1
Q
Which of the following is the most common variant of dentigerous cyst?
A. Lateral
B. Central
C. Circumferential
D. Periapical
A
Answer: B. Central
2
Q
The tooth most commonly associated with a dentigerous cyst is:
A. Maxillary lateral incisor
B. Mandibular third molar
C. Mandibular second premolar
D. Maxillary canine
A
Answer: B. Mandibular third molar
3
Q
The periapical cyst is most often associated with:
A. Vital tooth
B. Impacted tooth
C. Non-vital tooth
D. Developing tooth follicle
A
Answer: C. Non-vital tooth
4
Q
A residual cyst most commonly presents as:
A. Multilocular radiolucency
B. Well-defined unilocular radiolucency in the site of an extracted tooth
C. Mixed radiolucent-radiopaque lesion
D. Radiopacity around a non-vital tooth
A
Answer: B. Well-defined unilocular radiolucency in the site of an extracted tooth
5
Q
What percentage of odontogenic cysts are dentigerous cysts?
A. 10%
B. 20%
C. 33%
D. 50%
A
Answer: C. 33% (1/3 of all odontogenic cysts)
6
Q
Dentigerous cysts are most commonly associated with:
A. Root apex of a non-vital tooth
B. Crown of an impacted permanent tooth
C. Gingiva adjacent to erupted tooth
D. Developing alveolar bone without teeth
A
Answer: B. Crown of an impacted permanent tooth
7
Q
Which of the following teeth are most commonly involved in dentigerous cysts (in order)?
A. Mandibular 3rd molar > Maxillary cuspid > Maxillary 3rd molar > Mandibular 2nd premolar
B. Maxillary lateral incisor > Mandibular 1st molar > Maxillary 2nd molar > Mandibular canine
C. Mandibular 2nd premolar > Maxillary 3rd molar > Mandibular 3rd molar > Maxillary canine
D. Mandibular 3rd molar > Mandibular canine > Maxillary 2nd premolar > Maxillary lateral incisor
A
Answer: A. Mandibular 3rd molar > Maxillary cuspid > Maxillary 3rd molar > Mandibular 2nd premolar
8
Q
The circumferential variant of a dentigerous cyst:
A. Grows along the lateral aspect of the tooth
B. Surrounds the entire crown
C. Surrounds the entire tooth giving appearance that the tooth is within cystic cavity
D. Always causes root resorption
A
Answer: C. Surrounds the entire tooth giving appearance that the tooth is within cystic cavity
9
Q
Radiographically, dentigerous cysts may cause all EXCEPT:
A. Bony expansion
B. Root displacement
C. Root resorption
D. Cotton-wool appearance
A
Answer: D. Cotton-wool appearance
10
Q
Dentigerous cysts rarely involve:
A. Permanent impacted tooth
B. Unerupted deciduous tooth
C. Maxillary canine
D. Mandibular third molar
A
Answer: B. Unerupted deciduous tooth
11
Q
Which of the following best describes the pathogenesis of a dentigerous cyst?
A. Proliferation of rests of Malassez at the apex of a non-vital tooth
B. Proliferation of dental lamina remnants in the jaw
C. Accumulation of fluid between the reduced enamel epithelium and the crown of an unerupted tooth
D. Epithelial proliferation from gingival remnants around an erupted tooth
A
Answer: ✅ C. Accumulation of fluid between the reduced enamel epithelium and the crown of an unerupted tooth
12
Q
Which of the following is a typical radiographic feature of a dentigerous cyst?
A. Poorly defined radiolucency with irregular borders
B. Well-delineated unilocular or multilocular radiolucency associated with an impacted tooth
C. Radiopacity with a sclerotic rim
D. Sunburst appearance with cortical perforation
A
Answer: ✅ B. Well-delineated unilocular or multilocular radiolucency associated with an impacted tooth
13
Q
A 25-year-old patient has a cyst associated with an impacted mandibular third molar. The radiograph shows root resorption and displacement of the tooth. The most likely diagnosis is:
A. Periapical cyst
B. Dentigerous cyst
C. Residual cyst
D. Odontogenic keratocyst (OKC)
A
Answer: ✅ B. Dentigerous cyst
14
Q
What is the preferred treatment for a small dentigerous cyst?
A. Marsupialization only
B. Curettage without extraction
C. Enucleation
D. Observation
A
Answer: ✅ C. Enucleation
15
Q
In the treatment of a large dentigerous cyst, what is the most common sequence of management?
A. Enucleation only
B. Marsupialization followed by enucleation
C. Resection with 1 cm margins
D. Incision and drainage
A
Answer: ✅ B. Marsupialization followed by enucleation
16
Q
Which of the following is TRUE regarding recurrence of dentigerous cysts?
A. Recurrence is very common
B. Recurrence is uncommon
C. Recurrence occurs in >50% of cases
D. Recurrence requires chemotherapy
A
Answer: ✅ B. Recurrence is uncommon
17
Q
What is the most common cyst of the jaw bones?
