Modul 2 a 32-years-old patient appealed to the oral surgeon concerning rehabilitation of the oral cavity. Durinп еру examination the doctor found that the crown of the 25 tooth is broken. The root is stable, percussion is painless



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1.A 32-years-old patient appealed to the oral surgeon concerning rehabilitation of the oral cavity.Durinп еру examination the doctor found that the crown of the 25 tooth is broken.The root is stable, percussion is painless.Mucosa of the alveolar process is not altered.The x-rayrevealed a slight
enlarged to the periodontal space. What is the presumptive diagnosis?

A Chronic fibrotic periodontitis of the 25 tooth

B Chronic periodontitis of the 25 tooth

C Chronic granulomatous periodontitis of the 25 tooth

D Chronic granulative periodontitis of the 25 tooth

E Cystogranuloma
2. A 32-years-old patient appealed to the oral surgeon concerning rehabilitation of the oral cavity.Durinп еру examination the doctor found that the crown of the 25 tooth is broken.The root is stable, percussion is painless.Mucosa of the alveolar process is not altered.The x-rayrevealed a slight
enlarged to the periodontal space. What is the presumptive diagnosis?

A Chronic fibrotic periodontitis of the 25 tooth

B Chronic periodontitis of the 25 tooth

C Chronic granulomatous periodontitis of the 25 tooth

D Chronic granulative periodontitis of the 25 tooth

E Cystogranuloma


  1. A 31-ears-old |husband|appealed to|by| the policlinic withcomplaints about periodic pain|anguish| in area|domain| of the 48 during|for| 4 years. Objectively: submandibular |lymphatic nodes on the right |to the right|are enlarged, painless|analgic|. The 38 tooth is partly erupted, mucous around |about|it is bloodshot. During sounding of the gingival |pocke tof the 48 tooth a drop |gutta|of pus with bloodflowsout.What additional method of examination |work-up|is the mos tinformative in this case|pathematoloy|?

A Rentgenological examination

B Blood test

C Electro-odonto measuring

D Blood and urine tests

E Contrast x-ray

4. An 8-year-old child was diagnosed with granulating periodontitis of the 55 tooth. The crown

is completely destroyed. X-ray picture shows separated tooth roots. Choose an optimal

tool for operative intervention:



A Root bayonet-shaped forceps

B Root straight forceps

C Root beak-shaped forceps

D Crown bayonet-shaped forceps

E Crown S-shaped forceps
5. A patient complains of the presence of a tooth root.Tooth was destroyed longago.Objective:
crown of the 36 tooth is destroyed on 2/3. Percussion of the tooth is painless, mucosa in the area
tooth is palepink, without pathological changes. On radiograph on the top of the medial root- thefocusofenlightenmentwithclearcontours,
roundshaped.What diagnosis can be assumed?

AChronic granulomatous periodontitis.

B Chronic granulative periodontitis.

C Chronic fibrotic periodontitis.

D Exacerbation of chronic periodontitis.

E Acute purulent periodontitis.
6. Diagnosis: acute apical periodontitis of tooth 35. Which diseases should hold the differential diagnosis?

A. The exacerbation of chronic periodontitis apex, chronic pulpitis, lymphadenitis

B. Deep caries, periodontal abscesses, purulent odontogenic cyst

C. The exacerbation of chronic periodontitis apex, acute diffuse pulpitis, acute purulent periostitis

D. Chronic pulpitis , acute deep caries, phlegmon of submandible area
7. During the last day the patient have the complaining about the pain in the 25 tooth, which is aggravated during the biting. OBJECTIVE: on the medial surface of 25 tooth cavity wich is not connected with the pulp cavity. The reaction to temperature stimuli is absent. Vertical percussion of the 25 tooth is painful. On radiograph: Periapical tissue of the 25 tooth without pathological changes. What is the most likely diagnosis:

