Home/Quiz/Board Exams MCQs on Tooth Extraction (Exodontia) and Impactions Board Exams MCQs on Tooth Extraction (Exodontia) and Impactions Welcome to your Board Exams MCQs on Tooth Extraction (Exodontia) and Impactions 1. During extraction of a grossly carious maxillary molar under local anesthesia, a fractured tooth fragment accidentally slips posteriorly into the patient’s airway. Shortly afterward, the patient develops coughing and respiratory distress. Chest radiograph confirms aspiration of the fragment into the bronchial tree. Which of the following statements regarding an inhaled tooth fragment is FALSE? It usually enters the right bronchus It may cause lung abscess It may cause bronchiectasis It will be coughed out spontaneously; no treatment is necessary Bronchoscopy may be required for retrieval None 2. During routine extraction of an upper anterior tooth, the oral surgeon applies a controlled rotational movement after initial luxation to facilitate removal of the tooth from its socket. The trainee is asked which tooth is most suitable for this extraction technique. Rotatory movement is most commonly used for extraction of which tooth? Mandibular canine Maxillary central incisor Maxillary lateral incisor Mandibular molar All of the above None 3. A patient undergoes radiographic evaluation for an impacted mandibular third molar prior to surgical extraction. On intraoral periapical radiograph (IOPA), the impacted tooth demonstrates a characteristic “bull’s eye” appearance, helping determine its buccolingual position. This radiographic appearance is most commonly associated with: Lingually placed mandibular third molar Buccally placed mandibular third molar Inverted mandibular third molar Distoangular impaction Horizontal impaction None 4. A 28-year-old pregnant woman in her second trimester develops dizziness and syncope while undergoing extraction of an upper molar under local anesthesia. The oral surgeon suspects supine hypotensive syndrome caused by compression of the inferior vena cava by the gravid uterus. What is the most appropriate position for managing this patient? Trendelenburg position Head down toward her feet Right lateral position Left lateral position Upright sitting position None 5. A 52-year-old hypertensive patient undergoes extraction of a mandibular molar. Initial hemostasis is achieved successfully, but a few hours later the patient returns with renewed bleeding from the extraction socket after the vasoconstrictive effect of local anesthesia has worn off. Reactionary hemorrhage following tooth extraction most commonly occurs because of: Broken roots High blood pressure Sharp interdental septum Gingival laceration Dry socket formation None 6. During routine exodontia clinic, a dental intern experiences difficulty while extracting a maxillary tooth because of its bifurcated roots and tendency for root fracture. The supervising oral surgeon explains that this tooth is considered one of the most difficult teeth to extract in the maxillary arch. Which of the following teeth is generally the most difficult to extract in the maxillary arch? Lateral incisor First premolar Second premolar Canine Central incisor None 7. During extraction of a grossly carious maxillary molar, the operator suddenly loses resistance and suspects displacement of a root fragment into the maxillary sinus. Radiographic examination confirms the presence of the root within the sinus cavity. Displacement of a root into the maxillary sinus is most likely to occur during extraction of which tooth? Canine Deciduous first molar First molar Second molar Central incisor None 8. During a routine extraction clinic, a dental intern experiences significant resistance while attempting to remove a maxillary tooth with a long, dense root embedded in thick surrounding bone. The supervising surgeon explains that this tooth is considered relatively difficult to extract because of its root anatomy and strong alveolar support. Which of the following teeth is relatively difficult to extract? Maxillary canine Maxillary central incisor Mandibular premolar Mandibular canine Maxillary lateral incisor None 9. A 60-year-old male on long-term dicumarol anticoagulant therapy requires extraction of a mandibular molar. Before performing the procedure, the oral surgeon evaluates the patient’s coagulation status to assess the risk of postoperative bleeding. Which laboratory investigation is most valuable in evaluating the surgical risk in this patient? Clotting time Bleeding time Prothrombin time (PT/INR) Complete blood cell count Platelet count alone None 10. A 50-year-old male on long-term corticosteroid therapy is scheduled for routine tooth extraction under local anesthesia. He has been taking hydrocortisone 60 mg daily for a chronic medical condition. The oral surgeon evaluates whether any perioperative steroid dose modification is required. What should be done regarding the patient’s hydrocortisone dose on the day before extraction? Remain unchanged Be reduced to half Be doubled Be reduced to one fourth Be discontinued temporarily None 11. A 50-year-old male on long-term