1) The patient, a 40-year old, reported a slowly growing hard swelling on the posterior mandible where a wisdom tooth is missing. 2) To manage the patient, the doctor will take a history, examine clinically and radiographically, consider differential diagnoses, make a diagnosis, discuss treatment options including enucleation or marsupialization, and follow up after treatment. 3) Key considerations include the cystic nature suggested by slow growth, missing tooth suggestive of a dentigerous cyst, and treatments aimed at complete removal while minimizing morbidity.

1. Attempting
Exam
Dr. Waqar Ali Jeelani
wjeelani@gmail.com

2. • How to attempt MCQ’s?
• How to attempt SEQ’s?

3. Attempting MCQ’s
• Attempt as many questions as you can
• Four Options = 25%
• Five Options = 20 %

4. Go for the easy money!

5. • Things you know!
• Answer them!
• Things you do not know!
• Read them!

6. Reading The Question
• Instead of reading "which of the following
suggests a disease other than multiple
sclerosis", students read "which of the
following suggests multiple sclerosis" and
give the wrong answer.
• Look out especially for the phrase "all of the
following statements are correct except..."

7. Reading The Options
• Read every option, even if you are more than
100% sure about the 1st option.
• If the first option is a correct one, look at the
last option to make sure it is not an "all of the
above" option

8. Using Exclusion Method
• If you do not know what is the right
answer, try to find out what is
wrong.
• In case there is confusion always
apply exclusion method. Try to
exclude those options which cannot
be the answers.

9. WHAT IF YOU DO NOT KNOW THE ANSWER?
• If you do not know anything about the
question or the options :
• Never attempt that question if there is
negative marking
• Always attempt the question if there is no
negative marking

10. GUESSING!
DO NOT HATE THE BLIND
HATE THE BLINDNESS
One cannot do “inky pinky ponki”
and choose an answer

11. Certainty Words
• Look for certainty words – there will be
questions with absolute certainty which
requires equally certain answers.
Which of the following is most painful condition
• Acute pulpitis
• Periradicular periodontitis
• Gingivitis
• Recurrent aphthous ulcer

12. First is the Best
• Many Researches indicate that your first
answer is usually the correct one.
• However, don't be afraid to change answers
when you have quite a good reason for doing
so.

13. The Commonest is the Correct
• A patient has missing #36, 37, 38 and #33, 34.
According to Kennedy’s Classification this is a
case of:
• Class I Modification I
• Class IV Modification II
• Class II Modification I
• Class II Modification II
• Class III Modification I

14. Exclusion Based Marking
The leading cause of death in 21st century is:
• Cancer
• Diabetes
• Ischemic heart disease
• AIDS
• Wars

15. The Longer is the Answer
A 39 year old man goes to see his doctor as he is
feeling slowed down. He has previously been
super fit. What did his doctor do?
A. Diagnose hypothyroidism
B. Diagnose hypothyroidism and start thyroxine
C. Diagnose hypothyroidism, start thyroxine, and
send him out to fight Leon Spinks.
You don't need to be a fight fan to realise that option C is the
longest and most specific and therefore correct (Ali's doctor had
perhaps not heard of parkinsonism due to multiple head trauma).

16. Middling the Middle
What is the optimal dose of bisoprolol in
patients with heart failure?
A. 5 mg
B. 10 mg
C. 20 mg.
The correct answer is 10 mg in this case.
• This is not a reliable method. Good examiners will not put all the
correct answers in the middle. And this tip will definitely let you
down when you are faced with a "best of four" question where
there is no middle answer.

17. ALL OF THE ABOVE
Which of the following are signs of heart
failure?
A. Ankle oedema
B. Raised jugular venous pulse
C. Displaced apex beat
D. Third heart sound
E. All of the above.
You may not know all the signs of heart failure but if you
know that two of the answers are correct then all of
them have to be correct.

18. THE MOST IMPORTANT TIP

19. THERE IS NO
SUBSTITUTE FOR
KNOWLEDGE OF
YOUR SUBJECT

20. From where you can get knowledge?
1. Text Books
2. Teachers
3. Other Books and Notes
4. Discussions

21. Attempting the SEQ’s

22. Understanding the Question
• Reading the Question twice
• Understanding the common terms
• See the Marks
• See the Checked Papers
• See the Keys

23. Planning your questions
Better results are product of
Better Planning

24. More Information
Less Information

25. Useful information
Useless information

26. Right Information
Correct Information
Wrong Information

27. Discuss different techniques of labial fenectomy. 3 Marks
Frenectomy is the surgical procedure of removal of fraenum for prosthetic, orthodontic or
aesthetic reasons.
Techniques of frenectomy
• Simple Excision
• Frenectomy with secondary epithelialization
• Z plasty
• LASER assisted Frenectomy
Technique Procedure Adv Dis Adv Special
indications
Simple Excision Frenum removed with the help Simple procedure Less vestibular depth Thin frenum
of Artery forecep, wound Scarring,
closed
Frenectomy with Frenum removed, Simple technique More painful, slow healing Wide based
secondary Periosteum lined wound left frenum
epithelialization open for healing
Z plasty Two releasing incisions given, Better vestibular depth Time consuming, More Suitable for thin
flaps interposed and sutured Less scaring suture placement freni
LASER assisted Laser surgery done and wound No bleeding, Better Special instrument req. any type of
Frenectomy left open for healing healing Scarring fraenum

28. • A 40 year old patient reported to Dental OPD
with slowly growing hard swelling on the
posterior part of mandible. On intraoral
examination there is missing wisdom tooth.
How will you manage this patient?
3 Marks

29. The Process of Diagnosis
• A 40 year old patient reported to Dental OPD
with slowly growing hard swelling on the
posterior part of mandible. On intraoral
examination there is missing wisdom tooth.
How will you MANAGE this patient?

30. MANAGE
• History
• Clinical Features
• Investigation
• Differential Diagnosis
• Diagnosis
• Treatment options
• Treatment of Choice
• Follow up

31. • History:
– Slowly growing – More likely to be cystic
– History of Pain, Fever, Pus discharge – infectious disease
– Pain at lips – Nerve involvement
– Non-vital teeth – Neoplastic lesion
– Straw color fluid discharge?
• Examination:
Hard swelling – Intrabony lesion
Missing tooth – Suggestive of Dentigerous cyst/Keratocyst
Mucosa – inflammed Pericoronitis
Mouth opening – Limited -> pericoronitis
Egg shell crackling
• Investigations:
– Aspiration
• Straw color – radicular cyst/dentigerous cyst
• White cheasy – keratocyst
– Biochemistry of cyst content
• Low protein – keratocyst
• Radiographs:
• OPG, PA view skull
• CT scan
• MRI
• Biopsy

32. • DD:
 Dentigerous cyst
 OKC
 lateral periodontal cyst
 Ameloblastoma
 myxoma
 Central Giant cell granuloma
 Central mucoepidermoid carcinoma
 Browns’s tumor
 Diagnosis: Dentigerous Cyst
 Treatment options: intraoral procedures
 Enucleation – If small – primary closure – whole lesion for biopsy
 Marsupelization – If large – window creation with BIPP packing – part
of lesion for biopsy
 Enucleation after Marsupelization – to save morbidity and discomfort
 Antibiotics only if the lesion is large or for prophylaxis
 Follow up:
 After 7 days for stitch removal
 After one month- to see the signs of bone formation
 After 6 month and on yearly bases

33. Thank You!
and
Goodbye 