A. Acute purulent pulpitis

B. Acute diffuse pulpitis

C. Acute serous periodontitis

D. Acute purulent periostitis

E. Acute purulent periodontitis


8. The patient 27 years old complains of constant intense pain in the 36 tooth. The pain appeared 2 days ago. OBJECTIVE: on the medial surface of the 36-tooth caries cavity are filled with the permanent plomb. In thermal stimuli tooth does not respond, vertical and horizontal percussion sharply painful. Noted pathological tooth mobility in the 36. Mucosa around the 36 hiperemic, swollen, smooth transition fold, palpation of the gingiva painful. Determine diagnosis:

A. Acute diffuse pulpitis

B. Acute serous periodontitis

C. Exacerbations of chronic periodontitis

D. Acute purulent pulpitis

E. Acute purulent periodontitis

9. The patient 19 years old complains of constant pain in the 22 tooth, aggravated during the biting on the tooth, a sense of "grown" tooth, swelling of the upper lip. In history it is known that there was the injury of the upper jaw. OBJECTIVE: 22 tooth intact. Vertical percussion sharply painful. Upper lip swollen, transition fold near the 22 tooth hiperemic, painful during palpation. What examination method is required for diagnosis:

A. Transilyuminatsiya

B. Elektroodontometry test

C. Reodentohraphy

D. Radiography

E. Thermography


10. The patient 25 years old complained of constant aching in the 25 tooth, aggravated during the biting. OBJECTIVE: on the chewing surface of the 25 tooth caries cavity, connected with the pulp cavity of the tooth. The transition section near the 25 tooth swollen, hiperemic, painful during palpation, percussion of the 25 sharply painful. After the probing of the channel the pus is present. What method is necessary to conduct the diagnosis:

A. X-ray examination

B. Elektroodontometry test

C. Temperature stimuli test

D. Bacteriological study

E. Deep probing


11.Patient 45 years complains on the slight swelling of the left cheek, painful lower left side of the jaw, temperature 37, 6ºС. Objectively: asymmetrical face due to edema of left cheek and submandibular area on the left. Opening of the mouth is not limited, on the transitional fold present dense painful infiltration, in the area of 47, 46, and 45 -- fluctuation. A crown of 46 is destroyed by 2/3. Percussion is painful. Wh is the most exact diagnosis?

A.Acute purulent periostitis of lower jaw

B.Phlegmon of left submandibular area

C.Acute serous periostitis of lower jaw

D.Exacerbation of chronic Pt

E.Acute osteomyelitis


12. In a man|husband| 20 years old sickly|morbid| slight swelling in the area|domain| of upper|top| jaw in the left|on the left|. Body temperature 37,5о С. 2 days ago|that is why| athere was the pain in 26 tooth |. Then|after| the slight swelling appeared and pain|anguish| in the area|domain| of upper|top| jaw. During the inspection|examination|: asymmetry of the face in the area|domain| of the left cheek and infraorbital| , slight swellings |on the left. Intraoral examination. Intraoral examination: it was swollen and hyperemia of mucus shell alveolar jaw and transitional fold limits of 25 – 27 teeth. These teeth are immobile. During palpation| on a transitional fold fluctuation| |shown|. Percussion of 26 – painless. The crown of him is blasted fully. Set a diagnosis.

A Acute odontogenic periostitis.

B Sharp festering periodontitis

C Sharp оdontogenic osteomielitis

D Chronic оdontogenic osteomielitis

E Chronic periodonttis

13. Constant pain localized character. Tooth cavity open, filled with food debris. Probing eyes of root canals are not painful. Percussion painful. Palpation slyzivky top of the root in the area is painful. Percussion painful. Palpation slyzivky top of the root in the area is painful. Electric pulp: tooth reacts to the current 100 MAbs, radiography - about riding no changes. Put a diagnosis.

