6 Minor Oral Surgery, Local Anaesthesia and Anxiety Control
Multiple choice questions
1. A patient attends the surgery for the extraction of a grossly carious lower left third molar tooth. On examination, the dentist anticipates that the procedure will require a surgical approach, and is likely to use which one of the following instruments to protect the lingual nerve?
(a) Austin retractor
(b) Coupland’s chisel
(c) Periosteal elevator
(d) Tissue dissecting forceps
(e) Warwick James’ elevator
2. A gingivectomy procedure is to be carried out on an epileptic patient. The technique will involve the removal of hyperplastic gingival tissue from the buccal side of the upper left premolar teeth. Which one of the following nerves must be anaesthetised to allow the procedure to be carried out painlessly?
(a) Greater palatine nerve
(b) Inferior dental nerve
(c) Long buccal nerve
(d) Middle superior dental nerve
(e) Posterior superior dental nerve
3. All local anaesthetic cartridges have a variety of contents, besides the agent that prevents electrical activity of the nerves. Which one of the following constituents is added to ensure the contents do not cause local soft tissue irritation, by neutralising the pH of the solution?
(a) Anaesthetic
(b) Buffer
(c) Preservative
(d) Sterile water
(e) Vasoconstrictor
4. A 35-year-old man attends the surgery as a new patient for a routine dental examination, after relocating to the area 3 months previously. On examination, the dentist notices that the lower right third molar is not present orally, but the patient states that he has never had an extraction performed. A dental radiograph reveals the tooth is unerupted in the mandible and is surrounded by a radiolucent area coronally. Which one of the following lesions is most likely to be present?
(a) Dentigerous cyst
(b) Granuloma
(c) Lateral periodontal abscess
(d) Periapical abscess
(e) Squamous cell carcinoma
5. A patient attends the surgery for the surgical extraction of an impacted lower right third molar tooth. To carry out the procedure painlessly, the inferior dental nerve will require anaesthetising by the dentist. Which one of the following anatomical structures prevents damage to this nerve during correct administration of the local anaesthetic?
(a) Body of the mandible
(b) Coronoid process
(c) Lingula
(d) Ramus of the mandible
(e) Sigmoid notch
6. A 31-year-old pregnant patient attends the surgery for the removal of an epulis, which has formed labially in the region of the upper right canine tooth. Which one of the following local anaesthetic presentations must not be used for this procedure?
(a) Lidocaine 2%
(b) Mepivacaine 2%
(c) Mepivacaine 3%
(d) Prilocaine 3%
(e) Prilocaine 4%
7. A surgical procedure is to be carried out to remove the apical section of a retained root of an upper tooth. A periapical radiograph of the root shows that it is lying in contact with the floor of the maxillary antrum. Which one of the following teeth is most likely to be involved in this scenario?
(a) Upper canine
(b) Upper central incisor
(c) Upper first molar
(d) Upper first premolar
(e) Upper supernumerary
8. An elderly patient attends the surgery for an alveolectomy procedure of the lower alveolar ridge. Once a periosteal flap has been raised, the dentist will remove any sharp spicules of bone so that future dentures can be worn comfortably. Which one of the following instruments is used for this procedure?
(a) Austin retractor
(b) Bone rongeurs
(c) Coupland’s chisel
(d) Periosteal elevator
(e) Tissue dissecting forceps
9. A patient attends the surgery following an unsuccessful repeat root filling of the upper left central incisor. A radiograph shows a distinct periapical area associated with the tooth, but the patient does not want an extraction performed. Which one of the following procedures is carried out to resolve the problem?
(a) Alveolectomy
(b) Apicectomy
(c) Frenectomy
(d) Operculectomy
(e) Pulpectomy
10. Many patients who attend the surgery for dental treatment are nervous and require some form of anxiety control to enable them to undergo their treatment successfully. Which one of the following techniques is most likely to be used for children?
(a) General anaesthesia
(b) Hypnosis
(c) Inhalation sedation
(d) Intravenous sedation
(e) Oral sedation
11. A 22-year-old patient attends for an operculectomy procedure involving the partially erupted lower left third molar tooth. In order for the procedure to be carried out painlessly, the dentist must ensure that which one of the following nerves is anaesthetised?
(a) Greater palatine nerve
(b) Inferior dental nerve
(c) Long buccal nerve
(d) Mental nerve
(e) Posterior superior dental nerve
12. An adult male attends the surgery for the simple extraction of a fractured upper left canine tooth. Although fractured, the dentist will be able to remove the tooth by severing the periodontal ligament and slightly dilating the socket, without resorting to a surgical technique. Which one of the following instruments is used by the dentist for this procedure?
(a) Bayonet forceps
(b) Coupland’s chisel
(c) Left Cryer’s elevator
(d) Luxator
(e) Upper left beaked forceps
13. Following the successful extraction of the lower right second molar tooth, a patient returns to the surgery 3 days later as an emergency. She is complaining of an aching pain at the extraction site and a bad taste in the mouth. Which one of the following is the most likely diagnosis in this instance?
(a) Localised osteitis
(b) Oroantral fistula
(c) Primary haemorrhage
(d) Reactionary haemorrhage
(e) Surgical emphysema
14. All local anaesthetic cartridges have a variety of contents, besides the agent that prevents electrical activity of the nerves. Which one of the following constituents is added to prolong the activity of the anaesthetic?
(a) Anaesthetic
(b) Buffer
(c) Carrying solution
(d) Preservative
(e) Vasoconstrictor
15. The anxiety control technique of inhalation sedation requires the patient to inhale a carefully controlled combination of two gases, oxygen and nitrous oxide. The coloured gas cylinders are fitted to a sedation machine or are piped directly into the surgery through colour-coded tubing. Which one of the following colours indicates a nitrous oxide cylinder?
(a) Black
(b) Black with white shoulder
(c) Blue
(d) Blue with white shoulder
(e) White
16. A 20-year-old patient attends the surgery complaining of severe pain in the lower left quadrant and is unable to fully open his mouth to allow the dentist to carry out a dental examination. A dental panoramic tomograph shows the presence of an unerupted lower left third molar tooth, which is leaning towards the erupted second molar tooth. Which one of the following describes this type of tooth impaction?
(a) Disto-angular impaction
(b) Horizontal impaction
(c) Mesio-angular impaction
(d) Transverse impaction
(e) Vertical impaction
17. Following the successful amputation of the root apex of a lower lateral incisor tooth, the dentist proceeds to remove the remaining infected debris from the surgical site. Which one of the following instruments is used for this task?
(a) Austin retractor
(b) Bone rongeurs
(c) Mitchell’s trimmer
(d) Periosteal elevator
(e) Tissue dissecting forceps
18. A 17-year-old patient attends for the restoration of the lower left first molar tooth, by the preparation and placement of a full gold crown onto the tooth. As the tooth is fractured buccally, a crown lengthening procedure will also be carried out at the preparation stage. To ensure this first stage of the restorative procedure is carried out painlessly, the dentist must anaesthetise which pair of the following combinations of nerves?
(a) Inferior dental and lingual nerves
(b) Inferior dental and long buccal nerves
(c) Lingual and long buccal nerves