A. Dentigerous cyst
B. Periapical (radicular) cyst
C. Odontogenic keratocyst (OKC)
D. Residual cyst
A
Answer: ✅ B. Periapical (radicular) cyst
18
Q
Periapical cysts most commonly occur in which location?
A. Mandibular ramus
B. Maxilla
C. Mandibular anterior teeth
D. Posterior mandible
A
Answer: ✅ B. Maxilla
19
Q
Periapical cysts usually arise as a sequela of which condition?
A. Acute pulpitis
B. Chronic inflammation in a preexisting periapical granuloma
C. Trauma to deciduous teeth
D. Developmental anomalies
A
Answer: ✅ B. Chronic inflammation in a preexisting periapical granuloma
20
Q
Radiographically, a periapical cyst is best described as:
A. Multilocular radiolucency with scalloped borders
B. Radiopaque lesion with sclerotic margins
C. Well-circumscribed unilocular radiolucency at the apex of a non-vital tooth
D. Mixed radiolucent-radiopaque lesion
A
Answer: ✅ C. Well-circumscribed unilocular radiolucency at the apex of a non-vital tooth
21
Q
Which of the following is NOT a typical treatment option for periapical cysts?
A. Endodontic therapy
B. Extraction of tooth with curettage/enucleation
C. Endodontic therapy with apicoectomy
D. Marsupialization only
A
Answer: ✅ D. Marsupialization only
22
Q
The lateral periodontal cyst most commonly arises from which structure?
A. Reduced enamel epithelium
B. Periodontal ligament
C. Dental lamina rests
D. Pulpal remnants
A
Answer: ✅ B. Periodontal ligament
23
Q
In which decades of life are lateral periodontal cysts most common?
A. First–second
B. Second–fourth
C. Fifth–sixth
D. Seventh–eighth
A
Answer: ✅ B. Second–fourth
24
Q
Radiographically, how does a lateral periodontal cyst typically appear?
A. Radiopaque with sclerotic borders
B. Unilocular or multilocular radiolucency along the lateral surface of the tooth root
C. “Soap bubble” multilocular radiolucency in posterior mandible
D. Well-defined mixed lesion with calcifications
A
Answer: ✅ B. Unilocular or multilocular radiolucency along the lateral surface of the tooth root
25
Which of the following statements about lateral periodontal cysts is TRUE?
A. Teeth are non-vital
B. Occurs most often in anterior maxilla
C. Has a botryoid variant with a multilocular “grape-like” appearance
D. Always symptomatic
Answer: ✅ C. Has a botryoid variant with a multilocular “grape-like” appearance
26
The lateral periodontal cyst most commonly occurs in which locations?
A. Mandible: canine–premolar region; Maxilla: lateral incisor–canine region
B. Mandible: third molar region; Maxilla: canine–premolar region
C. Mandible: anterior incisors; Maxilla: second molars
D. Mandible: ramus; Maxilla: posterior molars
Answer: ✅ A. Mandible: canine–premolar region; Maxilla: lateral incisor–canine region
27
# Treatment for lateral periodontal cyst
B.Marsupialization
C. Enucleation
D. Root canal therapy
Answer: ✅ C. Enucleation
28
In which location is the gingival cyst of adults most commonly found?
A. Mandibular canine–premolar region
B. Maxillary central incisors
C. Mandibular third molar region
D. Palatal midline
Answer: ✅ A. Mandibular canine–premolar region
29
What is the treatment of choice for gingival cyst of adults?
A. Endodontic therapy
B. Enucleation/excision
C. Marsupialization
D. Extraction of associated tooth
Answer: ✅ B. Enucleation/excision
30
How does the gingival cyst of adults appear radiographically?
A. Well-defined radiolucency around the crown of an unerupted tooth
B. Multilocular radiolucency resembling grapes
C. It usually does not appear on radiographs (no bony involvement)
D. Mixed radiolucent-radiopaque lesion with calcifications
Answer: ✅ C. It usually does not appear on radiographs (no bony involvement)
31
Clinically, the gingival cyst of adults most often presents as:
A. Painful fluctuant swelling with purulent discharge
B. Firm, fibrous swelling of the alveolus
C. Small, painless, bluish, dome-shaped swelling on the gingiva
D. Radiolucent lesion at the apex of a non-vital tooth
Answer: ✅ C. Small, painless, bluish, dome-shaped swelling on the gingiva
32
Which age group is most commonly affected by the gingival cyst of adults?
A. Children under 12
B. Adolescents
C. Adults in the 5th–6th decade
D. Neonates
Answer: ✅ C. Adults in the 5th–6th decade
33
In which location is the gingival cyst of adults most commonly found?
