NBDE II: Oral Surgery Questions and
Answers
Indications for EXT - correct answers✅✅- Caries
- Endo
- Ortho
- Cracked teeth
- Impacted teeth
- Supernumerary
- Pathology
- Questionable teeth should be EXT'd before radiation
Contraindications for EXT - correct answers✅✅- Unstable diabetes
- ESRD
- Unstable angina
- Leukemia and lymphoma
- Hemophilia or platelet disorder (can be managed)
- H&N radiation- hyperbaric oxygen before and after EXT
- IV bisphosphonates (restore with RCT then coronotomy and seal!!)
- Pericoronitis (treat infection first)
Note: hyperbaric oxygen is beneficial for pts at high risk for ORN. Allows
more oxygen to reach damaged areas and prevents tissues from dying for
lack of oxygen and blood flow. It is good for pts that have already had H&N
radiation and need an EXT
T/F: An acute dentoalveolar abscess should NOT be a contraindication to
extraction because infections can resolve very quickly when the affected
tooth is removed. - correct answers✅✅TRUE
,NBDE II: Oral Surgery Questions and
Answers
Absolute contraindication for EXT is... - correct answers✅✅Oral ulcer of
unknown origin
-Note: oral ulcers may indicate an underlying systemic issue that needs to be
diagnosed before any surgery. Ulcers can be associated with viral infections,
fungal disease, bacterial or mucosal trauma
What teeth fail to erupt in the dental arch within the expected time? -
correct answers✅✅Impacted teeth
Most impact teeth to least impacted teeth - correct
answers✅✅Mandibular 3rd molars> maxillary 3rds, maxillary canines
Reason for impacted teeth... - correct answers✅✅Inadequate arch length
Congenitally missing teeth - correct answers✅✅Third molars, maxillary
laterals, mandibular 2nd PMs
What is soft tissue impaction? - correct answers✅✅HOC is above bone
and gingiva is completely or partially covering tooth
***easiest to EXT
What is a hard tissue impaction where the HOC is below bone level? -
correct answers✅✅Partial bony impaction
,NBDE II: Oral Surgery Questions and
Answers
What is a hard tissue impaction where the tooth is entirely encased in bone
and is the most difficult to EXT? - correct answers✅✅Full bony impaction
In Winter's classification, which tooth position is easiest to EXT on the lower?
- correct answers✅✅Mesioangular
Note: *most mandibular 3rd molars are angled toward the
LINGUAL.
In Winter's classification, which tooth position is most difficult to EXT on the
lower? - correct answers✅✅Distoangular
("D" for distoangular and "D" for difficult)
The ideal time to remove impacted 3rd molars is when the root is
approximately ______formed - correct answers✅✅2/3
-Pt is around 17-21 years old and bone is more flexible and roots are not all
the way formed to have curves and dont fracture
T/F: If root development is insufficient (1/3 or less), the tooth is more difficult
to remove because it tends to roll in its crypt (like a ball in a socket),
preventing easy elevation. - correct answers✅✅True
--Pell and Gregory Classification--
(Impaction depth) - correct answers✅✅
, NBDE II: Oral Surgery Questions and
Answers
Class A - correct answers✅✅Same plane as the other molars
Class B - correct answers✅✅Halfway down other molars
Class C - correct answers✅✅Below cervical line of 2nd molar (most
difficult)
near IA nerve
**Remember "C" for cervical
Class I - correct answers✅✅3rd molar crown is anterior to ramus
Class II - correct answers✅✅3rd molar half crown is within ramus
Class III - correct answers✅✅Entire 3rd molar crown is w/i ramus (most
difficult)
OAC is most common with which teeth? - correct answers✅✅Maxillary
first molars
How to treat OAC if <2 mm? - correct answers✅✅DO NOTHING!