corticosteroid therapy is scheduled for routine dental extraction under local anesthesia. He has been taking hydrocortisone 60 mg daily for a chronic systemic condition. The oral surgeon evaluates whether any alteration in steroid dosage is necessary before the procedure. What should be done regarding the patient’s hydrocortisone dose on the day before extraction? Remain unchanged Be reduced to half Be doubled Be reduced to one fourth Be discontinued temporarily None 12. During surgical removal of an impacted mandibular third molar, an operator uses an air-rotor handpiece operating at 300,000 rpm for bone removal. Shortly after the procedure, the patient develops rapid swelling with crepitus in the facial tissues due to air being forced into the soft tissue spaces. What is the most likely complication associated with use of an air-rotor at high speed during impacted molar surgery? Necrosis of bone Tissue laceration Tissue necrosis Emphysema Dry socket None 13. Before performing a tooth extraction, the oral surgeon takes a detailed medical history from the patient. During questioning, the patient reports prolonged bleeding after previous minor injuries and a family history of abnormal bleeding tendencies. What is the most important use of medical history in extraction patients? In medicolegal cases To assess the growth stage of a patient To determine bleeding disorder To determine communicable disease To assess nutritional status only None 14. A patient with chronic liver disease presents for extraction of a grossly carious mandibular molar. During preoperative assessment, the oral surgeon is particularly concerned about complications related to impaired hepatic function and reduced synthesis of clotting factors. What is the most likely complication during extraction in a patient with liver disease? Dry socket Fascial space infection Bleeding Loss of clot Delayed eruption None 15. A 32-year-old patient returns 3 days after extraction of a mandibular third molar with severe throbbing pain, foul odor, and an empty-looking extraction socket. Clinical examination reveals exposed bone with absence of the normal blood clot. Which of the following statements regarding dry socket is TRUE? Results from loss of blood clot in the socket Is treated with reinducing bleeding into the socket Is a form of osteomyelitis Is common in extraction of anterior teeth Is caused primarily by pus formation None 16. A patient presents with persistent trismus 4 weeks after extraction of a mandibular molar performed under inferior alveolar nerve block anesthesia. Clinical examination shows restricted mouth opening without signs of acute infection. Radiographic evaluation is advised to identify a possible foreign body in the pterygomandibular region. What is the most likely cause of trismus in this patient? Breakage of needle in pterygomandibular space Hematoma of TMJ Submasseteric space abscess Root stump in the socket Dry socket None 17. A patient undergoes extraction of an impacted mandibular third molar with satisfactory immediate hemostasis. Several hours later, the patient develops renewed bleeding from the surgical site after the vasoconstrictor effect of local anesthesia subsides. Reactionary hemorrhage after surgery typically occurs: Within 24 hours After 24 hours After 72 hours After 7 days After 2 weeks None 18. During surgical removal of a fractured root tip, the oral surgeon selects a small elevator that can be comfortably held and rotated between the thumb and fingers for delicate controlled movements in a confined area. Which of the following elevators best fits this description? Coupland elevator Hospital pattern elevator Winter’s elevator Warwick-James elevator Cryer elevator None 19. A patient presents for extraction of a mandibular molar associated with a radiolucent vascular lesion within the jaw. Clinical and radiographic findings suggest a central hemangioma involving the mandible. The oral surgeon decides not to proceed with extraction because of the risk of catastrophic bleeding. Which of the following is an absolute contraindication for tooth extraction? Hypertension Myocardial infarction Thyrotoxicosis Central hemangioma Controlled diabetes mellitus None 20. A 58-year-old male presents for elective extraction of multiple teeth. His medical history reveals that he suffered a myocardial infarction (MI) two months ago and is currently under cardiology follow-up. The oral surgeon considers the safest management approach for this patient. What is the best management for elective dental extractions in this patient? Performed under oral sedation Performed using epinephrine-free local anesthetic Performed using both of the above Postponed until at least six months have elapsed Performed immediately with antibiotic prophylaxis None 21. During surgical removal of a fractured root apex, the oral surgeon selects an apex elevator to carefully luxate the root fragment from the socket without excessive bone removal. The instrument functions by forcing itself between the root and surrounding bone to displace the fragment. Which mechanical principle is primarily