BOARD Exam MCQs on Temporomandibular Joint (TMJ) and Maxillary Sinus

A 12-year-old child undergoes gap arthroplasty for unilateral temporomandibular joint (TMJ) ankylosis. On the first postoperative day, the surgeon emphasizes aggressive physiotherapy and jaw-opening exercises. What is the importance of early mobilization following surgery for TMJ ankylosis?

A patient with temporomandibular joint (TMJ) ankylosis is scheduled for surgical release. The surgeon discusses various surgical approaches to access the TMJ region. Which of the following is NOT a recognized surgical approach to the TMJ?

An 8-year-old child presents with severe restriction of mouth opening and facial asymmetry. The parents report a history of facial trauma at the age of 5 years, after which progressive limitation of jaw movement developed. Clinical and radiographic examination confirm TMJ ankylosis. What is the most appropriate treatment?

An 8-year-old child with severe bilateral TMJ ankylosis is scheduled for release of ankylosis and reconstruction using a costochondral graft. Preoperative examination reveals a mouth opening of only 2 mm, making conventional laryngoscopy impossible. What is the preferred method of securing the airway?

A 10-year-old child presents with TMJ ankylosis following facial trauma several years ago. The surgeon plans treatment according to modern principles of ankylosis management, including resection of the ankylotic mass, coronoidectomy, and interpositional grafting. Which of the following procedures is NOT routinely performed in the treatment of TMJ ankylosis?

A 25-year-old healthy individual undergoes a routine examination of the temporomandibular joint (TMJ). The clinician evaluates joint function and asks about symptoms during mandibular movements. Which of the following is NOT considered a normal feature of the TMJ?

A 9-year-old child develops TMJ ankylosis several years after a condylar fracture. During a discussion of the pathogenesis of ankylosis, the surgeon reviews the various theories proposed to explain bony fusion of the temporomandibular joint. Which of the following is NOT a recognized theory for the development of TMJ ankylosis?

A 32-year-old patient with chronic temporomandibular joint (TMJ) internal derangement undergoes arthroscopic surgery. During the procedure, dense fibrous adhesions within the superior joint space are identified and require lysis. Which laser is most commonly used during TMJ arthroscopy for adhesion lysis?

A patient presents with chronic maxillary sinusitis. During endoscopic evaluation, the otolaryngologist identifies obstruction of the natural ostium responsible for drainage of the maxillary sinus. Into which nasal meatus does the maxillary sinus normally drain?

A patient undergoes root canal treatment of a maxillary posterior tooth. During obturation, excessive filling material is extruded beyond the root apex and is later identified radiographically within the maxillary sinus. In which tooth is this complication most likely to occur?

A 45-year-old patient undergoes extraction of a maxillary posterior tooth. Following the procedure, the patient reports passage of fluids from the mouth into the nose. Clinical examination confirms an oroantral communication, which later develops into an oroantral fistula. Extraction of which tooth is most commonly associated with this complication?

A 40-year-old patient requires extraction of a maxillary molar. The oral surgeon explains that the roots of these teeth are often in close proximity to the maxillary sinus floor, increasing the risk of oroantral communication. In the adult, the maxillary sinus is consistently found directly superior to which group of teeth?

A 35-year-old patient develops an oroantral communication immediately following extraction of a maxillary first molar. On examination the defect is recent, there is no epithelial lining, and no evidence of chronic sinus infection. In which situation can spontaneous closure reasonably be expected?

A 28-year-old patient presents with a history of intermittent clicking in the temporomandibular joint (TMJ) during mouth opening and closing. Clinical examination reveals normal mouth opening and no significant pain. Which of the following is the most common cause of TMJ clicking?

A 22-year-old dental student is asked during an oral surgery viva to classify the temporomandibular joint (TMJ) based on its structure and function. Which of the following best describes the TMJ?

A 38-year-old patient presents with facial pain, nasal congestion, and tenderness over the maxillary sinus. A radiograph of the paranasal sinuses is obtained. Which of the following is the most characteristic radiographic feature of maxillary sinusitis?

A 26-year-old patient complains of a clicking sound in the TMJ during the early phase of mouth opening. Clinical examination suggests anterior disc displacement with reduction. Which of the following best explains the cause of the initial click?

A 42-year-old patient develops a persistent oroantral fistula following extraction of a maxillary third molar. The defect is located posteriorly in the maxillary tuberosity region and requires surgical closure. Which flap is considered the best treatment option for closure of an oroantral fistula in this region?

A 30-year-old patient presents with a history of recurrent anterior dislocation of the mandible. Conservative measures have failed, and surgical intervention is planned to prevent repeated dislocation of the condyle beyond the articular eminence. Which condition is the Dautrey procedure primarily used to treat?

A 12-year-old child with TMJ ankylosis requires reconstruction of the temporomandibular joint after ankylosis release. The surgeon is considering various autogenous grafts. Which joint is considered to histologically and morphologically most closely resemble the TMJ?

A 48-year-old patient presents with painful TMJ arthritis characterized by joint pain, tenderness, and limitation of mandibular movements. The clinician decides to administer an intra-articular injection of hydrocortisone acetate. What is the primary purpose of this treatment?

A 16-year-old patient presents with facial asymmetry and deviation of the chin to the right side during mouth opening. Clinical examination reveals restricted growth of the right mandibular condyle. Which of the following is the most likely cause of this deviation?

