# If hematoma formation occurs after posterior superior alveolar nerve block, it is due to the damage of:
A. Pterygoid venous plexus
B. Small capillaries and arterioles in the region
C. Facial artery
D. Internal maxillary artery
The correct answer is A. Pterygoid venous plexus.
Complications after posterior superior alveolar nerve block
1. Hematoma:
a. This is commonly produced by inserting the needle too far posteriorly into the pterygoid plexus of veins. In addition, the maxillary artery may be perforated. Use of a short needle minimizes the risk of pterygoid plexus puncture.
b. A visible intraoral hematoma develops within several minutes, usually noted in the buccal tissues of the mandibular region.
(1) There is no easily accessible intraoral area to which pressure can be applied to stop the hemorrhage.
(2) Bleeding continues until the pressure of extravascular blood is equal to or greater than that of intravascular blood.
Reference: Handbook of Local Anesthesia, Malamed, 6th Edition, Page 195
# Medial dislocation of fractured condyle in subcondylar fracrure is caused by:
A. Medial pterygoid
B. Lateral pterygoid
C. Masseter
D. Buccinator
# A dental surgeon has recoverd from Hepatitis B by 3 months rest. His laboratory findings are normal but he is not allowed to attend patients as per medical board as he is:
A. healthy carrier
B. active carrier
C. convalescent carrier
D. paradoxical carrier
# The duration of fixation generally required for fracture of mandible:
A. 2-4 weeks
B. 3-5 weeks
C. 6-8 weeks
D. 8-10 weeks
The correct answer is C. 6-8 weeks.
In the past, one of the major considerations in the immediate postoperative period was the difficulty resulting from IMF. When the jaws are wired together, the patient has initial difficulties in obtaining adequate nutrition, performing necessary oral hygiene, and communicating verbally. The average IMF period ranges from 6 to 8 weeks.
Reference: Contemporary Oral and Maxillofacial Surgery, James R. Hupp, 6th Edition 2013, Page No: 557
Inflammation of palatine tonsils is called tonsillitis. Each tonsil is a mass of lymphoid tissue at the back of your throat-one on each side.
What is the role of tonsils in our body?
It provides local immunity and surveillance to our body to fight against foreign intruders.
Tonsils are most active from 4 to 10 years of age. After puberty, gradual involution of the tonsils takes place..
Types:
1.Acute tonsillitis
2.Chronic tonsillitis
Etiology:
- Most common in school going children but may affect adult. Viruses are the most common offenders in tonsillitis.
1.Adenovirus
2.Influenza virus
3.Parainfluenza virus
4.Herpes simplex virus (HSV)
- Hemolytic streptococcus is a common bacteria causing tonsillitis. Other bacteria causing tonsillitis are:
1.Staphylococci
2.Pneumococci
3.Haemophilus Influenzae
What are the symptoms of Acute tonsillitis?
The most common symptoms of tonsillitis are:
1. Enlarged, red tonsils
2. Sore throat
3. Not able to swallow due to which drooling may occur
4. Fever
5. Ear pain
6. Abdominal pain in children
7. Headaches
8. General body aches
9. Constipation
Diagnosis:
The doctor will do physical examination and look at your tonsils for signs of inflammation. A throat swab will be taken for culture. Growth of bacterial colony indicates bacterial tonsillitis. No growth will give a inference of viral disease.
Complications:
Complications will arise if the treatment is not provided or not adequate.
1.Collection of pus around tonsil (Peritonsillar abscess)
2. Infection may spread into surrounding tissues
3. Parapharyngeal abscess
4. Obstructive sleep apnea
5. Rheumatic fever if the causative agent is Group A beta-hemolytic streptococcus.
6. Glomerulonephritis
Treatment
1. Medical treatment
Antibiotics will be given if the culture shows growth of bacteria. Penicillin is the drug of choice. In patients with penicillin allergy, erythromycin can be given. If the cause is a virus then there is no role of antibiotics. With adequate bed rest and plenty of fluids body will recover on its own. Sometimes, your doctor may prescribe antibiotics in viral tonsillitis to prevent secondary bacterial infection. Paracetamol is given for fever and relief of pain. Prepare salt water solution at home and gargle the solution and spit it out.
2.Surgery
Removal of the tonsils (tonsillectomy) is required if there is recurrent tonsillitis. Recurrent tonsillitis is defined as;
- Seven or more episodes of tonsillitis in one year
- Five episodes per year for two consecutive year
- Three episodes per year for three consecutive year
# A bony opening in the canine fossa is commonly used to:
A. Enter the maxillary sinus
B. Establish drainage of an alveolar abscess
C. Remove mandibular third molars
D. Uncover and marsupialize a cyst
The correct answer is A. Enter the maxillary sinus.
The wall of the sinus is very thin in this area. This area is used for following: (i) Diagnostic aspiration, and (ii) The site for Caldwell-Luc operation; that is, the antral exploration with or without an intraoral antrostomy.
Reference: Textbook of Oral and Maxillofacial Surgery, Third Edition, Neelima Anil Malik, Page no. 639
'Dry socket' derives its name from the fact that after the clot is lost the socket has a dry appearance because of the exposed bone. This condition is more common in women and tobacco users, and is most frequently associated with difficult or traumatic extractions and thus most commonly follows removal of an impacted mandibular third molar. In a series of 138 ‘dry sockets’ among 6,403 teeth extracted in human patients, Krogh reported that 95% were in lower bicuspid and molar sockets, and this is confirmed by most other large series of cases.
