[HAADOralSurgery] HAAD Oral Surgery
DOH Licensureination for Specialist Oral
Surgery Certification Exam Guide
**Question 1.** Which laboratory test is most critical for assessing bleeding risk before a major
dentoalveolar surgery in a patient on warfarin?
A) Complete blood count (CBC)
B) Serum creatinine
C) Prothrombin time/International Normalized Ratio (PT/INR)
D) Liver function tests
Answer: C
Explanation: PT/INR directly measures the anticoagulant effect of warfarin and guides
peri‑operative management of bleeding risk.
**Question 2.** A 62‑year‑old diabetic patient scheduled for mandibular third‑molar extraction
has an HbA1c of 9 %. What is the best pre‑operative recommendation?
A) Proceed without changes
B) Delay surgery until HbA1c <7 %
C) Optimize glycemic control and aim for fasting glucose <130 mg/dL on the day of surgery
D) Cancel the procedure permanently
Answer: C
Explanation: Good peri‑operative glycemic control reduces infection and delayed healing; an
exact HbA1c target is not required before a single extraction.
**Question 3.** Which of the following local anesthetic agents is an amide with the longest
duration of action for inferior alveolar nerve block?
A) Lidocaine
, [HAADOralSurgery] HAAD Oral Surgery
DOH Licensureination for Specialist Oral
Surgery Certification Exam Guide
B) Mepivacaine
C) Bupivacaine
D) Procaine
Answer: C
Explanation: Bupivacaine, an amide, provides profound anesthesia lasting up to 4–6 hours,
longer than lidocaine or mepivacaine.
**Question 4.** The maximum recommended dose of lidocaine with 1:100,000 epinephrine for
a healthy adult is:
A) 2 mg/kg
B) 4.4 mg/kg
C) 7 mg/kg
D) 10 mg/kg
Answer: B
Explanation: The safe limit of lidocaine with epinephrine is 7 mg/kg without epinephrine and
4.4 mg/kg with epinephrine; exceeding this raises toxicity risk.
**Question 5.** During conscious IV sedation, which drug combination is most commonly used
for its synergistic anxiolytic and analgesic properties?
A) Midazolam and fentanyl
B) Propofol and ketamine
C) Nitrous oxide and lidocaine
D) Diazepam and morphine
, [HAADOralSurgery] HAAD Oral Surgery
DOH Licensureination for Specialist Oral
Surgery Certification Exam Guide
Answer: A
Explanation: Midazolam (benzodiazepine) provides anxiolysis, while fentanyl (opioid) adds
analgesia; together they produce effective conscious sedation.
**Question 6.** A patient develops a sudden drop in oxygen saturation to 85 % during a dental
procedure under nitrous oxide sedation. What is the first immediate action?
A) Increase nitrous oxide flow
B) Turn off nitrous oxide and administer 100 % oxygen
C) Give intravenous epinephrine
D) Continue procedure and monitor
Answer: B
Explanation: The priority is to restore oxygenation; stopping nitrous oxide and delivering 100 %
oxygen corrects hypoxia quickly.
**Question 7.** Which classification best describes a horizontally impacted mandibular third
molar located entirely within the ramus?
A) Class I, Position A
B) Class II, Position B
C) Class III, Position C
D) Class IV, Position D
Answer: C
, [HAADOralSurgery] HAAD Oral Surgery
DOH Licensureination for Specialist Oral
Surgery Certification Exam Guide
Explanation: According to Pell and Gregory, a Class III impaction lies within the ramus, and
Position C indicates the deepest vertical level.
**Question 8.** The most appropriate incision for removal of a large mandibular torus is:
A) Crestal incision from canine to canine
B) Sulcular incision following the gingival margin
C) Full‑thickness vestibular incision extending beyond the torus
D) Horizontal incision in the palate
Answer: C
Explanation: A full‑thickness vestibular incision provides adequate exposure and allows
complete removal of the torus without compromising the alveolar ridge.
**Question 9.** Which of the following is a contraindication to immediate implant placement
after extraction?
A) Presence of a periapical radiolucency ≤2 mm
B) Adequate primary stability (>30 Ncm)
C) Active infection at the extraction site
D) Good bone volume
Answer: C
Explanation: Active infection compromises osseointegration; implants should be delayed until
the infection resolves.
