Oral Pathology Exam – Oral and Maxillofacial
Pathology Practice Examination 2026/2027
Practice Questions & Study Guide | Complete
Exam-Style Questions with Correct Detailed
Answers & Rationales (Reliable Answers) |
Latest Updated Version | Instant Download
PDF
Question 1
A 23-year-old patient presents with a painless, slow-growing
radiolucency in the posterior mandible. The lesion extends from
the molar region toward the ramus and is associated with an
unerupted mandibular third molar. Histologic examination
demonstrates islands of odontogenic epithelium resembling the
enamel organ within a mature fibrous stroma. Which diagnosis
is most appropriate?
A. Dentigerous cyst
B. Ameloblastoma
C. Odontogenic keratocyst
D. Adenomatoid odontogenic tumor
Correct Answer: B. Ameloblastoma
,The conventional solid or multicystic ameloblastoma is a benign
but locally aggressive odontogenic neoplasm that commonly
occurs in the posterior mandible and ramus. Histologically, it
characteristically contains islands or cords of odontogenic
epithelium within a fibrous connective-tissue stroma. Peripheral
palisading and reverse polarization of the peripheral epithelial
cells may also be present. Although ameloblastoma is benign in
the sense that it generally does not metastasize, it can produce
extensive bone destruction and has a significant tendency to
recur if inadequately treated. A dentigerous cyst would show a
cystic cavity lined by relatively thin nonkeratinized epithelium,
while an odontogenic keratocyst is characterized by a
keratinized epithelial lining rather than proliferating
ameloblastomatous epithelial islands. An adenomatoid
odontogenic tumor is more commonly associated with an
unerupted canine and often occurs in the anterior jaws.
Question 2
A 10-year-old child has a well-circumscribed radiolucency
surrounding the crown of an unerupted mandibular premolar.
The radiolucency attaches near the cemento-enamel junction
and is discovered incidentally. Which lesion is most consistent
with these findings?
,A. Radicular cyst
B. Dentigerous cyst
C. Traumatic bone cyst
D. Lateral periodontal cyst
Correct Answer: B. Dentigerous cyst
A dentigerous cyst is an odontogenic developmental cyst
associated with the crown of an unerupted tooth. Its defining
radiographic relationship is attachment at or near the cemento-
enamel junction. It is one of the most common developmental
odontogenic cysts and frequently occurs around impacted
mandibular third molars, maxillary canines, and other
unerupted teeth. In children, dentigerous cysts can develop
around developing premolars, sometimes following
inflammatory processes involving primary predecessors. A
radicular cyst is associated with the apex of a non-vital tooth
rather than the crown of an unerupted tooth. A traumatic bone
cyst typically lacks an epithelial lining and often scallops
between roots. A lateral periodontal cyst characteristically
occurs along the lateral root surface of a vital tooth and is
generally much smaller.
Question 3
A patient presents with a painless, multilocular radiolucency of
the posterior mandible. Histology shows a cystic epithelial lining
, with a corrugated parakeratin surface, a relatively uniform
epithelial thickness, and palisaded hyperchromatic basal cells.
Which diagnosis is most likely?
A. Odontogenic keratocyst
B. Radicular cyst
C. Calcifying odontogenic cyst
D. Glandular odontogenic cyst
Correct Answer: A. Odontogenic keratocyst
The described microscopic features are characteristic of an
odontogenic keratocyst. The lining typically consists of a thin,
relatively uniform stratified squamous epithelium with a
corrugated parakeratin surface and a palisaded basal cell layer.
Odontogenic keratocysts frequently occur in the posterior
mandible and ramus and may grow extensively within
cancellous bone while producing relatively little expansion
compared with their size. Their recurrence potential is clinically
important. A radicular cyst generally has a nonkeratinized
epithelial lining of variable thickness associated with
inflammation. A calcifying odontogenic cyst can contain ghost
cells and calcifications. A glandular odontogenic cyst often
exhibits mucous cells, duct-like spaces, and other glandular-type
epithelial features rather than the characteristic parakeratinized
lining described here.