A. Acute diffuse pulpitis

B. Acute apical periodontitis serous

S. Chronic apical periodontitis fibrotic

D. Chronic granulomatous apical periodontitis


14. Diagnosis: acute apical periodontitis of tooth 35. Which diseases should hold the differential diagnosis?

A. The exacerbation of chronic periodontitis apex, chronic pulpitis, lymphadenitis

B. Deep caries, periodontal abscesses, purulent odontogenic cyst

C. The exacerbation of chronic periodontitis apex, acute diffuse pulpitis, acute purulent periostitis



D. Chronic pulpitis , acute deep caries, phlegmon of submandible area
15. Patient 18 years, grumbles about the edema of the left cheek area, sharp pain|anguish| of this area. Objectivly: asymmetry of the face due to the edema of the left cheek area, skin in a color unchanging, in a fold undertakes, palpation| is sickly|morbid|. The opening of mouth without limitations. Crown of the 46 tooth blasted on 1/3 parts|portion|, percusion| is tenderness.The transitional fold in a projection of 46 tooth is tension, palpation| is sickly|morbid|, fluctuation| is marked|note|. What diagnosis.

A Acute festering periostitis of lower jaw from a 46 tooth.

B Sharp serosis periostitis of lower jaw from a 46 tooth.

C Sharpening of chronicperiodontitis of a 46 tooth.

D Sharp serosis lymphadenitis of the left cheek area.

E Abscess of the left cheek area from a 46 tooth.
16.A patient 38 years appealed to the stomatological policlinics with complaints about aching pain in the area of the 48 tooth which increases at biting, worsening of feel and fervescence to 37,6о. Objectively: in the retromolar area insignificant slight swelling and hyperemia of mucosa, 48 tooth is covered with mucous hood, sharply painful at palpation, from under whichthea pus is selected. What most credible diagnosis?

    1. Acute|bitingly| festering perecoronitis|.

    2. Acute|bitingly| pulpitis

    3. Acute periodontitis| of the 48 tooth

    4. Acute purulent stomatitis

    5. Acute|bitingly| festering periostitis




  1. A 39-years-old man underwent |the operation|erasion| of atypical extraction| of the 48 tooth with a help of|by means of| a chisel and hammer. Next|second-| day a severe pain appeared in the area of angular of the lower|bottom| jaw on thr right|jow||affair|, that increased|aggravate| during the reception of hard|scirrhous| meal|food|. Insignificant|trace-level| numbness of the lower|bottom| lip appeared on the right|affair|. Objectively: t=36,9°,painful palpation|| in the angular area of the lower|bottom| jaw|jow| on the right|affair|, trismus of the 1st degree, the socket of a removed 48 tooth is sewn|inseam| tight, not much painful| at palpation|. Name|call| the most credible|probable| diagnosis|diacrisis|.

    1. Traumatic rihgtangular| fracture|breaking| of the lower|bottom| jaw|jow|.

    2. Acute|bitingly| periostitis of thew lower|bottom| jaw|jow| on the rihgt|affair|.

    3. |bitingly| | Acute odontogenic osteomiyelitis| of the angular of the lower|bottom| jaw|jow| on the rihgt|affair|.

    4. Posttraumatic neuralgia|neurodynia| of the alveolar inferior| nerve|nervus|.

    5. An abscess|apostasis| of the retromolar| area is business|affair|.




  1. A 25-years-old man |Hecht| feels|note| pain|anguish| in the area of the 38 tooth, pain|anguish| during swallowing, opening of the mouth|Roth| is laboured. What method of anaesthetizing is optimal|quality-controlled| during operative|efficient| interference|intervention| at perecoronitis|?

A Anaesthesia after Bershe-Dubov

B Anaesthesia after Vaisblat

C Infiltration anaesthesia

D Anaesthesia after Verlotskim

E General anaesthetizing


  1. A 25-years-old woman|Hecht| appealed |by| to the dentist| concerning laboured| erruption| of the 38 tooth. The extraction|erasion| of the 38 tooth is planned|glide||diseased|. It is found out from anamnesis, that the patient|diseased| is on 22 weeks of pregnancy. Application of what anaesthetic| is expedient, taking into account patient’s anamnesis|diseased|?

