File breakage in Endodontics

# Which of the following describes the BEST management strategy for a separated instrument AFTER cleaning and shaping has occurred?
A. Do not attempt to remove and proceed to obturation
B. Place calcium hydroxide
C. Attempt to bypass the instrument

The correct answer is A. Do not attempt to remove and proceed to obturation.

If an instrument separates at the filling/obturation stage, the instrument does NOT require removal because the etiology of the problem has already been resolved
through cleaning and shaping of the canals.

The prognosis for the tooth will be
considered more favorable if the infected
dentin has already been debrided from the
canal.

The prognosis for the tooth will also be
considered more favorably the more apical
the instrument separation occurred.

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Causes of Pulpal Necrosis

# Which of the following types of trauma is LEAST likely to result in pulpal necrosis?
A. Lateral luxation
B. Avulsion
C. Subluxation
D. Concussion
E. Extrusion 

The correct answer is D. Concussion. 

Concussion - An injury to the tooth supporting structures without increased

mobility or displacement of the tooth, but

can present with pain to percussion.

Pulpal necrosis can occur following a

serious tooth trauma, especially if the the

apical blood vessels are severed.

Subluxation- An injury to the tooth supporting structures resulting in increased

mobility, but without displacement of the

tooth. Bleeding from the gingival sulcus confirms the diagnosis.

Extrusion- The partial displacement of the

tooth out of its socket.

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Flap design for periodontal surgery

# When designing a flap for a periodontal surgery, which of the following findings is most influential?
A. Probing depth
B. Frenum attachment level
C. Vestibular depth
D. Quantity of attached gingiva
E. Presence of intrabony defect

Attached gingiva maintains a tight contact
with the periosteum of the bone and certain
areas of the tooth root.

Its function is to keep the free gingiva in
close contact with the tooth while also
protecting the soft and free moving alveolar
mucosa.

Insufficient attached gingiva makes the
mucosa more prone to trauma during
function and compromises the periodontal
support of teeth.

In order to avoid periodontal problems after surgery, the width of the attached gingiva must be preserved.

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Paracetamol is contraindicated in:

# Paracetamol is contraindicated in:
A. Nephritis
B. Chronic hepatitis
C. Bleeding disorders
D. Pregnancy

The correct answer is B. Chronic Hepatitis. 

Most prominent toxic effect associated with acetaminophen use is hepatic necrosis. 

Paracetamol (Acetaminophen) has only analgesic and antipyretic action without any anti inflammatory action. Hypersensitivity reactions to paracetamol are rare and can be given to patients to whom aspirin is contraindicated. The most serious acute adverse effect of overdose of acetaminophen is a potentially fatal hepatic necrosis. Renal tubular necrosis and hypoglycemic coma may also occur. 

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What are Pessaries?

# Pessaries are the dosage forms of drug at the following mucosal sites?
A. Vagina
B. Oral Cavity
C. Bronchi
D. Anal canal

The correct answer is A. Vagina.

Pessaries are a form of topical application of drug in the vagina for localized action.

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Pain associated with elongated styloid process

# The pain on swallowing or turning the head associated with elongated styloid process is known as:
A. Tic douloureux
B. Gorham syndrome
C. Costen syndrome
D. Eagle’s syndrome

The correct answer is D. Eagle's Syndrome.

The association of an elongated styloid process with pharyngeal and cervical pain is known as Eagle syndrome and was first described in 1937. Eagle syndrome is characterized as a dull, aching pain localized to one or both sides of the throat with referred otalgia.

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Unilateral TMJ ankylosis

# In unilateral TMJ ankylosis, chin is deviated to:
A. The contralateral side
B. The affected side
C. No deviation seen
D. Side where growth is occurring

The correct answer is B. The affected side.

Unilateral TMJ ankylosis 

Seen in a child or in a person where the onset was usually in the childhood.

1. Obvious facial asymmetry.

2. Deviation of the mandible and chin on the affected side.

3. The chin is receded with hypoplastic mandible on the affected side.

4. Roundness and fullness of the face on the affected side.

5. The appearance of the flatness and elongation on the unaffected side.

6. The lower border of the mandible on the affected side has a concavity that ends in a well defined antegonial notch.

7. In unilateral ankylosis, some amount of oral opening may be possible. Interincisal opening will vary depending on whether it is fibrous or bony ankylosis.

8. Cross bite may be seen.

9. Class II angles malocclusion on the affected side plus unilateral posterior cross bite on the ipsilateral side seen.

10. Condylar movements are absent on the affected side.

Ref: Textbook of Oral and Maxillofacial Surgery, Prof. Dr. Neelima Anil Malik, Third Edition Page 263

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