Pathology Practice Examination 2026/2027
Practice Questions & Study Guide | Complete
Exam-Style Questions with Correct Detailed
Answers & Rationales (Reliable Answers) |
Latest Updated Version | Instant Download
Question 1
A 23-year-old patient presents with a painless, slow-growing
radiolucency in the posterior mandible. The lesion extends from
the molar region toward the ramus and is associated with an
unerupted mandibular third molar. Histologic examination
demonstrates islands of odontogenic epithelium resembling the
enamel organ within a mature fibrous stroma. Which diagnosis
is most appropriate?
A. Dentigerous cyst
B. Ameloblastoma
C. Odontogenic keratocyst
D. Adenomatoid odontogenic tumor
Correct Answer: B. Ameloblastoma
,The conventional solid or multicystic ameloblastoma is a benign
but locally aggressive odontogenic neoplasm that commonly
occurs in the posterior mandible and ramus. Histologically, it
characteristically contains islands or cords of odontogenic
epithelium within a fibrous connective-tissue stroma. Peripheral
palisading and reverse polarization of the peripheral epithelial
cells may also be present. Although ameloblastoma is benign in
the sense that it generally does not metastasize, it can produce
extensive bone destruction and has a significant tendency to
recur if inadequately treated. A dentigerous cyst would show a
cystic cavity lined by relatively thin nonkeratinized epithelium,
while an odontogenic keratocyst is characterized by a
keratinized epithelial lining rather than proliferating
ameloblastomatous epithelial islands. An adenomatoid
odontogenic tumor is more commonly associated with an
unerupted canine and often occurs in the anterior jaws.
Question 2
A 10-year-old child has a well-circumscribed radiolucency
surrounding the crown of an unerupted mandibular premolar.
The radiolucency attaches near the cemento-enamel junction
and is discovered incidentally. Which lesion is most consistent
with these findings?
,A. Radicular cyst
B. Dentigerous cyst
C. Traumatic bone cyst
D. Lateral periodontal cyst
Correct Answer: B. Dentigerous cyst
A dentigerous cyst is an odontogenic developmental cyst
associated with the crown of an unerupted tooth. Its defining
radiographic relationship is attachment at or near the cemento-
enamel junction. It is one of the most common developmental
odontogenic cysts and frequently occurs around impacted
mandibular third molars, maxillary canines, and other
unerupted teeth. In children, dentigerous cysts can develop
around developing premolars, sometimes following
inflammatory processes involving primary predecessors. A
radicular cyst is associated with the apex of a non-vital tooth
rather than the crown of an unerupted tooth. A traumatic bone
cyst typically lacks an epithelial lining and often scallops
between roots. A lateral periodontal cyst characteristically
occurs along the lateral root surface of a vital tooth and is
generally much smaller.
Question 3
A patient presents with a painless, multilocular radiolucency of
the posterior mandible. Histology shows a cystic epithelial lining
, with a corrugated parakeratin surface, a relatively uniform
epithelial thickness, and palisaded hyperchromatic basal cells.
Which diagnosis is most likely?
A. Odontogenic keratocyst
B. Radicular cyst
C. Calcifying odontogenic cyst
D. Glandular odontogenic cyst
Correct Answer: A. Odontogenic keratocyst
The described microscopic features are characteristic of an
odontogenic keratocyst. The lining typically consists of a thin,
relatively uniform stratified squamous epithelium with a
corrugated parakeratin surface and a palisaded basal cell layer.
Odontogenic keratocysts frequently occur in the posterior
mandible and ramus and may grow extensively within
cancellous bone while producing relatively little expansion
compared with their size. Their recurrence potential is clinically
important. A radicular cyst generally has a nonkeratinized
epithelial lining of variable thickness associated with
inflammation. A calcifying odontogenic cyst can contain ghost
cells and calcifications. A glandular odontogenic cyst often
exhibits mucous cells, duct-like spaces, and other glandular-type
epithelial features rather than the characteristic parakeratinized
lining described here.
