in nerve repair (Larry M. WOLFORD et al)
Facial esthics:
• Different surgical treatment option (only names)
• Fillers, chemical peeling and BOTOX (Botox uses in dentistry and technique) from contemporary and fonsica
• Complications from current
Orofacial clefts:
Tessier ‘s classification of clefts (PETERSON)
CLP
• Secret
• current (whole section)
• laskin study guide
• Peterson (chapter 43 & 44)
• FRCS viva book
U should learn following points
✓ Classification (Veau’s classification, LASHAL from WB)
✓ Etiology and syndromes related to CLP (only names)
✓ Diff surgical techniques for Lip, soft &hard palate (esp. drawing of MILLARD)
✓ Diff of orthoghnathic sx in clp vs in normal pts
✓ Secondary procedures
✓ VPI & its Mx
✓ ABG (normal anatomy of ant and post iliac crest & its harvesting techniques (from Sharukh bakhari) anatomy & its complications
✓ DO in CLP
PAIN:
Contemporary + Navellie
• BMS (only Tx flowchart from article by HEIDI. C CROW et. al)
• Trigeminal neuralgia (neelma chapter 44)
• Injection therapy for headaches & pain (article by Jonathan k. kleen
et. al)
• Add laskin study guide + secret
Syndromes:
• WB chapter 58
✓ Craniosynostosis
✓ Pfeiffer syndrome
✓ Crouzon syndrome
✓ Apert syndrome
✓ Treacher collins
✓ Hemifacial microsomia
✓ Cleidocranial
✓ Ectodermal dysplasia
TMJ:
• Contemporary
• WB (Chapter 95-100)
• Peterson (if u have time chap 47-52)
• Add secret+ FRCS viva book + laskin study guide
Clear your concepts about
✓ Tmj anatomy
✓ Myofascial disorders
✓ Internal derangements classification & their stage wise
management
✓ DJDs from wardbooth (chapter 74 in tmj section)
Facial asymmetry:
From current and article (condylar hyperplasia: an updated review of the literature by Luis Eduardo Almeida et. Al)
Oral squamous cell carcinoma:
▪ Werning chapters no. 2,3,4,6,7,9,10,11,12,13,14,15,16,17,18,19,22,29,30
▪ NCCN guidelines
▪ Stell and maran: chapters 34: Neck metastasis, 35: unknown primary and 36: neck dissection
▪ WB (chapter 15,17,18,20,22,23,24,25,29)
▪ Radiotherapy: WB / net +NCCN guidelines
▪ Chemo: werning / net + NCCN guidelines
▪ Management of patients with chemo and radio form contemporary OMFS
▪ Novel therapeutics: werning
▪ Add secret+ FRCS viva book+ laskin study guide
Reconstruction:
• WB chapter no.32,33,34,35,36,38,39,40,41,43
• + pectoralis major from current+ cervicofacial flap and rectus abdominis from Net
• Temporalis system of flap current chapter 64
• Add secret+ laskin study guide + FRCS viva book
• Updated brown classification of maxillectomy
• For mandibular defects &reconstruction (Cordeiro MD et. Al 2017:
A defect classification system algorithm for flap selection & sx outcome)
Clear your concepts of:
✓ Basic anatomy of each flap e.g. vascular supply, nerve supply
✓ Definitions of axial flap, random flap, rotational flap and interpolated flap, prelaminated & prefabricated flap, septocutaneous, osteocutanous flaps, pedicle and paddle
✓ Incisions and surgical technique of each (watch videos)
✓ Coleman fat grafting (Net & FRCS viva book)
✓ Flap monitoring (current chapter 69+net)
✓ Chlye leak & mx (WB +Net)
Trauma :
▪ ATLS: fonsica trauma / Peterson /WB (your own choice)
▪ Osteosynthesis: Peterson / AO guidelines
▪ Mandible + condyle: WB +current
▪ Midface + NOE+ Palatal fracture+ nasal #: new fonsica trauma + current
▪ Frontal sinus: WB+ Current
▪ ZMC: fonsica trauma+ current
▪ Orbit: WB/Peterson +current
▪ Panfacial: new fonsica trauma +current
▪ FAI: current
▪ Traumatic epistaxis: current
▪ Csf rhinorrhea: Medscape article
▪ Soft tissue: WB
▪ Classification of bomb blast injury: WB
▪ Retrobulbar hemorrhage: fonsica