-Monitor and tell pt to sneeze or cough only with mouth open, dont blow
nose; may suture
How to treat OAC if 2-6mm - correct answers✅✅4As and figure 8 suture
-Abx
Answers
Indications for EXT - correct answers✅✅- Caries
- Endo
- Ortho
- Cracked teeth
- Impacted teeth
- Supernumerary
- Pathology
- Questionable teeth should be EXT'd before radiation
Contraindications for EXT - correct answers✅✅- Unstable diabetes
- ESRD
- Unstable angina
- Leukemia and lymphoma
- Hemophilia or platelet disorder (can be managed)
- H&N radiation- hyperbaric oxygen before and after EXT
- IV bisphosphonates (restore with RCT then coronotomy and seal!!)
- Pericoronitis (treat infection first)
Note: hyperbaric oxygen is beneficial for pts at high risk for ORN. Allows
more oxygen to reach damaged areas and prevents tissues from dying for
lack of oxygen and blood flow. It is good for pts that have already had H&N
radiation and need an EXT
T/F: An acute dentoalveolar abscess should NOT be a contraindication to
extraction because infections can resolve very quickly when the affected
tooth is removed. - correct answers✅✅TRUE
,NBDE II: Oral Surgery Questions and
Answers
Absolute contraindication for EXT is... - correct answers✅✅Oral ulcer of
unknown origin
-Note: oral ulcers may indicate an underlying systemic issue that needs to be
diagnosed before any surgery. Ulcers can be associated with viral infections,
fungal disease, bacterial or mucosal trauma
What teeth fail to erupt in the dental arch within the expected time? -
correct answers✅✅Impacted teeth
Most impact teeth to least impacted teeth - correct
answers✅✅Mandibular 3rd molars> maxillary 3rds, maxillary canines
Reason for impacted teeth... - correct answers✅✅Inadequate arch length
Congenitally missing teeth - correct answers✅✅Third molars, maxillary
laterals, mandibular 2nd PMs
What is soft tissue impaction? - correct answers✅✅HOC is above bone
and gingiva is completely or partially covering tooth
***easiest to EXT
What is a hard tissue impaction where the HOC is below bone level? -
correct answers✅✅Partial bony impaction
,NBDE II: Oral Surgery Questions and
Answers
What is a hard tissue impaction where the tooth is entirely encased in bone
and is the most difficult to EXT? - correct answers✅✅Full bony impaction
In Winter's classification, which tooth position is easiest to EXT on the lower?
- correct answers✅✅Mesioangular
Note: *most mandibular 3rd molars are angled toward the
LINGUAL.
In Winter's classification, which tooth position is most difficult to EXT on the
lower? - correct answers✅✅Distoangular
("D" for distoangular and "D" for difficult)
The ideal time to remove impacted 3rd molars is when the root is
approximately ______formed - correct answers✅✅2/3
-Pt is around 17-21 years old and bone is more flexible and roots are not all
the way formed to have curves and dont fracture
T/F: If root development is insufficient (1/3 or less), the tooth is more difficult
to remove because it tends to roll in its crypt (like a ball in a socket),
preventing easy elevation. - correct answers✅✅True
--Pell and Gregory Classification--
(Impaction depth) - correct answers✅✅
, NBDE II: Oral Surgery Questions and
Answers
Class A - correct answers✅✅Same plane as the other molars
Class B - correct answers✅✅Halfway down other molars
Class C - correct answers✅✅Below cervical line of 2nd molar (most
difficult)
near IA nerve
**Remember "C" for cervical
Class I - correct answers✅✅3rd molar crown is anterior to ramus
Class II - correct answers✅✅3rd molar half crown is within ramus
Class III - correct answers✅✅Entire 3rd molar crown is w/i ramus (most
difficult)
OAC is most common with which teeth? - correct answers✅✅Maxillary
first molars
How to treat OAC if <2 mm? - correct answers✅✅DO NOTHING!
-Monitor and tell pt to sneeze or cough only with mouth open, dont blow
nose; may suture
How to treat OAC if 2-6mm - correct answers✅✅4As and figure 8 suture
-Abx
