MCQs on Tooth Extraction (Exodontia) and Impactions

In this Post you will be able to take quiz containing important MCQs of Oral and Maxillofacial Surgery and topic covered in this Quiz will be Tooth Extraction (Exodontia) and Impactions in Oral and Maxillofacial Surgery. Correct Answers are Marked in Bold and Blue colour.

Tooth Extraction (Exodontia) and Impactions Multiple Choice Questions

1. All of the following statements about inhaled tooth fragment are true except:
A. It usually enters in the right bronchus
B. It may cause lung abscess
C. It may cause bronchiectasis
Answer: D. It will be coughed out spontaneously, no treatment is necessary

2. Rotatory movement is used for the extraction of the :
A. Mandibular canine
Answer: B. Maxillary central incisor
C. Maxillary lateral incisor
D. All of the above

3. Bulls eye type of appearance in IOPA is seen in:
Answer: A. Lingually placed mandibular third molar
B. Buccally placed mandibular third molar
C. Inverted mandibular third molar
D. Disto angular impaction

4. A pregnant patient in second trimester falls into syncope during extraction of upper molars. She should be kept in:
A. Trendelenburg position
B. Head down towards her feet
C. Right lateral position
Answer: D. Left lateral position

5. Reactionary hemorrhage occurs after extraction because of:
A. Broken roots
Answer: B. High blood pressure
C. Sharp interdental septum
D. Gingival laceration

6. The mechanical advantage obtained from the wheel and axle principle of elevator is:
A. 2.5
B. 3
Answer: C. 4.6
D. 6

7. The extraction of which of the following is most difficult in maxillary arch ?
A. Lateral incisor
Answer: B. First premolar
C. Second premolar
D. Canine

8. Displacement of a root into the maxillary sinus during extraction is most likely to happen during the extraction of maxillary:
A. Canine
B. Deciduous first molar
Answer: C. First molar
D. Second molar

9. Which of the following is relatively difficult tooth to extract?
Answer: A. Maxillary canine
B. Maxillary central incisor
C. Mandibular premolar
D.Mandibular canine

10. A patient who is on dicumarol therapy require a tooth extraction. Which laboratory test is the most valuable in evaluating this patient’s surguical risk ?
A. Clotting time
B. Bleeding time
Answer: C. Prothrombin time
D. Complete blood cell count

11. A male is taking 60 mg of hydrocortisone daily. On the day before extraction, this dose should :
Answer: A. Remain unchanged
B. Be reduced to half
C. Be doubled
D. Be reduced to one fourth

12. The complication of using airotor at 300000 rpm for impacted molar is :
A. Necrosis of bone
B. Tissue laceration
C. Tissue necrosis
Answer: D. Emphysema

13. The use of medical history in extraction patients is :
A. In medicolegal cases
B. To assess the growth stage of a patient
Answer: C. To determine bleeding disorder
D. TO determine communicable disease

14. In a patient of liver disease, the possible complication during extraction is:
A. Dry socket
B. Fascial space infection
Answer: C. Bleeding
D. Loss of clot

15. Dry socket :
Answer: A. Results from loss of blood clot in the socket
B. Is treated with reinducing bleeding into the socket
C. Is a form of osteomyelitis
D. Is common in extraction of anterior teeth

16. The trismus following a lower molar extraction after 4 weeks may be due to:
Answer: A. Breakage of needle in pterygomandibular space
B. Hematoma of TMJ
C. Submasseteric space abscess
D. Root stump in the socket

17. Reactionary hemorrhage is hemorrhage after surgery that occurs :
Answer: A. Within 24 hours
B. After 24 hours
C. After 72 hours
D. After 7 days

18. Which of the following elevators fits well in the operators hand and can be rotatetd between the thumb and the finger?
A. Couplan elevator
B. Hospital pattern elevator
C. Winter’s elevator
Answer: D. Warwick-James elevator

19. An absolute contraindication for extraction of teeth is:
A. Hypertension
B. Myocardial infarction
C. Thyrotoxicosis
Answer: D. Central hemangioma

20. Elective dental extractions on a patient who has had myocardial infarction two months prior are best:
A. performed under oral vacuum sedation
B. performed using an epinephrine free local anesthetic
C. performed using both of the above
Answer: D. postponed until at least six months have elapsed