utilized by an apex elevator? Wedge Pulley Wheel and axle Screw principle None of the above None 22. During extraction of a mandibular third molar, the oral surgeon notices that the distal root has disappeared from the socket during elevation. Clinical suspicion arises that the root tip has been displaced through the lingual cortical plate into an adjacent fascial space. The missing root tip is most likely displaced into which space? Submental space Submandibular space Parapharyngeal space Pterygomandibular space Buccal space None 23. A patient undergoes complete mouth extraction under local anesthesia. The following day, bluish-black discolorations are noticed over the neck region without significant pain or fever. The oral surgeon reassures the patient that this is a common postoperative finding caused by subcutaneous bleeding. These blue-black spots most likely indicate: Thrombocytopenic purpura Postoperative ecchymoses Impaired blood circulation Cellulitis Allergic reaction None 24. Following surgical extraction of an impacted mandibular third molar, the oral surgeon advises the patient regarding postoperative pain control. The goal is to maintain adequate analgesia before severe pain develops after the local anesthetic effect subsides. What is the best time to administer analgesics after tooth extraction? Before anesthesia wears off Prior to extraction When pain becomes moderate to severe After anesthesia wears off Only at bedtime None 25. A patient presents with severe pain and swelling associated with an acutely infected mandibular molar indicated for extraction. The oral surgeon decides to proceed with extraction after initiating appropriate antibiotic therapy and ensuring adequate systemic coverage. What is the effect of extracting a tooth during acute infection? Can cause extensive spread of infection Helps drainage and relieves pain if proper antibiotic is given and adequate blood level is reached Can cause sudden death due to pulmonary embolism Can lead to trigeminal neuralgia postoperatively Always contraindicated until swelling subsides None 26. During a difficult extraction of a grossly decayed mandibular molar, the oral surgeon decides to section the tooth into pieces rather than applying excessive force. The aim is to preserve surrounding tissues and promote optimal healing. What is the most important principle during tooth extraction? Least trauma to bone while extracting the whole tooth intact Least trauma to mucosa while extracting the whole tooth intact Least trauma to both bone and mucosa while extracting the tooth in pieces Rapid extraction with maximum force None of the above None 27. During extraction of a maxillary premolar, the oral surgeon properly seats the extraction forceps around the cervical portion of the tooth before beginning luxation movements. The surgeon emphasizes that the initial direction of force is critical for effective socket expansion and controlled tooth removal. When using forceps for tooth extraction, the first direction of force application should be: Occlusally Buccally Lingually Apically Rotationally None 28. A patient returns 3 days after extraction of a mandibular third molar complaining of severe throbbing pain radiating to the ear. Examination reveals an empty socket with exposed bone and foul odor, consistent with alveolar osteitis (dry socket). What is the ideal treatment for this condition? Topical antibiotics Systemic antibiotics Debridement of socket and sedative dressing Curettage to induce fresh bleeding Immediate surgical closure None 29. During extraction of multiple periodontally compromised teeth in the same quadrant, the oral surgeon uses a dental elevator extensively to luxate the teeth before forceps application. The surgeon explains that elevators are particularly advantageous when damage to adjacent teeth is not a concern. The elevator can be used to greatest advantage when: The tooth to be extracted is isolated The interdental bone is used as a fulcrum The adjacent tooth is not to be extracted Multiple adjacent teeth are to be extracted Only anterior teeth are involved None 30. During extraction of a maxillary molar, the operator notices fracture of the maxillary tuberosity. The fractured segment, however, remains attached to the mucoperiosteum and maintains an intact blood supply. What is the most appropriate management in this situation? Remove the tuberosity Refer to an oral surgeon Elevate a flap and perform transosseous wiring Reposition the fragments and stabilize with sutures Remove the tooth and fractured bone together immediately None 31. During extraction of a grossly decayed mandibular first molar, the oral surgeon selects a No. 16 cowhorn forceps to engage the furcation area and facilitate atraumatic removal of the tooth. No. 16 cowhorn forceps are specially designed for extraction of: Maxillary first and second premolars Mandibular central incisors Mandibular molars Maxillary molars Mandibular canines None 32. A patient returns 3 days after extraction of a mandibular third molar complaining of severe throbbing pain radiating to the ear, foul taste, and bad