A. Mandibular canine–premolar region
B. Maxillary central incisors
C. Mandibular third molar region
D. Palatal midline
Answer: ✅ A. Mandibular canine–premolar region
34
The gingival cyst of adults is best described as:
A. A developmental odontogenic cyst arising within bone
B. The soft tissue counterpart of the lateral periodontal cyst
C. A cyst of inflammatory origin
D. A cyst always associated with non-vital teeth
Answer: ✅ B. The soft tissue counterpart of the lateral periodontal cyst
35
The most common location for a Lateral Periodontal Cyst in the mandible is:
A. Third molar region
B. Canine–premolar region
C. Incisor region
D. Angle of the mandible
Answer: ✅ B. Canine–premolar region
36
The most common location for a Lateral Periodontal Cyst in the maxilla is:
A. Central incisor region
B. Lateral incisor–canine region
C. Premolar–molar region
D. Palatal midline
Answer: ✅ B. Lateral incisor–canine region
37
The gingival cyst of adults shares the same anatomic predilection as which cyst?
A. Dentigerous cyst
B. Lateral periodontal cyst
C. Odontogenic keratocyst
D. Residual cyst
Answer: ✅ B. Lateral periodontal cyst
38
The glandular odontogenic cyst most commonly presents in which region?
A. Posterior maxilla
B. Anterior mandible
C. Maxillary canine region
D. Posterior mandible
✅ Answer: B. Anterior mandible
39
The average age of presentation for glandular odontogenic cyst is:
A. 1st–2nd decade
B. 2nd–4th decade
C. 5th decade (but can range from 2nd–8th)
D. 9th decade
✅ Answer: C. 5th decade (range: 2nd–8th decades)
40
Which of the following is a radiographic feature of glandular odontogenic cysts?
A. Ill-defined borders with mixed radiolucency
B. Well-defined unilocular or multilocular radiolucency with sclerotic border
C. Ground glass appearance
D. Cotton-wool appearance
✅ Answer: B. Well-defined unilocular or multilocular radiolucency with sclerotic border
41
Which of the following is TRUE about glandular odontogenic cysts?
A. They are common odontogenic cysts with low recurrence
B. They have aggressive clinical behavior and may cross the midline
C. They only occur in the maxilla
D. They never cause bony expansion
✅ Answer: B. They have aggressive clinical behavior and may cross the midline
42
The histological appearance of glandular odontogenic cyst may mimic features of:
A. Ameloblastoma
B. Mucoepidermoid carcinoma
C. Central ossifying fibroma
D. Dentigerous cyst
✅ Answer: B. Mucoepidermoid carcinoma
43
What is the primary treatment option for a glandular odontogenic cyst?
A. Observation only
B. Curettage
C. Endodontic therapy
D. Marsupialization only
✅ Answer: B. Curettage
44
Why do some surgeons advocate for marginal or en bloc resection in cases of glandular odontogenic cysts?
A. Because they are always malignant
B. Because they have a high recurrence rate (~30%)
C. Because curettage is never successful
D. Because they occur only in children
✅ Answer: B. Because they have a high recurrence rate (~30%)
45
The recurrence rate of glandular odontogenic cysts is approximately:
A. 5%
B. 10%
C. 30%
D. 60%
✅ Answer: C. 30%
46
Odontogenic keratocyst (OKC) most commonly occurs in which age group?
A. First decade
B. Second–third decade
C. Fourth–fifth decade
D. Sixth decade
✅ Answer: B. Second–third decade
47
Which genetic mutation is associated with OKC?
A. TP53
B. KRAS
C. PTCH tumor suppressor gene
D. BRCA1
✅ Answer: C. PTCH tumor suppressor gene
48
OKCs are derived from which source?
A. Reduced enamel epithelium
B. Rests of Malassez
C. Rests of dental lamina (rests of Serres)
D. Hertwig’s epithelial root sheath
✅ Answer: C. Rests of dental lamina (rests of Serres)
49
The most common location for OKC in the mandible is:
A. Anterior mandible
B. Ramus/third molar area
C. Premolar region
D. Condyle
✅ Answer: B. Ramus/third molar area
50
Which of the following is true about OKCs?
A. They are usually symptomatic and painful
B. They have aggressive growth and high recurrence rates
C. They are lined by thick epithelium with rete ridges
D. They are never associated with syndromes
✅ Answer: B. They have aggressive growth and high recurrence rates
51
Histologically, OKCs are lined by:
A. 15–20 layers of keratinized squamous epithelium
B. 6–8 layers of parakeratotic stratified squamous epithelium with inconspicuous rete ridges
C. Columnar epithelial cells with reversed polarity
D. Respiratory-type epithelium
✅ Answer: B. 6–8 layers of parakeratotic stratified squamous epithelium with inconspicuous rete ridges
52
OKC may be associated with which syndrome?