▪ SOF syndrome, orbital apex syndrome, oculocardioreflex & carato cavernous fistula
▪ Add secret+ FRCS viva book + challenging concepts +laskin study guide
Clear your concepts of;
✓ Diplopia
✓ Orbital anatomy
✓ Different eye gazes
✓ Enophthalmos, exophthalmos, proptosis, exorbitism
✓ Trauma pts examination & CT interpretation
Pathology:
• Chapter 1:
o Fordyce granules
o Leukoedema
o Hairy tongue
o Eagle syndrome
o Developmental cysts: ALL (Add brachial cyst from
ward)
• Chapter 3: Pulpal disease
o Periapical granuloma
o Periapical cyst
o Osteomyelitis (Add from clinical review+ fonsica+
contemporary)
• Chapter 4: PDL disease
o Necrotizing ulcerative gingivitis
o Drug related gingival hyperplasia
• Chapter 5: Bacterial disease
o Syphilis
o Tuberculosis
o Noma
o Actinomycosis
o Sinusitis
• Chapter 6: fungal & protozoal disease
o Candidiasis
o Mucormycosis
o Aspergillosis
o (add article about isavuconaznium sulphate: a
new agent for the Tx of invasive mucormycosis
& aspergillosis)
• Chapter 7: Virus
o Herpes simplex
o Varicella
o Herpes zoster
o Inf mononucleosis
o cytomegalovirus
o Mumps
o HIV
• Chapter 8: Physical & chemical injury
o Linea alba
o Morsicatio buccarum
o Mronj
• Chapter 9: Allergies & immunologic disease
o Aphthous ulceration
o Behcet’s syndrome
o Orofacial granulomatosis
o Wegener’s granulomatosis
• Chapter 10: epithelial pathology
o Papilloma
o Sinonasal papilloma
o Oral melanotic macule
o Leukoplakia
o Erythroplakia
o Oral submucous fibrosis
o Nicotinic stomatitis
o Actinic cheilosis
o Squamous cell ca
o Verrucous ca
o Spindle cell ca
o Ca of maxillary sinus
o Sino nasal undiff ca
o Basal cell ca
o Melanoma (add NCCN guidelines)
Chapter 11: salivary gland
o Sialorrhea
o Sjogren syndrome
o Necrotizing sialometaplasia
• Salivary gland tumor
o Pleomorphic adenoma
o Warthin tumor
o Mucoepidermoid ca
o intraosseous mucoepidermoid ca
o Acinic cell ca
o Ca ex pleomorphic adenoma
o Adenoid cystic ca
o Polymorphous low grade adenocarcinoma
• Chapter 12: soft tissue tumor:
o Fibroma
o Epulis fissuratum
o Myofibroma
o Pyogenic granuloma
o Peripheral gaint cell granuloma
o Peripheral ossifying fibroma
o Lipoma
o Neuroma
o Neurofibromatosis type 1
o MEN 2B
o Vascular malformation (add from WB & current)
o Sturge weber angiomatosis
o Lymphangioma
o Leiomyoma
o Rhabdomyoma
Soft tissue sarcoma: (add from fonsica if time)
o Liposarcoma
o Kaposi’s sarcoma
o Leiomyosarcoma
o Rhabdomyosarcoma
Chapter 13: Hematologic disorders (with scully)
o Hemophilia
o Anemia
o Sickle cell anemia
o Thalassemia
o Neutropenia
o Leukemia
o Langerhans cell histiocytosis (add from fonsica)
o Hodgkin’s & non-Hodgkin’s lymphoma
o Burkitt’s lymphoma
o Multiple myeloma
Chapter 14: Bone pathology
o Complete
o Add fibrous dysplasia from WB
o Add gaint cell lesions from Fonsica
o Add osteosarcomas from articles or fonsica
o Difference b/w fibrous dysplasia & ossifying
fibroma
Chapter 18: odontogenic cysts & tumors
o Complete
o Add ameloblastoma from fonsica & current
o Add keratocyst from fonsica & current
Chapter 19: dermatological
o Connective tissues disorders ehlers-Danlos syndromes & its differential
o Immune mediated disease
✓ Pemphigus
✓ Mucous membrane pemphigoid
✓ Erythema multiforme
✓ Erythema migrans
✓ Reactive arthritis
✓ Lichen planus (add from net/article)
✓ Lupus erythematosus
Chapter 17: Oral manifestation of systemic disease
o Hyperparathyroidism
Chapter 18: Facial pains
o Whole chapter
o BMS (article Tx flow chart by HEIDI. C CROW et. al)
Surgical approaches:
✓ Surgical approaches to the facial skeleton by Edwards Ellis
✓ Approach for skull base tumors from WB.
Amazing help for beginners