21. Apex elevator utilizes which principle?
Answer: A. Wedge
B. Pulley
C. Wheel and axle
D. None of the above

22. While extracting a mandibular third molar, it is noted that the distal root is missing. The root tip is most likely in the :
A. Submental space
Answer: B. Submandibular space
C. Parapharyngeal space
D. Pterygomandibular space

23. One day after complete mouth extraction, blue black spots are seen on the neck of the patients. These spots indicate :
A. Thrombocytopenic purpura
Answer: B. Postoperative ecchymoses
C. Impaired blood circulation
D. Cellulitis

24. In extraction, best time to administer analgesics is :
Answer: A. Before anesthesia wears off
B. Prior to extraction
C. When pain is moderate to severe
D. After anaesthesia wears off

25. Extraction of a tooth during acute infection:
A. Can cause extensive spread of infection
Answer: B. Helps drainage and relieves pain if proper antibiotic is given and its adequete blood level is reached
C. Can cause sudden death due to pulmonary embolism

D. Can lead to trigeminal neuralgia in post operative period

26. Most important principle during extraction :
A. Least trauma to bone while extracting whole tooth out
B. Least trauma to mucosa while extracting the whole tooth out
Answer: C. Least trauma to both bone and mucosa while extracting the tooth in pieces
D. None of the above

27. When a forceps is to be utilized for removal of a tooth, the first direction for the force to be applied is:
A. Occlusally
B. Buccally
C. Lingually
Answer: D. Apically

28. The ideal treatment of alveolar osteitis after dental extraction is :
A. Topical antibiotics
B. Systemic antibiotics
Answer: C. Debridement of socket and sedative dressing
D. Curettage to induce fresh bleeding

29. The elevator can be used to advantage when :
A. The tooth to be extracted is isolated
B. The interdental bone is used as a fulcrum
C. The adjacent tooth is not to be extracted
Answer: D. Multiple adjacent teeth are to be extracted

30. During extraction, it is seen that the tuberosity is fractured but remains attached to the mucoperiosteum with an intact blood supply. The treatment is :
A. Remove the tuberosity
B. Refer to an oral Surgeon
C. Elevate a flap and do transosseous wiring
Answer: D. Reposition the fragments and stabilize with sutures

31. Number 16 cowhorn forceps are specially designed to extract :
A. Maxillary first and second premolars
B. Mandibular central incisors
Answer: C. Mandibular molars
D. Maxillary molars

32. Diagnosis of dry socket is done by :
Answer: A. History
B. Clinical Examination
C. Radiographs
D. None of the above

33. Pain of dry socket is experienced on:
A. 1st day after extraction
B. 2nd day after extraction
Answer: C. 3rd day after extraction
D. after 7 days

34. Bleeding caused in a extraction socket due to wound sepsis after few days is called as:
A. Primary hemorrhage
B. Reactionary hemorrhage
Answer: C. Secondary hemorrhage
D. Systemic hemorrhage

35. For a patient undergoing anticoagulant therapy, who requires unavoidable dental surgical treatment, the dental surgeon should :
A. Not take up the patient till the therapy is over
B. Bring down the dosage and proceed further
C. Adjust the dosage before and after dental visit
Answer: D. Consult the physician of the patient for joint decision

36. The principal action of ammonia in syncope is as a :
A. Vasomotor stimulant
Answer: B. Respiratory stimulant
C. Vagal stimulant
D. Inhibitor of vasomotor tone

37. Commonest complication after removal of mandibular third molar:
A. Lingual nerve damage
Answer: B. Dry socket
C. Fracture of mandible
D. Bleeding

38. The best time of extraction in pregnancy is:
A. First trimester
Answer: B. Second trimester
C. Third trimester
D. None of these

39. ‘Rubber band extraction’ is a method of extraction in patients having :
Answer: A. Bleeding disorders
B. Myocardial infarction and angina pectoris
C. Supernumerary teeth
D. impacted teeth

40. Hypoglycemia may occur in a patient taking insulin and undergoing extraction when :
Answer: A. Extraction is done on empty stomach
B. Patient had an infection
C. Patient had no exercise in the morning
D. Patient consumed breakfast before extraction