A. Gorlin syndrome (nevoid basal cell carcinoma syndrome)
B. Treacher Collins syndrome
C. Pierre Robin sequence
D. Crouzon syndrome
✅ Answer: A. Gorlin syndrome
53
Which of the following is NOT a feature of Gorlin syndrome?
A. Multiple basal cell carcinomas
B. Calcified falx cerebri
C. Multiple OKCs
D. Neurofibromas
✅ Answer: D. Neurofibromas
54
Radiographically, OKC most commonly appears as:
A. Radiopaque lesion
B. Soap-bubble appearance
C. Unilocular or multilocular radiolucency
D. Ground glass appearance
✅ Answer: C. Unilocular or multilocular radiolucency
55
Peripheral Ossifying Fibroma (POF) arises from which tissue of origin?
A. Reduced enamel epithelium
B. Periodontal ligament
C. Rests of Malassez
D. Rests of dental lamina
✅ Answer: B. Periodontal ligament
56
The most common site for Peripheral Ossifying Fibroma is:
A. Tongue dorsum
B. Palate
C. Gingiva (interdental papilla)
D. Buccal mucosa
✅ Answer: C. Gingiva (interdental papilla)
57
Peripheral Ossifying Fibroma most commonly occurs in which region of the jaws?
A. Anterior maxilla
B. Posterior maxilla
C. Anterior mandible
D. Ramus of mandible
✅ Answer: A. Anterior maxilla
58
Which age group is most commonly affected by POF?
A. Children and adolescents
B. Third to fourth decades
C. Fifth to sixth decades
D. Elderly patients (>65 years)
✅ Answer: A. Children and adolescents
(peak in second decade, female predilection)
59
POF is best described as:
A. A developmental odontogenic cyst
B. A reactive gingival lesion
C. A salivary gland neoplasm
D. A bone tumor
✅ Answer: B. A reactive gingival lesion
60
Histologically, POF is characterized by:
A. Thin parakeratotic epithelium with keratin pearls
B. Fibrous connective tissue with focal calcifications or ossifications
C. Islands of odontogenic epithelium
D. Cystic lining with goblet cells
✅ Answer: B. Fibrous connective tissue with focal calcifications or ossifications
61
The recurrence rate of POF after surgical excision is approximately:
A. <5%
B. 8–20%
C. 30–40%
D. >50%
✅ Answer: B. 8–20%
62
Peripheral Ossifying Fibroma must be distinguished clinically from:
A. Peripheral giant cell granuloma and pyogenic granuloma
B. Ameloblastoma
C. Lateral periodontal cyst
D. Adenomatoid odontogenic tumor
✅ Answer: A. Peripheral giant cell granuloma and pyogenic granuloma
63
Which of the following is not one of the “3 Ps” reactive gingival lesions?
A. Pyogenic granuloma
B. Peripheral giant cell granuloma
C. Peripheral ossifying fibroma
D. Periapical cyst
✅ Answer: D. Periapical cyst
64
The “3 Ps” lesions (PG, POF, PGCG) all occur most commonly on:
A. Buccal mucosa
B. Tongue
C. Gingiva / alveolar mucosa
D. Hard palate
✅ Answer: C. Gingiva / alveolar mucosa
65
Which “P” lesion is most often associated with pregnancy?
A. Peripheral ossifying fibroma
B. Pyogenic granuloma
C. Peripheral giant cell granuloma
D. Periapical cyst
✅ Answer: B. Pyogenic granuloma (aka “pregnancy tumor”)
66
Which lesion is histologically characterized by multinucleated giant cells within a fibrovascular stroma?
A. Pyogenic granuloma
B. Peripheral giant cell granuloma
C. Peripheral ossifying fibroma
D. Odontogenic keratocyst
✅ Answer: B. Peripheral giant cell granuloma
67
Which lesion arises from the periodontal ligament and often contains calcifications or ossifications?
A. Peripheral ossifying fibroma
B. Peripheral giant cell granuloma
C. Pyogenic granuloma
D. Ameloblastoma
✅ Answer: A. Peripheral ossifying fibroma
68
Which “P” lesion has the highest recurrence potential after excision (up to 20%)?
A. Pyogenic granuloma
B. Peripheral ossifying fibroma
C. Peripheral giant cell granuloma
D. All recur at equal rates
✅ Answer: B. Peripheral ossifying fibroma
69
Which lesion is most likely to cause “cupping resorption” of underlying alveolar bone?
A. Pyogenic granuloma
B. Peripheral ossifying fibroma
C. Peripheral giant cell granuloma
D. Ameloblastoma
✅ Answer: C. Peripheral giant cell granuloma
70
Which genetic marker helps distinguish mucoepidermoid carcinoma (MEC) from glandular odontogenic cyst (GOC)?