DOH Licensureination for Specialist Oral
Surgery Certification Exam Guide
**Question 1.** Which laboratory test is most critical for assessing bleeding risk before a major
dentoalveolar surgery in a patient on warfarin?
A) Complete blood count (CBC)
B) Serum creatinine
C) Prothrombin time/International Normalized Ratio (PT/INR)
D) Liver function tests
Answer: C
Explanation: PT/INR directly measures the anticoagulant effect of warfarin and guides
peri‑operative management of bleeding risk.
**Question 2.** A 62‑year‑old diabetic patient scheduled for mandibular third‑molar extraction
has an HbA1c of 9 %. What is the best pre‑operative recommendation?
A) Proceed without changes
B) Delay surgery until HbA1c <7 %
C) Optimize glycemic control and aim for fasting glucose <130 mg/dL on the day of surgery
D) Cancel the procedure permanently
Answer: C
Explanation: Good peri‑operative glycemic control reduces infection and delayed healing; an
exact HbA1c target is not required before a single extraction.
**Question 3.** Which of the following local anesthetic agents is an amide with the longest
duration of action for inferior alveolar nerve block?
A) Lidocaine
, [HAADOralSurgery] HAAD Oral Surgery
DOH Licensureination for Specialist Oral
Surgery Certification Exam Guide
B) Mepivacaine
C) Bupivacaine
D) Procaine
Answer: C
Explanation: Bupivacaine, an amide, provides profound anesthesia lasting up to 4–6 hours,
longer than lidocaine or mepivacaine.
**Question 4.** The maximum recommended dose of lidocaine with 1:100,000 epinephrine for
a healthy adult is:
A) 2 mg/kg
B) 4.4 mg/kg
C) 7 mg/kg
D) 10 mg/kg
Answer: B
Explanation: The safe limit of lidocaine with epinephrine is 7 mg/kg without epinephrine and
4.4 mg/kg with epinephrine; exceeding this raises toxicity risk.
**Question 5.** During conscious IV sedation, which drug combination is most commonly used
for its synergistic anxiolytic and analgesic properties?
A) Midazolam and fentanyl
B) Propofol and ketamine
C) Nitrous oxide and lidocaine
D) Diazepam and morphine
, [HAADOralSurgery] HAAD Oral Surgery
DOH Licensureination for Specialist Oral
Surgery Certification Exam Guide
Answer: A
Explanation: Midazolam (benzodiazepine) provides anxiolysis, while fentanyl (opioid) adds
analgesia; together they produce effective conscious sedation.
**Question 6.** A patient develops a sudden drop in oxygen saturation to 85 % during a dental
procedure under nitrous oxide sedation. What is the first immediate action?
A) Increase nitrous oxide flow
B) Turn off nitrous oxide and administer 100 % oxygen
C) Give intravenous epinephrine
D) Continue procedure and monitor
Answer: B
Explanation: The priority is to restore oxygenation; stopping nitrous oxide and delivering 100 %
oxygen corrects hypoxia quickly.
**Question 7.** Which classification best describes a horizontally impacted mandibular third
molar located entirely within the ramus?
A) Class I, Position A
B) Class II, Position B
C) Class III, Position C
D) Class IV, Position D
Answer: C
, [HAADOralSurgery] HAAD Oral Surgery
DOH Licensureination for Specialist Oral
Surgery Certification Exam Guide
Explanation: According to Pell and Gregory, a Class III impaction lies within the ramus, and
Position C indicates the deepest vertical level.
**Question 8.** The most appropriate incision for removal of a large mandibular torus is:
A) Crestal incision from canine to canine
B) Sulcular incision following the gingival margin
C) Full‑thickness vestibular incision extending beyond the torus
D) Horizontal incision in the palate
Answer: C
Explanation: A full‑thickness vestibular incision provides adequate exposure and allows
complete removal of the torus without compromising the alveolar ridge.
**Question 9.** Which of the following is a contraindication to immediate implant placement
after extraction?
A) Presence of a periapical radiolucency ≤2 mm
B) Adequate primary stability (>30 Ncm)
C) Active infection at the extraction site
D) Good bone volume
Answer: C
Explanation: Active infection compromises osseointegration; implants should be delayed until
the infection resolves.