breath. The oral surgeon suspects alveolar osteitis (dry socket) based mainly on the patient’s symptoms and postoperative course. Diagnosis of dry socket is primarily made by: History Clinical examination Radiographs Blood investigations None of the above None 33. A patient reports severe throbbing pain radiating to the ear three days after extraction of a mandibular third molar. Examination reveals an empty socket with exposed bone and foul odor, consistent with dry socket (alveolar osteitis). Pain associated with dry socket is most commonly experienced on: 1st day after extraction 2nd day after extraction 3rd day after extraction After 7 days Immediately after extraction None 34. A patient presents several days after tooth extraction with renewed bleeding from the extraction socket associated with foul odor and signs of local infection. The oral surgeon explains that the bleeding is due to wound sepsis causing breakdown of the healing tissues and clot. Bleeding occurring a few days after extraction due to wound infection is termed: Primary hemorrhage Reactionary hemorrhage Secondary hemorrhage Systemic hemorrhage Delayed clotting hemorrhage None 35. A patient receiving long-term anticoagulant therapy requires an unavoidable dental extraction. The oral surgeon evaluates the bleeding risk and plans management carefully to avoid both hemorrhagic and thromboembolic complications. What is the most appropriate approach in managing such a patient? Do not treat the patient until anticoagulant therapy is completely over Reduce the dosage independently and proceed Adjust the dosage before and after the dental visit independently Consult the patient’s physician for a joint decision Stop anticoagulants immediately before extraction None 36. A patient develops vasovagal syncope during administration of local anesthesia for tooth extraction. The operator places the patient in a supine position and uses aromatic ammonia to help revive the patient. The principal action of ammonia in syncope is as a: Vasomotor stimulant Respiratory stimulant Vagal stimulant Inhibitor of vasomotor tone Cardiac depressant None 37. A patient returns 3 days after surgical removal of an impacted mandibular third molar complaining of severe throbbing pain radiating to the ear and foul taste in the mouth. Clinical examination reveals an empty extraction socket with exposed bone. What is the most common complication following removal of a mandibular third molar? Lingual nerve damage Dry socket (alveolar osteitis) Fracture of mandible Bleeding Osteomyelitis None 38. A pregnant woman requires extraction of a severely carious tooth causing persistent pain and infection. The oral surgeon plans treatment during the safest period of pregnancy to minimize risk to both the mother and fetus. What is the best time for dental extraction during pregnancy? First trimester Second trimester Third trimester Immediately after delivery only None of these None 39. A patient with a known bleeding disorder requires removal of a mobile tooth. To minimize surgical trauma and reduce the risk of hemorrhage, the oral surgeon considers using a gradual non-traumatic extraction technique employing elastic pressure around the tooth. “Rubber band extraction” is a method mainly used in patients with: Bleeding disorders Myocardial infarction and angina pectoris Supernumerary teeth Impacted teeth Temporomandibular joint disorders None 40. A diabetic patient taking insulin presents for tooth extraction early in the morning. He took his usual insulin dose but skipped breakfast before the appointment. During the procedure, he develops sweating, tremors, confusion, and dizziness. Hypoglycemia in such a patient most likely occurs when: Extraction is done on an empty stomach Patient has an infection Patient had no exercise in the morning Patient consumed breakfast before extraction Local anesthesia is administered None 41. A 15-year-old patient undergoing orthodontic evaluation is found to have an impacted maxillary canine on radiographic examination. CBCT imaging reveals close proximity of the impacted tooth to the roots of adjacent incisors with evidence of external root resorption. Which of the following statements regarding impacted canines is TRUE? Most likely to be ankylosed They may damage roots of other teeth Good function is impossible without them They will not erupt until root formation is complete They always erupt spontaneously after orthodontic expansion None 42. During preoperative assessment of an impacted mandibular third molar, the oral surgeon carefully evaluates the relationship between the tooth roots and the inferior alveolar canal on panoramic radiograph. A radiolucent band crossing the root with grooving and tunneling appearance is observed, suggesting close proximity to the nerve canal. Which radiographic finding indicates this relationship? Tram lines visible Radiolucent band evident in relation to the root of the third molar which is grooved and tunneled Winter’s lines Tram lines enhanced Hypercementosis of roots None 43. During surgical removal of a deeply impacted distoangular mandibular third