41. Impacted canines :
A. Most likely to be ankylosed
Answer: B. They may damage roots of other teeth
C. Good function is impossible without them
D. They will not erupt until root formation is complete

42. Radiographic appearance of the inferior dental canal and roots of the mandibular third molar :
A. Tram lines visible
Answer: B. Radiolucent band evident in relation to root of the third molar which is grooved and tunneled
C. Winter’s lines
D. Tram lines enhanced

43. Extraction of distoangular impaction of mandibular third molar can cause:
A. Slippage in lingual pouch
Answer: B. Fracture of ramus of mandible
C. Excessive hemorrhage
D. Dry socket

44. The ‘red line’ in winter’s classification of impacted teeth represents :
Answer: A. The depth at which the impacted teeth is located
B. The angulation of the second molar
C. The summit of the alveolar bone covering the impacted tooth
D. Relation of the third molar to the ramus

45. During extraction of lower impacted right molar, bone is removed :
A. To expose maximum dimension of tooth
Answer: B. Upto CE junction
C. Upto furcation area
D. Upto half of roots

46. Which is best treatment for pericoronitis involving an impacted mandibular third molar?
A. Antibiotic and analgesic therapy
B. Operculectomy
Answer: C. Extraction of the involved third molar
D. Gentle application of heat and cold simultaneously

47. A dentist planning to remove an impacted tooth will need which of the following radiographs ?
A. A periapical film will be all that is required
Answer: B. A bite wing film will be of little or no use
C. A lateral view will be all that is required
D. An anteroposterior view is all that is required

48. Which of the following is the most difficult impaction of the third molar ?
A. Mesioangular impaction
B. Vertical impacted tooth
C. Partially impacted tooth
Answer: D. Distoangular impacted tooth

49. A 23 year old female patient complains of decreased mouth opening since 4 days. This could be due to :
Answer: A. Impacted third molar
B. Oral submucous fibrosis
C. Oropharyngeal fibrosis
D. Bony ankylosis of TMJ

50. The direction of the bevel of the chisel during bone cutting is :
A. Away from the bone to be sacrificed
Answer: B. Towards the bone to be sacrificed
C. Independent of the bone to be sacrificed
D. Parallel to stress lines

51. In winter’s WAR line, Amber line represents the :
A. Relative depth of the third molar
B. Point of application of the elevator
Answer: C. Bone level covering the impacted tooth
D. Axial inclination of the impacted tooth relative to II molar

52. After surgery of third molar, patches of anesthesia on chin is due to damage of:
A. Lingual nerve
Answer: B. Inferior alveolar nerve
C. Mental nerve impaction
D. None of the above

53. The antibiotic cover is mandatory before extraction in the following condition of the heart:
A. Ischemic heart disease
B. Hypertension
C. Congestive Cardiac failure
Answer: D. Congenital heart disease

54. After multiple tooth extraction, suture is placed at:
Answer: A. Interdental septum
B. Across the socket
C. Adjacent tooth
D. None of the above

55. Mucoperiosteal flaps :
A. When raised do not cause postoperative swelling and pain
Answer: B. Are raised whenever bone removal is desired to facilitate extraction
C. are routinely raised during extraction
D. When raised will cause trauma and injury to underlying osseous tissues

56. The most common reason for the removal of impacted mandibular third molars:
A. Referred pain
B. Orthodontic treatment
Answer: C. Recurrent Pericoronitis
D. Chronic periodontal disease

57. The most common tooth to get impacted after third molars is :
Answer: A. Maxillary canine
B. Mandibular canine
C. Maxillary second premolar
D. Mandibular second premolar

58. Post extraction bleeding in a leukemic patieent is due to:
A. Increase in Leukocytes
B. Low calcium level
Answer: C. Platelet disorder
D. Deficiency of clotting factors

59. In wharfe assessment of impacted third molars, A stands for :
A. Axis of rotation
B. Application of elevator
C. Amber line
Answer: D. Angulation of third molar

60. The difficulty score for an mesioangular impacted mandibular third molar, Class II and level II is:
Answer: A. 5
B. 7
C. 10
D. 6

