Module 09

Exam Preparation

High-yield checklists and examiner-style question sets for BDS, FCPS and MS examinations.

77 topics

Abfraction

Dental Diseases

Key exam points

V-shaped at CEJ
Often on buccal of premolars
Associated with occlusal stress indicators

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Actinic Cheilitis

Premalignant Disorders

Key exam points

Loss of vermilion demarcation
Palpate for induration
Photograph and map lesion

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Adenomatoid Odontogenic Tumour

Odontogenic Tumors

Exam checklist

Check for missing permanent canine
OPG + IOPA
CBCT
Vitality of adjacent teeth

Key exam points

Young female + maxillary canine + pericoronal radiolucency with flecks = AOT
Extends apical to CEJ — critical differentiator from dentigerous cyst

BDS questions

Short note: Adenomatoid odontogenic tumour.
Short essay: Two-thirds tumour.

FCPS / MS questions

Discuss the differential diagnosis of a pericoronal radiolucency associated with an impacted maxillary canine.

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Amelogenesis Imperfecta

Developmental Disorders

Key exam points

Classify by Witkop classification
Distinguish from DI by dentin appearance
X-linked forms affect males more severely

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Aneurysmal Bone Cyst

Non-odontogenic Cysts

Exam checklist

Age (< 30 y)
Rate of growth (rapid)
Facial asymmetry
Cortical crackling on palpation
Tooth vitality/mobility
OPG + CBCT for extent
MRI for fluid–fluid levels
Consider pre-op angiography ± embolisation

Key exam points

Young patient + rapidly expanding jaw swelling = consider ABC
Palpable egg-shell crackling suggests ballooning cortex
Always obtain MRI to look for fluid–fluid levels

BDS questions

Long essay: Aneurysmal bone cyst — pathogenesis, features, diagnosis, and management.
Short essay: Fluid–fluid levels on MRI in bone lesions.
Short note: USP6 gene in ABC.

FCPS / MS questions

Discuss the WHO reclassification of ABC and its clinical implications.
Compare curettage, embolisation, sclerotherapy and denosumab in the management of ABC.
Discuss reconstruction of a segmental mandibular defect following ABC resection.

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Attrition

Dental Diseases

Key exam points

Matching wear facets = attrition
Bruxism = primary cause in young adults
Distinguish from erosion (acid) by facet pattern

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Behçet Disease

Ulcerative Diseases

Key exam points

Triple symptom complex: oral + genital + ocular
Pathergy test
HLA-B51

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Burkitt Lymphoma

Malignant Tumors

Key exam points

Child with rapidly growing jaw mass — biopsy immediately
Send fresh tissue for cytogenetics

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Cemento-osseous Dysplasia

Fibro-osseous Lesions

Key exam points

Confirm tooth vitality before surgical intervention
Recognise florid pattern to avoid iatrogenic osteomyelitis

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Cementoblastoma

Odontogenic Tumors

Exam checklist

Vitality testing
OPG + IOPA + CBCT
Percussion / palpation

Key exam points

Only true cementum neoplasm
Painful odontogenic tumour
Vital tooth
Fused to root, radiolucent halo

BDS questions

Short note: Cementoblastoma.
Short note: Fibro-cemento-osseous lesions.

FCPS / MS questions

Discuss the classification and management of cemental lesions of the jaws.

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Cervicofacial Actinomycosis

Maxillofacial Infections

Key exam points

Woody induration crossing tissue planes
Sulphur granules in pus
History of recent extraction

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Cervicofacial Necrotising Fasciitis

Maxillofacial Infections

Key exam points

Pain out of proportion + rapid spread → suspect NF
Skin appearance underestimates fascial destruction

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Chondrosarcoma of the Jaws

Malignant Tumors

Key exam points

Anterior maxilla mass in adult — image with CT & MRI
Biopsy before definitive surgery

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Cleft Lip & Palate Repair

Maxillofacial Surgery

Key exam points

Assess feeding, weight gain, ear disease
Evaluate speech resonance and articulation
Photograph pre/post at each stage

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Cleft Lip and Palate

Developmental Disorders

Key exam points

Rule of 10 for lip repair
VPI = velopharyngeal insufficiency
Alveolar bone graft timing: mixed dentition

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Cleidocranial Dysplasia

Developmental Disorders

Key exam points

Ability to approximate shoulders anteriorly — pathognomonic
OPG with 'crown of teeth' from multiple impactions
Autosomal dominant, RUNX2 mutation