    1. Ultracain

    2. Lidocain

    3. Bupivakain

    4. Novocaine|Novocainum|

    5. Lidocainum with epinephrin||




  1. A 65-years-old|Hecht| patient appealed to the separation of maxillofacial surgery with complaints about an edema in the area of angular|bottom| of mandible|jow|, pain|anguish| and weight at swallowing, laboured| opening of the mouth|Roth|. From anamnesis it is known about 48 toothaich week ago|that is why|. Clinically: |dropsical| swelling and hyperemia of soft|mild| tissues|CLO| of the pterigo-mandiblar| fold, half|hf| of the| soft palate|uraniscus| and sticking out of lateral pharyngial wall|paries|||. Specify|indicate| a clinical diagnosis|diacrisis|?

A. Phlegmon of the pterigo-mandiblar space|.

B. Abscess| |tongue| of the tongue.

C. Phlegmon of the retromandibular| area.

В. Phlegmon of the submandibular| area.



D. Phlegmon of the parapharengial| space.


  1. A 19-years-old patient for three days complains about pain and swelling of the soft
    tissues in the mandibular area on the left, increasing of the body temperature to 39°C, shivering. OBJECTIVE: Percussion of the 36 tooth and the adjacent intact 35 and 37 teeth is sharplypainful. The mucous membrane of the alveolar process at the level of these teeth is
    edematous, hyperemic on both sides. Positive symptom of Vincent.
    Determine the presumptive diagnosis.

A Acute odontogenic osteomyelitis of the lower jaw

B Odontogenic phlegmon of the left submandibular area

C Aggravation of chronic periodontitis of the 36 tooth

D Acute purulent periostitis of the lower jaw

E Chronic odontogenic osteomyelitis of the lower jaw
22. The patient was removed 37 tooth concerning the exacerbation of chronic periodontitis. But three days later this patient returned to the doctor complaining of constant aching pain in the area of ​​the removed tooth. The intensity of the pain is constantly growing. During thye review found: alveolar mucosa in the area of ​​tooth 37 is sharply painful and redness. The socket of the removed 37tooth is covered with a grayish bloom. From the patient’s mouth smells bad. Regional lymphatic nodes are enlarged, painful during palpation. What is the most correct diagnosis?

A Alveolitis

B Acute osteomyelitis of the lower jaw.

C Acute periostitis.

D Acute lymphadenitis

E Pericoronitis.
23. A 49-years-old patient |Hecht| complains about mobility of the|locomotive| 24,26,27 teeth; a selection of pus from the socket of extractrd 25 tooth is observed. The 25 tooth was extracted and periostotomy was done 1,5 months|moon| ago|that is why|. Objectively: a slight swelling|slightly swollen| of the soft|mild| tissues in the infraorbital area, lymphatic nodes in the submandibular area are enlarged, painful|, the nasal|nose| breathing|pneusis| is free. Mucous of the alveolar process in the area of 24, 26,27 teeth is swollen, cyanotic|. A fistula with active granulations on the transitional fold is found|. What is the most reliable|trustworthy| diagnosis|diacrisis|?

A Chronic osteomyelitis

B Acute osteomyelitis

C Exacerbation of chronic sinusitis

D Alveolitis

E Exacerbation of the limited parodontitis
24. A 63-years-old patient |Hecht|complainssc complains of mobility of the|locomotive| 24,26,27 teeth, selection a pus from the socket of the removed 25 tooth. An incision and extraction of the 25 tooth was done 1,5 monthes ago|erasion|. Objectively: the slight swelling|slightly swollen| of the soft|mild| tissues in the right infraorbital| area is observed;|CLO|. nasal|nose| breathing|pneusis| is free. Mucous of alveolar pproces in the area of 14,16,17 teeth is swollen, cyanotic|. A fistula with active granulations on the transitional fold is found|. What is the most reliable|trustworthy| diagnosis|diacrisis|?

A Chronic limited osteomyelitis

B Chronic diffuse osteomyelitis

C Exacerbation of limited parodontitis

D Exacerbation of chronic sinusitis

E Alveolitis
25.Patient 43 years complains on mobility 34, 36, 37, from a small hole of removed 35 tooth appears a purulent discharge. 1,5 months ago a dissection on transitional fold was done and removal of 35 tooth was provided. Objectively: on the left cheek area - dense swelling of soft tissues. Lymphatic nodes of left submandibular area are enlarged and painful. Mucosa of alveolar process in the area 34, 36,37 was swollen, bluish. On the transitional fold – fistula with granulations. In the socket of 35 tooth -- purulent granulations. Which is the most suitable diagnosis?