A. BRAF V600E mutation
B. PTCH gene mutation
C. MAML2 gene rearrangement
D. SHH gene mutation
✅ Answer: C. MAML2 gene rearrangement (present in MEC, not in GOC)
71
Which of the following treatment modalities for odontogenic keratocyst (OKC) has been banned in North America due to carcinogenic concerns, but remains associated with lower recurrence rates compared to its modified form?
A. Enucleation with peripheral ostectomy
B. Cryotherapy with liquid nitrogen
C. Carnoy’s solution containing chloroform
D. En bloc resection with 1 cm margins
Correct Answer: C. Carnoy’s solution containing chloroform
72
Which of the following describes the main drawback of cryotherapy with liquid nitrogen in the management of odontogenic keratocyst (OKC)?
A. High recurrence rate
B. Risk of paresthesia and mandibular fracture
C. Ineffective penetration into bone
D. Contraindicated in lesions involving the maxilla
Answer: B. Risk of paresthesia and mandibular fracture
Rationale: Liquid nitrogen penetrates ~1.5 mm into bone but can damage peripheral tissues, leading to paresthesia (especially if IAN exposed) and even mandibular fractures.
73
Carnoy’s solution is used as an adjunct in OKC treatment. Which statement is TRUE regarding its use?
A. The chloroform-containing form has been banned in North America due to carcinogenic risk
B. The modified form without chloroform has a lower recurrence rate
C. Carnoy’s solution is contraindicated in mandibular lesions
D. It is primarily used for decompression of large cysts
Answer: A. The chloroform-containing form has been banned in North America due to carcinogenic risk
74
Which of the following treatment options for OKC is most appropriate for aggressive lesions with a high recurrence rate?
A. Enucleation alone
B. Peripheral ostectomy
C. En bloc resection with 1 cm margins
D. Decompression only
Answer: C. En bloc resection with 1 cm margins
Rationale: Reserved for large/aggressive lesions or recurrences due to OKC’s high recurrence rate.
75
Which of the following combinations is the standard initial treatment for most OKCs?
A. Marsupialization alone
B. Enucleation with peripheral ostectomy
C. Cryotherapy alone
D. Carnoy’s solution alone
Answer: B. Enucleation with peripheral ostectomy
Rationale: Provides definitive removal while minimizing recurrence risk compared to enucleation alone. +5FU
76
What is 5-Fluorouracil (5-FU)?
A. An antimetabolite chemotherapeutic agent that inhibits DNA synthesis
B. A corticosteroid used to reduce cyst wall inflammation
C. An antibiotic that targets anaerobic bacteria in OKCs
D. A bisphosphonate used to prevent bone resorption
Answer: A. An antimetabolite chemotherapeutic agent that inhibits DNA synthesis
Rationale: 5-FU is a pyrimidine analog that interferes with thymidylate synthase, blocking DNA synthesis and cell proliferation.
77
What is the proposed role of 5-FU in the management of odontogenic keratocyst (OKC)?
A. To reduce the size of cystic cavity by decompression
B. To chemically cauterize the cyst lining like Carnoy’s solution
C. To prevent epithelial proliferation and reduce recurrence
D. To induce fibrosis of the cyst wall
Answer: C. To prevent epithelial proliferation and reduce recurrence
Rationale: 5-FU is applied topically to the cyst cavity after enucleation to suppress residual epithelial cells, lowering recurrence risk.
78
Compared to Carnoy’s solution, the main advantage of using 5-FU in OKC treatment is:
A. Lower recurrence rate without carcinogenic risk
B. Stronger penetration into surrounding bone
C. Easier availability and lower cost
D. Less need for en bloc resection
Answer: A. Lower recurrence rate without carcinogenic risk
Rationale: Carnoy’s solution (especially chloroform-based) carries carcinogenic concerns; 5-FU is safer and has shown promising outcomes in reducing recurrence.
79
Which of the following best describes the mechanism of action of 5-Fluorouracil (5-FU)?
A. Alkylation of DNA leading to cross-linking
B. Inhibition of thymidylate synthase causing impaired DNA synthesis
C. Inhibition of topoisomerase II causing DNA strand breaks
D. Binding to tubulin and preventing microtubule polymerization
Answer: B. Inhibition of thymidylate synthase causing impaired DNA synthesis
Mode of Action of 5-FU
Antimetabolite / Pyrimidine analog → structurally similar to uracil.
Inside cells, 5-FU is converted into 5-fluoro-2′-deoxyuridine-5′-monophosphate (FdUMP).
FdUMP irreversibly inhibits thymidylate synthase → enzyme required for conversion of dUMP → dTMP.
This leads to:
↓ dTMP (thymidine monophosphate) → depletion of thymidine pool.
Inhibition of DNA synthesis (S-phase specific).
Incorporation of fraudulent nucleotides into RNA, disrupting its function.
Net effect = suppression of rapidly dividing cells (like odontogenic epithelium in OKCs).
80
What is the primary mechanism of action of Carnoy’s solution in the management of odontogenic keratocyst (OKC)?