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Condylar Hyperplasia

TMJ Disorders

Key exam points

Chin deviation direction discriminates Type I vs II
Confirm activity before definitive surgery

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Deep Neck Space Infections

Maxillofacial Infections

Key exam points

Trismus + dysphagia = deep space involvement until proven otherwise
Airway is priority
Follow the fascial routes on CT

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Dental Erosion

Dental Diseases

Key exam points

Palatal erosion of 16, 26 = GERD/bulimia
Cupping of cusps
Restorations standing above tooth surface

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Dental Implantology

Maxillofacial Surgery

Key exam points

Assess bone width/height & inter-arch space
Identify vital structures on CBCT (IAN, sinus, incisive canal)
Manage soft-tissue phenotype

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Dentinogenesis Imperfecta

Developmental Disorders

Key exam points

Type I always with OI; Types II/III without OI
Pulp obliteration on radiograph is key
Enamel chips away due to poor DEJ support

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Dento-alveolar Trauma

Trauma

Key exam points

Extra-alveolar time and storage medium (avulsion)
Test vitality and record baseline

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Distraction Osteogenesis

Maxillofacial Surgery

Key exam points

Confirm vector before activation
Monitor occlusion during activation
Assess IAN function

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Epulis Fissuratum

Soft Tissue Lesions

Key exam points

Always assess denture fit
Excise + address cause
No malignant potential but biopsy to exclude SCC

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Erythema Multiforme

Vesiculobullous Diseases

Key exam points

Target lesions on skin
Haemorrhagic lip crusting
HSV is main trigger

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Erythematous (Atrophic) Candidiasis

Red Lesions

Exam checklist

Remove denture and examine underlying mucosa
Assess denture fit and hygiene
KOH mount
Screen for HIV/diabetes if recurrent

Key exam points

Denture-bearing mucosa
Dorsum of tongue for depapillation
Palate for kissing lesions

BDS questions

Short note: Denture stomatitis.
Describe the aetiology, clinical features and management of erythematous candidiasis (10 marks).

FCPS / MS questions

Discuss the role of Candida species in oral potentially malignant disorders.

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Erythroplakia

Red Lesions

Exam checklist

Full mucosal examination
Palpation for induration
Toluidine blue staining
Photograph and measure
Plan biopsy of most suspicious area

Key exam points

Site, size, colour uniformity
Induration and fixity
Cervical lymph nodes
Habit history

BDS questions

Compare and contrast leukoplakia and erythroplakia (10 marks).
Short note: Erythroplakia.

FCPS / MS questions

Discuss oral potentially malignant disorders with special reference to erythroplakia — molecular basis, clinical evaluation, and evidence-based management.

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Geographic Tongue

Red Lesions

Exam checklist

Full oral exam
Photograph for baseline (documents migration)
Ask about psoriasis, atopy, family history

Key exam points

Migrating pattern
White raised borders
Co-existent fissured tongue
Extra-lingual involvement

BDS questions

Short note: Geographic tongue.
Describe benign migratory glossitis — features, diagnosis and management.

FCPS / MS questions

Discuss the differential diagnosis of red patches on the tongue with emphasis on geographic tongue.

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Haemangioma

Benign Tumors

Key exam points

Differentiate from vascular malformation (history since birth, no involution)
Assess airway and vision in periorbital/segmental lesions

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Hemifacial Microsomia

Developmental Disorders

Key exam points

Pruzansky grading predicts surgical approach
Goldenhar = HFM + vertebral + eye anomalies
Distraction useful in growing child

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HPV-associated Oropharyngeal SCC

Oral Cancer

Key exam points

Cystic neck node in adult non-smoker → work up for HPV-OPSCC
Test p16 on every OPSCC

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Kaposi Sarcoma

Malignant Tumors

Key exam points

Purple palatal lesion → biopsy and HIV test
Assess extent (skin, GI, pulmonary)

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Lateral Periodontal Cyst

Odontogenic Cysts

Exam checklist

Vitality tests
Periodontal probing
IOPA + OPG
CBCT if surgical planning needed

Key exam points

Vital tooth + interradicular radiolucency = LPC
Do not confuse with lateral radicular cyst

BDS questions

Short note: Lateral periodontal cyst.
Short note: Botryoid odontogenic cyst.

FCPS / MS questions

Discuss the classification and management of lateral radiolucencies of the mandible with emphasis on developmental cysts.