A. Chronic local osteomyetitis

B. Chronic alveolitis

С. Acuteening limited parodontitis

D. Chronic recidivating periostitis

Е. Chronic diffuse osteomyetitis

26. In men 40 years old about 6 months ago after the removal of 26 was appered a connecction between oral cavity and the maxillary sinus. The first signs of sinusitis. Which kind of surgical treatment is necessary to carry out?

A sinusotomy with immediate fistula plastical closure


B sinusotomy by Caldwell-Luc
C Closure of fistula
D tamponade of fistula iodoformium tampon
E alveolar osteotomy

27. A |husband| 36-|years-old male |Hecht| complains of intensive head|leading|aiche, increasing|rise| of body temperature to|by| 39,1°C, general sickness. Objectively : slight|trace-level| asymmetry|unsymmetry| of the face due to edema the soft|mild| tissues|CLO| of the left|counter-clockwise| infraorbital| area. Crown of the 26 tooth is partly blasted. Percussion – sharply|hairpin| painful|morbid|. Mucous of the vestibular side in the area of 25,26 teeth is swollen, hyperaemic|. Breathing|pneusis| through|from| the left|counter-clockwise| half|hf| of the nose|beakhead| is laboured,| pus is selected . On the x-ray: left|counter-clockwise| half|hf| of the maxillary sinus| is homogeneously black-out. Diagnose.



A Acute purulent odontogenic maxillary sinusitis

B Exacerbation of chronic periodontitis of the 26 tooth

C Acute periostitis of the upper jaw

D Cyst of the upper jaw

E Acute odontogenic osteomyelitis of the upper jaw

28. In a 26-years-old|Hecht| patient symptoms|symptom| that characterize|character| chronic sinusitis appeared: headache, |anguispresence of fistula in the area of extracted 27 tooth | 5 months|moon| ago. What treatments is necessary to this patient?



A Sinusotimy with simultaneous the plastic of fistula

B Closing of fistula

C Tamponada of fistula by iodoform turunda

D Conservative therapy

E Sinusotomy

29. At patient 43 years old after removal of 26 tooth a communication between oral cavity and maxillary sinus occurred. On X-ray pathological changes of sinus are not visible. What is the doctors tactic in this case?


A. Washing a sinus with antibiotic solution

B. Suturing of the alveolar socket

C. Employment of hemostatic sponge

D. Curretage of the alveolar socket

E. Employment of iodine gauze


30. Patient 36 years appealed with the complaints about the acute permanent pain in teeth of the maxilla, normal body temperature. 26 is repeatedly treated, the other teeth are intact. After the roentgenological exploration the diagnosis was made: acute odontogenic sinusitis. Define the most effective method of medical treatment.

A. Sinusotomy

B. Medicinal therapy

С. Puncturing of the sinus

D. Medicinal and physical therapy

Е. Removal of causal tooth and medicinal therapy


31. A 43-year-old man complains about painful swallowing, limited mouth opening. Destroyed

37 tooth caused pain 3 days ago. Painful swallowing appeared the next day. Limited mouth

opening was present a day later. Objectively: there is a small soft swelling in the left

submaxillary area. An enlarged lymph node is palpated. The mouth can be opened by 1,5

cm. Edema of left palatine arch and pharynx lateral wall is present. The 37 tooth is

destroyed. Mucous membrane around the tooth is edematic. Percussion is slightly painful.

What is the most likely diagnosis?
A. Odontogenic peripharyngeal phlegmon

B. Odontogenic pterygomandibular phlegmon

C . Odontogenic submaxillary phlegmon

D. Peritonsillar abscess

E. Acute submaxillary lymphadenitis
32. During opening a phlegmon of mouth floor a doctor revealed greyish necrotic masses in

purulent foci, gas vesicles and fat droplets, sharp unpleasant smell of exudate. The tissues

are of dark-brown colour, muscles resemble of boiled meat. What medications should be

administered in order to prevent further spreading of this process?