A. Inhibition of thymidylate synthase
B. Fixation and chemical cauterization of residual epithelial cells in bone
C. Cross-linking of DNA and inhibition of replication
D. Disruption of microtubule polymerization
Answer: B. Fixation and chemical cauterization of residual epithelial cells in bone
81
Which of the following is the classic composition of Carnoy’s solution?
A. Ethanol, chloroform, glacial acetic acid, ferric chloride
B. Ethanol, formalin, hydrogen peroxide, ferric chloride
C. Ethanol, chloroform, sodium hypochlorite, acetic acid
D. Ethanol, chloroform, carbolic acid, ferric sulfate
A. Ethanol, chloroform, glacial acetic acid, ferric chloride ✅
82
What is the role of ethanol in Carnoy’s solution?
A. Fixation of proteins
B. Tissue penetration
C. Dehydration of tissues
D. Coagulation of blood
C. Dehydration of tissues ✅
83
Which component of Carnoy’s solution is responsible for tissue penetration but has been banned in many countries due to carcinogenicity?
A. Ethanol
B. Ferric chloride
C. Glacial acetic acid
D. Chloroform
D. Chloroform ✅
84
What is the function of ferric chloride in Carnoy’s solution?
A. Antiseptic effect
B. Coagulation of proteins and hemostasis
C. Enhancing tissue penetration
D. Preventing recurrence
B. Coagulation of proteins and hemostasis ✅
85
The modified Carnoy’s solution differs from the classic form by excluding:
A. Ethanol
B. Ferric chloride
C. Glacial acetic acid
D. Chloroform
D. Chloroform ✅
86
Q: Ameloblastoma arises from which of the following?
A. Reduced enamel epithelium
B. Rests of Malassez
C. Rests of Serres
D. Dental papilla
Answer: C. Rests of Serres ✅
87
Which histologic feature is pathognomonic of ameloblastoma?
A. Ghost cells
B. Reverse polarity of nuclei
C. Parakeratinized lining
D. Keratin pearls
Answer: B. Reverse polarity of nuclei ✅
88
The classic radiographic description of ameloblastoma is:
A. Onion-skin appearance
B. Cotton wool appearance
C. Soap-bubble appearance
D. Ground glass appearance
Answer: C. Soap-bubble appearance ✅
89
Which subtype of ameloblastoma is most common histologically?
A. Plexiform
B. Follicular
C. Granular cell
D. Desmoplastic
Answer: B. Follicular ✅
90
Unicystic Variant
Q: Unicystic ameloblastomas are most often associated with which radiographic feature?
A. Periapical radiolucency at apex of vital tooth
B. Dentigerous cyst appearance around impacted third molar
C. Onion-skin periosteal reaction
D. Multilocular honeycomb radiolucency
Answer: B. Dentigerous cyst appearance ✅
91
What is the recurrence rate after simple enucleation of ameloblastoma compared with resection?
A. Enucleation 10%, Resection 5%
B. Enucleation 60–80%, Resection 15%
C. Enucleation 25%, Resection 10%
D. Enucleation 5%, Resection 1%
Answer: B. Enucleation 60–80%, Resection 15% ✅
92
Which site is most common for desmoplastic ameloblastoma?
A. Posterior mandible
B. Anterior maxilla
C. Posterior maxilla
D. Mandibular condyle
Answer: B. Anterior maxilla ✅
93
Peripheral ameloblastoma typically presents as:
A. Radiolucent lesion at apex of non-vital tooth
B. Exophytic gingival mass without bone invasion
C. Multilocular radiolucency of ramus
D. Radiopaque mass with mixed density
Answer: B. Exophytic gingival mass without bone invasion ✅
94
Which is true of malignant (metastasizing) ameloblastoma?
A. Histologically malignant at primary site
B. Metastases usually histologically benign
C. Commonly metastasizes to liver
D. Occurs in children <10 years
Answer: B. Metastases usually histologically benign ✅
95
A 28-year-old male presents with a unilocular radiolucency associated with an impacted mandibular third molar. Biopsy reveals a unicystic ameloblastoma, luminal subtype. What is the most appropriate management?
A. Segmental mandibulectomy with 1-cm margins
B. Enucleation and simple curettage
C. Marginal resection with 1-cm margins
D. Excision with no recurrence expected
Answer: B. Enucleation and simple curettage
96
Which ameloblastoma subtype has the highest recurrence rate when treated with enucleation alone?
A. Peripheral ameloblastoma
B. Solid or multicystic ameloblastoma
C. Unicystic, luminal subtype
D. Unicystic, intraluminal subtype
Answer: B. Solid or multicystic ameloblastoma
Recurrence: Enucleation 60–80%; Resection ~15%
Also mural type
97
A 40-year-old female presents with a multilocular “soap bubble” radiolucency in the posterior mandible. Biopsy shows solid ameloblastoma. What is the standard treatment?