molar, excessive force is applied while elevating the tooth. Suddenly, a crack is heard and the patient experiences severe pain, raising suspicion of a mandibular fracture. Extraction of a distoangular impacted mandibular third molar can most commonly result in: Slippage into lingual pouch Fracture of the ramus of mandible Excessive hemorrhage Dry socket Fracture of zygomatic arch None 44. During radiographic evaluation of an impacted mandibular third molar, the oral surgeon uses Winter’s WAR lines to estimate the difficulty of extraction. One of these lines specifically indicates the depth of the impacted tooth within the bone. In Winter’s classification, the “red line” represents: The depth at which the impacted tooth is located The angulation of the second molar The summit of alveolar bone covering the impacted tooth Relation of the third molar to the ramus Occlusal plane of adjacent teeth None 45. During surgical removal of an impacted mandibular third molar, the oral surgeon performs controlled buccal bone removal to create adequate access for elevation and sectioning of the tooth while preserving surrounding structures. During extraction of a lower impacted molar, bone is ideally removed: To expose maximum dimension of tooth Up to the cementoenamel junction (CEJ) Up to the furcation area Up to half of the roots Only from the distal aspect of the crown None 46. A patient presents with recurrent pain, swelling, and difficulty in mouth opening associated with a partially erupted impacted mandibular third molar. Clinical examination reveals inflamed operculum and food debris accumulation consistent with pericoronitis. What is the best definitive treatment for this condition? Antibiotic and analgesic therapy Operculectomy Extraction of the involved third molar Gentle application of heat and cold simultaneously Irrigation alone None 47. Before surgical removal of an impacted mandibular third molar, the oral surgeon evaluates appropriate radiographic investigations to assess the tooth position, surrounding bone, and relation to vital structures. Which of the following statements regarding radiographs for impacted tooth removal is correct? A periapical film will be all that is required A bitewing film will be of little or no use A lateral view will be all that is required An anteroposterior view is all that is required Occlusal radiograph alone is sufficient None 48. During preoperative assessment of an impacted mandibular third molar, the oral surgeon explains to the trainee that certain angulations are associated with significantly greater surgical difficulty because of limited access, dense overlying bone, and relation to the mandibular ramus. Which of the following third molar impactions is considered the most difficult to remove? Mesioangular impaction Vertical impacted tooth Partially impacted tooth Distoangular impacted tooth Erupted third molar None 49. A 23-year-old female presents with pain and progressively reduced mouth opening for the past 4 days. Clinical examination reveals inflammation around a partially erupted mandibular third molar with tenderness in the retromolar region. What is the most likely cause of the decreased mouth opening? Impacted third molar Oral submucous fibrosis Oropharyngeal fibrosis Bony ankylosis of TMJ Fibrous dysplasia None 50. During surgical removal of impacted bone around a mandibular third molar, the oral surgeon uses a chisel and mallet for controlled bone cutting. Proper orientation of the chisel bevel is essential to preserve healthy bone while removing the desired portion. During bone cutting, the bevel of the chisel should be directed: Away from the bone to be sacrificed Towards the bone to be sacrificed Independent of the bone to be sacrificed Parallel to stress lines Towards the soft tissue flap None 51. While evaluating an impacted mandibular third molar radiographically, the oral surgeon uses Winter’s WAR lines to estimate the difficulty of extraction. One of these lines specifically indicates the level of bone covering the impacted tooth. In Winter’s WAR line assessment, the Amber line represents: Relative depth of the third molar Point of application of the elevator Bone level covering the impacted tooth Axial inclination of the impacted tooth relative to the second molar Relation to the inferior alveolar canal None 52. A patient complains of numbness over the lower lip and chin region following surgical removal of an impacted mandibular third molar. The oral surgeon suspects injury to a sensory nerve during the procedure. Postoperative anesthesia over the chin after third molar surgery is most likely due to damage to which nerve? Lingual nerve Inferior alveolar nerve Mental nerve impaction Buccal nerve None of the above None 53. A patient with a history of congenital cardiac abnormality is scheduled for tooth extraction. The oral surgeon considers the risk of infective endocarditis and plans prophylactic antibiotic coverage before the procedure. Antibiotic prophylaxis before extraction is mandatory in patients with: Ischemic heart disease Hypertension Congestive cardiac failure Congenital