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Le Fort Fractures

Trauma

Key exam points

Rock the maxilla to detect level
Assess CSF rhinorrhoea
Check vision and eye movements

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Leukoedema

White Lesions

Exam checklist

Inspect bilateral buccal mucosa
Perform stretch test
Reassure patient

Key exam points

Bilateral symmetry
Stretch test — pathognomonic
No induration or ulceration

BDS questions

Short note: Leukoedema — clinical features and differential diagnosis.

FCPS / MS questions

Discuss developmental white lesions of the oral mucosa with emphasis on differential diagnosis of leukoedema.

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Leukoplakia

White Lesions

Exam checklist

Inspect all mucosal surfaces including floor of mouth and ventral tongue
Palpate lesion for induration
Photograph and measure
Document habit history
Plan biopsy site (most suspicious area)

Key exam points

Site, size, colour (uniform vs mixed), surface (smooth, nodular, verrucous)
Consistency and induration
Wipes off? (excludes candidiasis)
Cervical lymphadenopathy
Habit history duration and frequency

BDS questions

Define leukoplakia. Classify and describe clinical features, histopathology and management of oral leukoplakia (10 marks).
Short note: Proliferative verrucous leukoplakia.

FCPS / MS questions

Discuss the concept of oral potentially malignant disorders, molecular basis of malignant transformation in leukoplakia, and evidence for chemoprevention.
Critically evaluate CO2 laser vs cold-knife excision for dysplastic leukoplakia.

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Median Rhomboid Glossitis

Red Lesions

Exam checklist

Full tongue exam with retraction
Assess palate for kissing lesion
Ask about smoking and inhaler use

Key exam points

Midline location anterior to circumvallate papillae
Well-demarcated rhomboidal shape
Palatal kissing lesion?

BDS questions

Short note: Median rhomboid glossitis.

FCPS / MS questions

Discuss the histopathological differential of a midline dorsal tongue lesion, including pseudo-epitheliomatous hyperplasia mimicking SCC.

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Medication-Related Osteonecrosis of the Jaws

Bone Diseases

Key exam points

Take a bisphosphonate history for EVERY extraction
Educate patients on oral hygiene before starting antiresorptives

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Mucocele

Soft Tissue Lesions

Key exam points

Extravasation type lacks epithelial lining
Lower lip most common site
Remove gland to prevent recurrence

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Mucoepidermoid Carcinoma

Salivary Gland Disorders

Key exam points

Bluish palatal swelling in adult → not a mucocele until proven otherwise
Always image before biopsy of parotid mass

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Mucous Membrane Pemphigoid

Vesiculobullous Diseases

Key exam points

Desquamative gingivitis common
Ocular involvement → scarring → blindness
DIF: linear BMZ

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Mumps (Epidemic Parotitis)

Salivary Gland Disorders

Key exam points

Bilateral parotid swelling with elevated earlobe
Absence of pus at Stensen duct

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Nasolabial Cyst

Non-odontogenic Cysts

Exam checklist

Extra-oral inspection: alar elevation, groove obliteration
Bimanual palpation of upper lip and nasal vestibule
Anterior rhinoscopy for intra-nasal bulge
Vitality tests of 12–24
MRI / CT for confirmation

Key exam points

Palpate the nasolabial fold bimanually (intra-oral + extra-oral)
Look for obliteration of the nasolabial groove and elevation of ala nasi
Bulge into nasal vestibule strongly suggests nasolabial cyst

BDS questions

Short essay: Nasolabial cyst — pathogenesis, features, and management.
Short note: Differences between nasolabial and nasopalatine cyst.
Short note: Fusion cysts of the face.

FCPS / MS questions

Compare open sublabial excision with endoscopic transnasal marsupialisation for nasolabial cyst.
Discuss the embryology of facial development and its relevance to fissural cysts.

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Nasopalatine Duct Cyst

Non-odontogenic Cysts

Exam checklist

Palpate anterior palate for fluctuant swelling
Inspect labial vestibule for expansion
EPT + cold on 11 and 21
Occlusal radiograph for buccolingual extent
CBCT if surgical planning required

Key exam points

Always vitality-test both central incisors
Measure lesion — ≥ 6 mm suggests cyst; < 6 mm may be normal incisive foramen
Look for salty discharge on palatal papilla

BDS questions

Short essay: Nasopalatine duct cyst — aetiology, features, differential and management.
Short note: Radiographic differential of anterior maxillary midline radiolucency.
Short note: Neurovascular bundle in nasopalatine cyst wall.