A. Simple enucleation
B. Enucleation with peripheral ostectomy
C. Resection with 1 cm margin and at least one anatomical barrier
D. Excision with no recurrence
Answer: C. Resection with 1 cm margin and one anatomical barrier
98
Which of the following ameloblastoma subtypes typically occurs in the 6th decade of life and has no recurrence after excision?
A. Peripheral ameloblastoma
B. Solid/multicystic ameloblastoma
C. Unicystic, mural subtype
D. Unicystic, intraluminal subtype
Answer: A. Peripheral ameloblastoma
99
A patient with a unicystic mural ameloblastoma is treated with enucleation alone. What is the major concern?
A. No recurrence risk
B. Potential for invasion into connective tissue, requiring resection with 1-cm margin
C. Malignant transformation to ameloblastic carcinoma
D. Peripheral soft tissue recurrence
Answer: B. Potential for invasion into connective tissue, requiring resection with 1-cm margin
100
After taking a 1 cm bony margin for ameloblastoma resection in the anterior mandible if periosteum is involved, what is the next anatomical barrier?
A. Buccinator muscle
B. Periosteum
C. Orbicularis oris muscle
D. Mylohyoid muscle
✅ Answer: C — Orbicularis oris muscle
(After periosteum, the next barrier is the orbicularis oris in the anterior mandible.)
101
In a posterior mandible resection (ramus), after the bone and periosteum, which structure represents the next anatomical barrier?
A. Temporalis muscle
B. Masseter and medial pterygoid muscles
C. Buccinator muscle
D. Digastric muscle
✅ Answer: B — Masseter (lateral) and medial pterygoid (medial)
(These form the soft tissue barriers around the ramus.)
102
For ameloblastoma involving the mandibular body, the next barrier after bone and periosteum is:
A. Buccinator muscle
B. Mylohyoid muscle (medial) and buccinator (lateral)
C. Geniohyoid muscle
D. Platysma
✅ Answer: B — Mylohyoid (floor of mouth, medial) and buccinator (lateral)
103
After bone and periosteum at the mandibular angle, which soft tissue structures are encountered?
A. Masseter (lateral) and medial pterygoid (medial)
B. Digastric (anterior belly)
C. Stylohyoid muscle
D. Platysma
✅ Answer: A — Masseter (lateral) and medial pterygoid (medial)
104
When resecting an ameloblastoma of the posterior maxilla with a 1 cm bony margin, the next anatomic barrier is:
A. Orbital periosteum (superior) or nasal/sinus mucosa (medial/inferior)
B. Buccinator muscle
C. Zygomaticus major
D. Levator anguli oris
✅ Answer: A — Orbital periosteum or sinus/nasal mucosa depending on site
105
AOT is often referred to as the “2/3 tumor.” Which of the following combinations is correct?
A. 2/3 occur in males, 2/3 in posterior mandible, 2/3 cause pain
B. 2/3 occur in females, 2/3 in the maxilla, 2/3 associated with impacted canine
C. 2/3 occur in older patients, 2/3 associated with molars, 2/3 multilocular
D. 2/3 recur after enucleation, 2/3 associated with premolars, 2/3 malignant
Answer: ✅ B
106
The treatment of choice for Adenomatoid Odontogenic Tumor is:
A. Segmental resection with 1 cm margins
B. Marginal mandibulectomy with reconstruction
C. Enucleation and curettage
D. Radiation therapy followed by chemotherapy
Answer: ✅ C
107
Which is the most common clinical presentation of an AOT?
A. Painful swelling with cortical perforation
B. Rapid expansion with paresthesia
C. Asymptomatic slow expansion of the jaw
D. Recurrent draining sinus tract
Answer: ✅ C
108
Radiographic features
On radiograph, AOT typically presents as:
A. Multilocular “soap bubble” radiolucency of the posterior mandible
B. Radiolucent lesion with irregular ill-defined borders and root resorption
C. Pear-shaped radiolucency often with scattered radiopaque foci
D. Unilocular radiolucency extending along the inferior alveolar canal
Answer: ✅ C
109
Which histologic description best characterizes an AOT?
A. Sheets of granular cells with eosinophilic cytoplasm
B. Columnar epithelial cells arranged in duct-like patterns
C. Spindle-shaped fibroblasts in a collagenous stroma
D. Clear cells with glycogen-rich cytoplasm
Answer: ✅ Which histologic description best characterizes an AOT?
110
The Adenomatoid Odontogenic Tumor arises from which structure?
A. Dental papilla
B. Reduced enamel epithelium
C. Hertwig’s epithelial root sheath
D. Odontogenic ectomesenchyme
Answer: ✅ C
111
A 19-year-old female presents with a radiolucent lesion associated with an impacted maxillary canine. Which of the following best fits the classic profile of an AOT?