heart disease Stable angina pectoris None 54. Following multiple tooth extractions in the mandibular arch, the oral surgeon places sutures to approximate the soft tissues, stabilize the clot, and promote healing of the extraction sites. After multiple tooth extraction, sutures are ideally placed at the: Interdental septum Across the socket Adjacent tooth Base of the vestibule None of the above None 55. During surgical extraction of an impacted mandibular third molar, the oral surgeon raises a mucoperiosteal flap to gain adequate access for controlled bone removal and tooth sectioning. Which of the following statements regarding mucoperiosteal flaps is TRUE? When raised, they do not cause postoperative swelling and pain They are raised whenever bone removal is desired to facilitate extraction They are routinely raised during all extractions When raised, they always cause trauma to underlying bone They eliminate the need for suturing None 56. A young adult patient presents with repeated episodes of pain, swelling, foul taste, and difficulty in mouth opening associated with a partially erupted mandibular third molar. The oral surgeon recommends extraction because the condition continues to recur despite conservative management. What is the most common reason for removal of impacted mandibular third molars? Referred pain Orthodontic treatment Recurrent pericoronitis Chronic periodontal disease Facial asymmetry None 57. A patient with leukemia undergoes tooth extraction and subsequently develops prolonged postoperative bleeding from the extraction socket. Laboratory investigations reveal severe thrombocytopenia. Post-extraction bleeding in a leukemic patient is most commonly due to: Increased leukocyte count Low calcium level Platelet disorder Deficiency of clotting factors Hypercoagulability None 58. During preoperative evaluation of an impacted mandibular third molar, the oral surgeon uses the WHARFE assessment system to estimate surgical difficulty and plan extraction strategy. In WHARFE assessment of impacted third molars, the letter “A” stands for: Axis of rotation Application of elevator Amber line Angulation of third molar Amount of bone removal None 59. A panoramic radiograph shows a mesioangular impacted mandibular third molar classified as Class II, Level II according to the Pell and Gregory classification. The oral surgeon calculates the extraction difficulty score to estimate the complexity of surgery. What is the difficulty score for this impacted tooth? 5 7 10 6 8 None 60. A 55-year-old male with a history of myocardial infarction has been taking Aspirin 75 mg daily for the past 6 months. He now requires extraction of a grossly carious tooth. The dentist evaluates whether the antiplatelet therapy should be altered before the procedure. What is the most appropriate management? Extraction can be performed as this dose of aspirin usually does not cause significant bleeding during extraction Stop aspirin for at least 3 days before extraction Stop aspirin for at least 7 days before extraction Give platelet infusion before extraction Postpone extraction indefinitely None 61. A patient reports severe pain on the 3rd postoperative day following extraction of a mandibular third molar. Clinical examination shows a tender extraction socket with loss of clot, but there is no fever or facial swelling. The oral surgeon diagnoses alveolar osteitis (dry socket). What is the most appropriate treatment? Irrigation of socket with sedative dressing placement and analgesics Curettage of socket and induction of bleeding Leave untreated and observe for a few days Start antibiotics followed by curettage of socket Immediate surgical closure of socket None 62. During extraction of a fractured mandibular molar root, the oral surgeon uses a dental elevator to luxate the root fragment by applying force against the surrounding bone acting as a fulcrum. Elevators used in exodontia mainly work on which mechanical principle? Class I lever Class I and II lever Class III lever Wedge Wheel and axle only None 63. A young female patient develops severe pain and an empty extraction socket three days after removal of a mandibular third molar. On reviewing her medical history, the oral surgeon identifies a medication known to increase the risk of dry socket formation. Intake of which of the following is associated with an increased incidence of dry socket? Antihypertensives Antiepileptics Oral hypoglycemics Oral contraceptives Antacids None 64. During extraction of an impacted maxillary third molar, the oral surgeon notices sudden mobility of the posterior maxillary bone along with the tooth, suggesting involvement of the maxillary tuberosity. What is the most commonly encountered complication during extraction of a maxillary third molar? Oro-antral communication Root displacement into sinus Excessive hemorrhage Fracture of the maxillary tuberosity Mandibular fracture None 65. During extraction of a maxillary molar, the palatal root fractures and remains deep within the socket. The oral surgeon avoids using an elevator aggressively because of the risk of displacing the