FCPS / MS questions

Discuss the embryological basis, imaging, histopathology and management of non-odontogenic cysts of the jaws.
Compare radicular cyst and nasopalatine cyst.
Surgical approaches to the anterior maxilla and management of complications.

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Odontogenic Keratocyst

Odontogenic Cysts

Exam checklist

Full facial and skin exam (BCCs, palmar pits)
Bimanual palpation of jaws
OPG + CBCT
Aspiration cytology
Genetic history for Gorlin
Photograph for records

Key exam points

Grows along the bone; minimal expansion
Aspirate protein < 4 g/dL, keratin flakes
Corrugated parakeratin, palisaded basal layer, flat CT interface
Always screen for Gorlin–Goltz syndrome

BDS questions

Long essay: Odontogenic keratocyst — aetiology, pathogenesis, clinical, radiographic and histopathological features, management and recurrence.
Short essay: Gorlin–Goltz syndrome.
Short note: Carnoy's solution.
Short note: Marsupialisation.

FCPS / MS questions

Discuss the molecular basis of OKC and Gorlin–Goltz syndrome and its implications for targeted therapy.
Evidence-based comparison of surgical modalities for OKC — recurrence and morbidity.
A 22-year-old female presents with multiple jaw radiolucencies. Discuss investigation and management.

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Odontogenic Myxoma

Odontogenic Tumors

Exam checklist

Bimanual palpation
Nerve function (IAN, mental)
OPG + CBCT ± MRI
Aspiration before open biopsy

Key exam points

Multilocular radiolucency with fine straight septa in a young adult
Aspirate first to rule out vascular lesion
Infiltrative — no capsule — high recurrence with curettage

BDS questions

Long essay: Differential diagnosis and management of multilocular radiolucencies of the mandible.
Short note: Odontogenic myxoma.

FCPS / MS questions

Discuss the surgical management and reconstruction options for a 4 cm odontogenic myxoma of the posterior mandible.

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Odontoma

Odontogenic Tumors

Exam checklist

Full eruption assessment
OPG
CBCT if unerupted tooth involved
Family history for Gardner

Key exam points

Most common odontogenic tumour
Compound = anterior maxilla, complex = posterior mandible
Radiopacity denser than bone with thin radiolucent halo

BDS questions

Long essay: Odontogenic tumours — classification and management with focus on odontoma.
Short note: Gardner syndrome.
Short note: Compound vs complex odontoma.

FCPS / MS questions

Discuss WHO 2022 classification of odontogenic tumours and current concepts on the hamartomatous nature of odontoma.

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Oral Candidiasis

White Lesions

Exam checklist

Full oral exam, including under dentures
KOH mount / smear
Assess systemic risk factors
Photograph lesions

Key exam points

Wipes off?
Denture-bearing area involvement?
Commissures for angular cheilitis?
Systemic disease clues?

BDS questions

Classify oral candidiasis. Describe the clinical features, investigations and treatment of denture stomatitis (10 marks).
Short note: Angular cheilitis.

FCPS / MS questions

Discuss chronic hyperplastic candidiasis as an oral potentially malignant disorder.
Management of azole-resistant oral candidiasis in HIV patients.

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Oral Lichen Planus

White Lesions

Exam checklist

Full mucocutaneous examination
Photograph lesions
Palpate for induration
Assess pain score and function
Document distribution map

Key exam points

Bilateral symmetry?
Type of lesion (reticular/atrophic/erosive)?
Skin, nail, genital involvement?
Drug and dental history?

BDS questions

Classify OLP. Describe the clinical features, histopathology and management of erosive lichen planus (10 marks).
Short note: Wickham striae.

FCPS / MS questions

Discuss the immunopathogenesis of oral lichen planus and evidence-based management of steroid-refractory disease.
Debate the malignant potential of OLP.

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Oral Lipoma

Benign Tumors

Key exam points

Slip sign, yellow hue transilluminates
MRI shows fat signal

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Oral Manifestations of CKD

Systemic Diseases

Key exam points

Check dialysis schedule and access site
Assess bleeding risk
Screen for gingival overgrowth in transplant patients

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Oral Manifestations of HIV/AIDS

Systemic Diseases

Key exam points

OHL and NUP are highly suggestive of HIV — investigate
Check CD4 before invasive procedures

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Oral Manifestations of Leukaemia

Systemic Diseases

Key exam points

New gingival enlargement + spontaneous bleeding in adult → FBC same day
Dental clearance before chemotherapy