A 28-year-old patient presents with a history of TMJ clicking and intermittent locking. MRI demonstrates displacement of the articular disc relative to the mandibular condyle. What is the most common direction of displacement of the TMJ articular disc?

A 45-year-old patient with chronic maxillary sinus disease undergoes a Caldwell-Luc procedure. At the end of the surgery, a nasal antrostomy is created to facilitate dependent drainage of the maxillary sinus into the nasal cavity. Where is this antrostomy typically made?

A 50-year-old patient with chronic maxillary sinusitis is scheduled for a nasal antrostomy to improve drainage of the maxillary sinus. Through which anatomical location is a conventional nasal antrostomy most commonly created?

A 48-year-old patient with chronic maxillary sinus disease is planned for a Caldwell-Luc operation. The surgeon reflects a mucoperiosteal flap in the canine fossa region and creates a bony window to gain access to the maxillary sinus. Through which anatomical site is entry into the sinus classically made?

A 45-year-old patient undergoes extraction of a maxillary first molar. During the procedure, a fractured root tip is accidentally displaced into the maxillary sinus and is confirmed radiographically. What is the treatment of choice?

A 30-year-old patient with chronic temporomandibular joint (TMJ) pain and intermittent locking is being evaluated for internal derangement. The surgeon wishes to directly visualize the joint cavity and assess intra-articular structures with minimal surgical exposure. Which of the following techniques is most suitable?

A 24-year-old patient presents to the emergency department with an inability to close the mouth following a wide yawn. Clinical examination reveals that both mandibular condyles have translated anterior to the articular eminence. Which is the most common type of TMJ dislocation?

An 8-year-old child presents with severe restriction of mouth opening and facial asymmetry due to TMJ ankylosis following trauma several years ago. Because the patient is still growing, reconstruction must restore joint function while allowing continued mandibular growth. What is the treatment of choice?

An 11-year-old child presents with unilateral TMJ ankylosis following trauma in early childhood. Clinical examination reveals mandibular growth disturbance and facial asymmetry. Which of the following is NOT a characteristic feature of unilateral TMJ ankylosis?

A 50-year-old patient is scheduled for submandibular gland excision through a standard submandibular (Risdon) incision. During flap elevation, special care must be taken to avoid injury to a nerve that runs superficially near the inferior border of the mandible. Which nerve is most commonly at risk?

A 35-year-old patient presents with a history of recurrent anterior dislocation of the temporomandibular joint (TMJ). Conservative treatment has failed, and surgical intervention is planned to prevent repeated locking of the condyle anterior to the articular eminence. Which of the following conditions is treated by eminectomy?

A 28-year-old patient presents with severe pain and inability to open the mouth following an acute pericoronal infection around an impacted mandibular third molar. Clinical examination reveals marked trismus. Inflammation of which muscle is most commonly responsible for this condition?

A 25-year-old patient presents with an acute anterior dislocation of the temporomandibular joint (TMJ) after yawning. The mouth is locked open and the patient is unable to close it. During manual reduction, in which direction should the mandible be manipulated to relocate the condyle into the glenoid fossa?

A 32-year-old patient requires open surgery of the temporomandibular joint (TMJ) for management of internal derangement. The surgeon chooses the Al-Kayat and Bramley incision, which provides improved access to the TMJ while reducing the risk of facial nerve injury. This approach is a modification of which classical surgical approach?

A 40-year-old patient develops a persistent oroantral communication (OAC) following extraction of a maxillary molar. Surgical closure is planned using a local flap technique. The Berger flap procedure is most commonly used for the management of which condition?

A 30-year-old patient presents with an acute anterior dislocation of the TMJ after yawning. Clinical examination reveals inability to close the mouth and bilateral preauricular depression. All of the following are features of TMJ dislocation EXCEPT:

A 42-year-old patient presents with facial pain, nasal congestion, tenderness over the cheek, and a persistent postnasal discharge. The patient also reports a change in voice resonance. Which of the following symptoms are associated with maxillary sinusitis?

A 27-year-old patient presents with an anterior dislocation of the mandible after excessive mouth opening during yawning. The mandibular condyle and articular disc have moved anterior to the articular eminence and cannot return to their normal position. Spasm or excessive contraction of which muscle is primarily responsible for maintaining this dislocated position?

A 12-year-old child presents with severe limitation of mouth opening following trauma several years earlier. CT scan reveals bony fusion between the mandibular condyle and temporal bone, confirming TMJ bony ankylosis. Which surgical procedure is most commonly performed to treat this condition?

A 35-year-old patient has a history of recurrent anterior dislocation of the TMJ. Conservative treatment has failed. The surgeon plans a procedure involving intentional osteotomy (fracture) of the zygomatic arch, repositioning it inferiorly to act as a mechanical obstacle preventing anterior translation of the condyle. This procedure is known as:

A 30-year-old patient presents with a history of recurrent TMJ dislocations occurring during yawning and wide mouth opening. Clinical examination reveals a shallow articular eminence, allowing the condyle to translate excessively beyond the articular tubercle. What is the most likely cause of the frequent dislocations?

A 10-year-old child presents with severe restriction of mouth opening and facial asymmetry several years after sustaining a condylar fracture. Clinical and radiographic examination confirms TMJ ankylosis. What is the most common cause of TMJ ankylosis?