root into adjacent anatomical spaces. Elevators should NOT be used to remove the palatal root of which tooth? Upper incisor Upper canine Upper premolar Upper molar Deciduous molar None 66. During surgical bone removal in oral surgery, the surgeon selects an osteotome instead of a chisel for controlled cutting and splitting of bone. The trainee is asked about the distinguishing feature between these two instruments. Osteotomes differ from chisels in that they are: Sharp Slightly curved Non-bevelled Bi-bevelled Serrated at the tip None 67. During surgical extraction of a grossly broken mandibular molar, the oral surgeon selects Winter’s elevators No. 14R and 14L to remove deeply seated root fragments from the socket. The long Winter elevators (Nos. 14R and 14L) are specially designed for removal of: Mandibular molar roots Mandibular incisor roots Mandibular canine roots Maxillary premolar roots None of the above None 68. During full mouth extraction, the oral surgeon follows the standard sequence of tooth removal to improve access, visibility, and control during the procedure. In routine extraction procedures, the most posterior teeth are usually removed: Least Maximal Last First Alternately from both arches None 69. Before surgical extraction of an impacted mandibular third molar, the oral surgeon carefully evaluates radiographic signs to determine the risk of injury to the inferior alveolar nerve. The assessment method described by Howe and Poyton (1960) is used for this purpose. Howe and Poyton developed criteria to diagnose the: Relation of long axis of impacted tooth to long axis of second molar Configuration of roots of impacted mandibular third molar Relationship of the root apices of impacted third molars to the inferior alveolar canal Position and depth of impacted mandibular third molar Presence of cystic changes around the crown None 70. During surgical extraction of an impacted mandibular third molar, the oral surgeon carefully retracts the lingual flap to protect the lingual nerve and improve visibility of the surgical field. Which instrument is commonly used to retract the lingual flap in mandibular third molar surgery? Austin retractor Howarth retractor Broad spatula It does not matter Minnesota retractor None 71. During removal of an impacted mandibular third molar using the lingual split technique, the surgeon employs a hand instrument to section and split the tooth after controlled bone removal. Which instrument is traditionally used to cut the tooth in the lingual split technique? Chisel Osteotome Straight elevator Surgical bur Rongeur None 72. During extraction of a maxillary molar, a root fragment is accidentally displaced into the maxillary sinus (antrum). The oral surgeon requests an appropriate radiograph to accurately determine the position of the displaced root before retrieval. Which is the ideal radiograph in this situation? Bitewing radiograph of maxillary posteriors IOPA of mandibular posterior teeth Upper oblique occlusal radiograph Lateral oblique view of mandibular posteriors Submentovertex view None 73. During a difficult tooth extraction, a patient suddenly develops cardiac dysrhythmia associated with intense pain and trigeminal stimulation. The oral surgeon recognizes this as a reflex response related to cranial nerve involvement during the procedure. Cardiac dysrhythmia during extraction is most commonly caused by stimulation of which nerve? Trochlear nerve Facial nerve Trigeminal nerve Oculomotor nerve Hypoglossal nerve None 74. A patient who lost multiple posterior teeth several years ago presents for prosthetic rehabilitation. Clinical and radiographic examination reveals narrowing of the alveolar ridge, reduced vertical bone height, and decreased trabecular density in the edentulous areas. Which of the following changes are expected after tooth loss? Decrease in trabecular pattern Loss of bone width Loss of bone height All of the above Increased cortical thickness only None 75. A patient presents with a mandibular fracture involving the tooth-bearing area. During evaluation, the oral surgeon assesses whether teeth present in the fracture line should be retained or extracted according to the criteria described by Killey and Kay. Which of the following is NOT an absolute indication for removal of a tooth from the fracture line? Vertical fracture of the root Pre-existing periapical lesion Luxation and subluxation of the tooth from the socket A tooth that is intact, non-mobile, and shows no evidence of inflammation despite being in the fracture line Grossly infected tooth in fracture line None 76. A patient receiving long-term corticosteroid therapy for a chronic systemic disease requires multiple tooth extractions. The oral surgeon considers the risk of adrenal suppression and plans appropriate perioperative management. What precaution should be taken before extraction in a patient on long-term steroid therapy? Stop steroids before extraction Additional steroids should be given More antibiotic cover is mandatory Continue steroids without any consideration Delay all dental treatment permanently None Time's up