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Oral Melanoma

Pigmented Lesions

Key exam points

Palate/maxillary gingiva
ABCDE criteria modified for mucosa
IHC: S-100, HMB-45

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Oral Melanotic Macule

Pigmented Lesions

Key exam points

Flat, well-circumscribed, stable size
Normal melanocyte number
Biopsy if atypical

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Oral Nevus

Pigmented Lesions

Key exam points

Palate most common site
Blue nevus may be raised, deeply pigmented
Biopsy to rule out melanoma

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Oral Schwannoma

Benign Tumors

Key exam points

Solitary tongue nodule → biopsy
MRI target sign

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Oral Tuberculosis

Ulcerative Diseases

Key exam points

Chronic painful ulcer with undermined edges
Tongue most common
Always screen for pulmonary TB

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Ossifying Fibroma

Fibro-osseous Lesions

Key exam points

Well-circumscribed vs FD's diffuse border
Cortical bowing on CBCT

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Osteomyelitis of the Jaws

Bone Diseases

Key exam points

Vincent sign in acute mandibular osteomyelitis
Sequestrum on plain film

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Paget Disease of Bone

Bone Diseases

Key exam points

Enlarging skull, ill-fitting dentures, isolated ALP rise

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Periapical Abscess

Dental Diseases

Key exam points

Drainage is paramount; antibiotics without drainage fail
Chronic abscess = radiolucency + sinus tract
Extraction if non-restorable

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Peripheral Giant Cell Granuloma

Soft Tissue Lesions

Key exam points

ALWAYS on gingiva/ridge (not intra-osseous)
Rule out hyperparathyroidism if recurrent
Giant cells on histology

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Pleomorphic Adenoma

Salivary Gland Disorders

Key exam points

Palpable, mobile, painless mass without facial nerve palsy
Enucleation is inadequate

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Primary Herpetic Gingivostomatitis

Vesiculobullous Diseases

Key exam points

Vesicles on ALL mucosa (keratinised + non-keratinised)
Fiery red gingivitis
Tzanck smear

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Pulpitis

Dental Diseases

Key exam points

Cold test: lingering >10s = irreversible
EPT negative = necrosis
Percussion tenderness = periapical involvement

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Radicular Cyst

Odontogenic Cysts

Exam checklist

Inspect for sinus / swelling / discolouration
Palpate for expansion, egg-shell crackling
Percuss suspected tooth
Cold and EPT vitality tests
Periapical + panoramic radiograph
CBCT if extension unclear
Aspiration in-office

Key exam points

Always test pulp vitality of adjacent teeth
Radiolucency + non-vital tooth = radicular cyst until proven otherwise
Aspiration protein content > 5 g/dL supports diagnosis

BDS questions

Long essay: Classify odontogenic cysts. Describe aetiopathogenesis, clinical & radiographic features, and management of radicular cyst.
Short essay: Rushton bodies.
Short note: Residual cyst.
Short note: Marsupialisation vs enucleation.

FCPS / MS questions

Discuss the molecular pathogenesis of inflammatory odontogenic cyst enlargement and evidence-based rationale for surgical vs non-surgical management.
Compare radicular cyst with OKC in terms of biology, imaging, histology, treatment and recurrence.
Discuss reconstruction of a large mandibular cystic defect following enucleation.

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Ranula

Soft Tissue Lesions

Key exam points

Ranula = mucocele of floor of mouth
Plunging = through mylohyoid
Marsupialization or gland removal

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Sjögren Syndrome

Salivary Gland Disorders

Key exam points

Salivary flow test, Schirmer test, focus score biopsy
Persistent unilateral parotid mass → exclude lymphoma

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Smoker's Melanosis

Pigmented Lesions

Key exam points

Anterior labial gingiva
Reversible with smoking cessation
Distinguish from melanoma by diffuse pattern

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Solitary Bone Cyst

Non-odontogenic Cysts

Exam checklist

Age (10–20 y)
Site (posterior mandible)
Vitality tests
OPG for scalloping
CBCT for extent
Plan surgical exploration

Key exam points

Always test vitality of adjacent teeth
Scalloping between roots on OPG is virtually pathognomonic in adolescents
An empty cavity on exploration is diagnostic

BDS questions

Short essay: Solitary bone cyst — pathogenesis, radiographic features, and management.
Short note: Traumatic bone cyst.
Short note: Pseudocysts of the jaws.

FCPS / MS questions

Discuss the classification, pathogenesis, and management of pseudocysts of the jaws.
Compare solitary bone cyst, aneurysmal bone cyst and Stafne bone cavity.

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