A Polyvalent antigangrenous serum

B Challenging dose of broad spectrum antibiotics

C Glucocorticoid medications

D Hyposensitizing medications

E Immunomodulators
33. A patient was admitted to the oral surgery department with a diagnosis "odontogenous

phlegmon of mouth floor". Objectively: general condition of the patient is grave, abed

position is forced, the patient is sitting with lowered head. He complains about pain behind

his breastbone that is getting worse during backward flexion of head; cough, dyspnea.

What complication has developed?

A Mediastinitis

B Phlegmon of retropharyngeal space

C Cervical phlegmon

D Phlegmon of tongue root

E Phlegmon of peripharyngeal space

34. A 28|diseased|-years-old patient|Hecht| appealed on the 3 day after the extraction|erasion| of the 16 tooth. In the place|seat| of injection it was noticed a soft|mild| poorly sickly|morbid| slight cianotic swelling|slightly swollen||underhue|. Patient complains of pain|anguish| in upper jaw, that irradiates| in a temple, eye and half|hf| of a chairman. Objectively: T=37,8°C. Asymmetry of the face|dissymmetric| due to the edema of the soft|mild| tissues of the right cheek, zygomatic and lower margin of the temporal area. Contractura is observed|. A blood clot is present in the postextractive sokcet of the 16 toot. Mucous at the area of 18 tooth is bloodshot, edematous, sharply painful at palpation|morbid|. Your|yours| previous|preliminary| diagnosis|diacrisis|?

A A postinjective phlegmon of subtemporal fossa on the right

B Acute periostitis of the upper jaw on the right

C A postinjective phlegmon of zygomatic area on the right

D An odontogeni phlegmon of temporal area on the right

E An odontogeni phlegmon of subtemporal fossa on the right


35. A 27-years-old patient, appealed to the oral surgeon concerning pain in the lower jaw, fever up to 39.0 C. 3 days ago observed pain the lower wisdom tooth. To the doctor did not address. OBJECTIVE: body temperature of 39.4 C, face is slightly asymmetrical, limited mouth opening to 0.5 cm, anpleasent breath from the mouth. Tongue is covered with gray and yellow plague. On palpation retromandibular area is sharply painful. On the mandibular radiograph of the lateral view: 48 tooth is impectedrests on the 47 tooth. Put the preliminary diagnosis.

APhlegmon of the pterygo-mandibular space

B Phlegmon of parapharengial space

C Paratonsilar abscess

D Phlegmon of the masticatory area

E Acute perulent retromolar periostitis

36. Primary maxillary spaces:


  1. canine, buccal, masseteric, infratemporal

  2. canine, buccal, infratemporal

  3. masseteric, buccal, infratemporal

  4. canine, masseteric, buccal

37. Parapharyngeal space infections usually result from one of the following:



  1. palatine tonsil;

  2. infections of the last two upper molars;

  3. infections of the buccal space;

  4. acute purulent parodontitis of the jaws

38. The rate of WBC at acute infections of the fascial spaces varies:



  1. 4,5-9 ×109 /l;

  2. 2,4-4,5×109 /l;

  3. 15-30×109 /l;

  4. 75-115×109 /l;

39. Piogenic membrane:



  1. internal layer of the abscess that isolates the purulent contents from the soft tissues;

  2. external layer of the abscess that isolates the purulent contents from the soft tissues;

  3. purulent formation resulted from the tissue necrosis;

  4. formation of the wall from the granulation tissue around the phlegmon



  1. Ludwig’s angina includes the infections of:

  1. parapharengial, submental, submandibular spaces bilaterally;

  2. parapharengial, submandibular, sublingual spaces monolaterally;

  3. submandibular, sublingual, submental spaces monolaterally;

  4. submandibular, sublingual, submental spaces bilaterally



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