A. Male, 40s, associated with mandibular premolars
B. Female, 2nd decade, associated with maxillary canine
C. Male, 3rd decade, associated with mandibular molars
D. Female, 5th decade, associated with mandibular incisors
Answer: ✅ B
112
The calcifying epithelial odontogenic tumor (Pindborg tumor) originates from:
A. Dental papilla
B. Stratum intermedium
C. Reduced enamel epithelium
D. Hertwig’s epithelial root sheath
Answer: ✅ B
113
Which of the following age ranges best describes the occurrence of CEOT?
A. Almost exclusively in teenagers (10–20 years)
B. Peak in 5th–6th decade with no cases reported under 40 years
C. Wide age range, between 13 and 80 years
D. Strictly pediatric, under 12 years of age
Answer: ✅ C
114
Which histologic feature is characteristic of CEOT?
A. Columnar epithelial cells forming duct-like structures
B. Liesegang rings and amyloid deposition
C. Islands of stellate reticulum and reverse polarity nuclei
D. Glycogen-rich clear cells without calcifications
Answer: ✅ B
115
What is the classic radiographic feature of a CEOT?
A. Multilocular “soap bubble” radiolucency in posterior mandible
B. Well-defined radiolucency with “snowflake” calcifications
C. Diffuse ill-defined radiopacity extending into adjacent bone
D. Pericoronal radiolucency without calcifications
Answer: ✅ B
116
The most common site for a calcifying epithelial odontogenic tumor is:
A. Maxillary canine region
B. Mandibular premolar region
C. Mandibular condyle
D. Maxillary tuberosity
Answer: ✅ B
117
The most common clinical presentation of CEOT is:
A. Painful swelling with paresthesia
B. Asymptomatic lesion detected incidentally
C. Ulcerated mucosal surface with fistula
D. Rapidly enlarging painful mass with fever
Answer: ✅ B
118
What is the recommended treatment for CEOT?
A. Simple enucleation with curettage
B. Resection with 1 cm margin due to recurrence risk
C. Radiation therapy followed by chemotherapy
D. Marsupialization followed by enucleation
Answer: ✅ B
119
Presence of which histologic feature suggests a more aggressive CEOT with cortical perforation?
A. Psammomatoid calcifications
B. Clear cells
C. Stellate reticulum
D. Amyloid deposition
Answer: ✅ B
120
Odontogenic myxoma arises from which of the following?
A. Stratum intermedium
B. Dental papilla
C. Reduced enamel epithelium
D. Hertwig’s epithelial root sheath
Answer: ✅ B
121
What is the most common age range for odontogenic myxoma?
A. Children under 12 years
B. 2nd to 4th decades, most often between 25–35 years
C. 5th to 6th decades, peak at 55 years
D. Any age, but strongly associated with patients >70 years
Answer: ✅
122
Which histologic description best characterizes odontogenic myxoma?
A. Columnar epithelial cells in duct-like pattern
B. Sheets of granular cells with eosinophilic cytoplasm
C. Stellate and spindle-shaped cells in abundant mucoid stroma
D. Islands of clear cells with amyloid deposition
Answer: ✅ C
123
Odontogenic myxoma most commonly occurs in which site?
A. Maxillary canine region
B. Mandible, anterior for unilocular and posterior for multilocular lesions
C. Mandibular condyle
D. Maxillary tuberosity
Answer: ✅ B
124
Which radiographic finding is most typical of odontogenic myxoma?
A. Well-defined radiolucency with snowflake calcifications
B. Ill-defined radiolucency with “soap-bubble” or “honeycomb” pattern, often multilocular
C. Radiopaque lesion with concentric “onion-skin” layering
D. Pear-shaped radiolucency around impacted canine
Answer: ✅ B
125
The most common clinical presentation of odontogenic myxoma is:
A. Painful swelling with paresthesia
B. Asymptomatic expansion, sometimes associated with unerupted tooth and root displacement
C. Rapidly growing ulcerated mass with draining sinus
D. Painful recurrent abscess
Answer: ✅ B
126
What is the treatment of choice for odontogenic myxoma?
A. Enucleation and curettage
B. Marsupialization followed by curettage
C. Segmental resection with 1-cm margin
D. Radiation therapy
Answer: ✅ C
127
Which of the following is true about recurrence of odontogenic myxoma?
A. Common with enucleation, uncommon after resection
B. Rare overall; simple enucleation sufficient
C. High recurrence regardless of treatment
D. Always requires adjunctive radiation
Answer: ✅ A
128
Which of the following is TRUE about the location and radiographic appearance of odontogenic myxoma?
A. More common in maxilla; always unilocular regardless of site
B. Mandible > maxilla; anterior lesions often unilocular, posterior lesions more often multilocular
C. Mandible < maxilla; posterior lesions usually unilocular, anterior multilocular
D. Mandible > maxilla; always multilocular regardless of site
Answer: ✅ B
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