61. A 55 year old patient of myocardial infarction is on 75 mg Aspirin for last 6 months. He has to undergo extraction of carious tooth. What the dentist should do ?
Answer: A. Extraction can be done as this dose of aspirin does not lead to marked bleeding during extraction
B. Stop aspirin at least for 3 days prior to extraction
C. Stop aspirin at least for 7 days prior to extraction
D. Give platelets infusion and then do extraction

62. A patient who underwent extraction of 3rd molar experiences pain in socket on 3rd day. Socket is tender with no fever and swellings. What treatment should be done ?
Answer: A. Irrigation of socket with sedative placement and analgesic
B. Curettage of socket and induce bleeding
C. Leave untreated and observe for few days
D. Start antibiotics followed by curettage of socket

63. Mainly elevators in exodontia works on the principle of :
Answer: A. Lever class I
B. Lever class I and II
C. Lever class III
D. Wedge

64. Intake of which of the following leads to increased incidence of dry sockets ?
A. Antihypertensives
B. Antiepileptics
C. Oral hyppoglycemics
Answer: D. Oral Contraceptives

65. Commonly encountered complication during extraction of maxillary third molar is :
A. Oro-antral communication
B. Root displacement into sinus
C. Excessive hemorrhage
Answer: D. Fracture of the maxillary tuberosity

66. Elevators should not be used to remove the palatal root of an :
A. Upper incisor
B. Upper canine
C. Upper premolar
Answer: D. Upper molar

67. Osteotomes differ from chisels in that they are :
A. Sharp
B. Slightly curved
C. Non bevelled
Answer: D. Bi-bevelled

68. The long winter elevators (Nos. 14R and 14L) were designed for the removal of:
Answer: A. Mandibular molar roots
B. Mandibular incisor roots
C. Mandibular canine roots
D. None of the above

69. The most posterior teeth are removed:
A. Least
B. Maximal
C. Last
Answer: D. First

70. An elderly man develops syncope. He is known to have IHD. Peripheral pulses are absent, BP is not recordable and ECG reveals wide complex tachycardia. Immediate management consists of which of the following ?
A. Thrombolysis with tissue plasminogen activator
B. A bolus dose of lidocaine
Answer: C. DC cardioversion
D. IV phenylephrine and carotid sinus pressure

71. Howe and Poyton (1960) developed a criteria to diagnose the :
A. Relation of long axis of the impacted tooth to the long axis of the second molar
B. Configuration of the roots of the impacted mandibular third molar
Answer: C. Relationship of the root apices of impacted 3rd molars to the inferior alveolar canal
D. Position and depth of the impacted mandibular third molar

72. Lingual flap in mandibular third molar is retracted by :
A. Austin Retractor
Answer: B. Howarth Retractor
C. Broad Spatula
D. It does not matter

73. Lingual split technique instrument used to cut the tooth is :
Answer: A. Chisel
B. Osteotome
C. Straight elevator
D. Surgical Bur

74. During an attempted extraction of upper posterior teeth, to determine the position of the roots displaced into antrum, ideal radiograph would be:
A. Bitewing radiography of maxillary posteriors
B. IOPA of mandibular posterior teeth
Answer: C. Upper oblique occlusal radiograph
D. lateral oblique view of mandibular posteriors

75. Cardia dysarrhythmia during extraction is caused by :
A. Trochlear nerve
B. Facial nerve
Answer: C. Trigeminal nerve
D. Occulomotor nerve

76. Which of the following is expected when a tooth is lost ?
A. Decrease in trabecular pattern
B. Loss of bone width
C. Loss of bone Height
Answer: D. All of the above

77. According to Kiley and Key, all the following are absolute indications for removal of a tooth from fracture line EXCEPT:
A. Vertical fracture of the root
B. Pre existing periapical lesion
C. Luxation and subluxation of the tooth from the socket
Answer: D. Tooth which is intact but present in the line of fracture and shows no evidence of mobility or inflammation

78. In a patient who is on long term steroid therapy, what precaution is to be taken prior to teeth extraction ?
A. Stop steroids before extraction
Answer: B. Additional steroids to be given
C. More antibiotic cover
D. Continue steroids as it is