Dental MCQ
Managing trauma · Oral Surgery · INBDE Patient Cases

Dentoalveolar & Facial Trauma INBDE Patient Cases

By Dr. Isaac Sun, DDS

7 ADA INBDE-format patient cases on dentoalveolar & facial trauma. Each case is a shared patient box (chief complaint, history, medications, allergies, exam) followed by linked multiple-choice questions with full distractor explanations. Practice the way the real exam is structured.

7 patient cases35 linked questionsADA INBDE formatFull distractor explanations

Seven ADA INBDE-format patient cases on dentoalveolar and facial trauma: the primary survey before the broken tooth in a multi-trauma patient, a mandibular angle fracture recognized by malocclusion and inferior alveolar nerve numbness and managed by reduction and fixation, a condylar fracture that deviates toward the fractured side on opening, a Le Fort midface fracture with a mobile maxilla and CSF rhinorrhea warranting referral, a zygomaticomaxillary complex fracture with a flattened cheek and infraorbital paresthesia, a lip laceration with a missing tooth that must be located to rule out aspiration, and a TMJ dislocation reduced with downward-and-backward pressure. Topics include dentoalveolar fractures, mandibular and midface (Le Fort) fractures, soft-tissue injuries, and TMJ dislocation.

Case Coverage Map
What each case is testing
A broken tooth in a multi-trauma patient:
Primary survey before the tooth, associated head/C-spine injuries, locating a missing fragment, and the trauma-patient-first principle.
A jaw that doesn't bite right after a blow:
Malocclusion as the key mandibular fracture sign, inferior alveolar nerve numbness, favorable vs unfavorable, reduction and fixation, and the open (compound) fracture.
Deviation on opening after a chin blow:
Condylar fracture (deviation toward the fractured side), the chin-blow mechanism, frequent closed management, and restoring occlusion.
A mobile midface after high-energy trauma:
Le Fort fracture recognition, classifying I to III, CSF rhinorrhea as a red flag, and referral to maxillofacial surgery.
A flattened cheek and a numb cheek skin:
ZMC fracture (flattened malar prominence, infraorbital paresthesia, trismus), the coronoid impingement, eye/orbit assessment, and referral.
A cut lip and a missing front tooth:
Exploring the laceration for an embedded fragment, locating an aspirated/swallowed tooth with imaging, layered closure, and tetanus status.
A jaw stuck open after a wide yawn:
TMJ dislocation (condyle anterior to the eminence, locked open), downward-and-backward reduction, recurrence advice, and the fracture contrast.
Patient case: A broken tooth in a multi-trauma patient
0 of 5 answered, 0 correct
Patient
Male, 30 years old
Chief Complaint
Brought in after a motor vehicle collision with facial injuries and a broken front tooth.
Background and/or Patient History
  • High-energy trauma with facial and other injuries
  • Family is focused on the visibly broken front tooth
  • Patient has not yet had a full trauma assessment
Allergies
NKDA
Medications
  • None
Current Findings
  • Multiple injuries possible; airway and other systems not yet cleared
  • A fractured maxillary incisor is visible
  1. Question 1
    Moderate
    The first priority in this patient is:
  2. Question 2
    Moderate
    Maxillofacial trauma of this severity should prompt evaluation for:
  3. Question 3
    Moderate
    A missing tooth fragment in this patient must be:
  4. Question 4
    Moderate
    Only after the patient is stabilized does the clinician:
  5. Question 5
    Easy
    This case illustrates the principle that:

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Patient case: A jaw that doesn't bite right after a blow
0 of 5 answered, 0 correct
Patient
Male, 27 years old
Chief Complaint
Jaw pain and a bite that feels off after being struck.
Background and/or Patient History
  • Blunt trauma to the jaw
  • The teeth no longer meet correctly; numb lower lip on one side
  • A step is palpable along the mandible near the angle
Allergies
NKDA
Medications
  • None
Current Findings
  • Malocclusion, a step deformity, and lower-lip numbness suggesting a mandibular angle fracture
  • Likely inferior alveolar nerve involvement
  1. Question 1
    Moderate
    The most sensitive sign pointing to a mandibular fracture here is:
  2. Question 2
    Moderate
    The lower-lip numbness indicates involvement of the:
  3. Question 3
    Hard
    Whether this fracture is 'favorable' or 'unfavorable' depends on:
  4. Question 4
    Moderate
    Management of the displaced fracture involves:
  5. Question 5
    Hard
    Because the fracture runs through a tooth-bearing area communicating with the mouth, it is:

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Patient case: Deviation on opening after a chin blow
0 of 5 answered, 0 correct
Patient
Female, 34 years old
Chief Complaint
Jaw pain and the chin shifts to one side when she opens after falling on her chin.
Background and/or Patient History
  • Fell and struck the point of the chin (a guard against condylar fracture pattern)
  • On opening, the mandible deviates to one side
  • Pain in front of the ear on that side
Allergies
NKDA
Medications
  • None
Current Findings
  • Deviation of the mandible on opening and preauricular pain suggesting a condylar fracture
  • Possible malocclusion (premature posterior contact on the affected side)
  1. Question 1
    Hard
    On opening, a unilateral condylar fracture causes the mandible to deviate:
  2. Question 2
    Moderate
    A blow to the point of the chin classically transmits force to fracture the:
  3. Question 3
    Hard
    Many condylar fractures are managed:
  4. Question 4
    Moderate
    A goal of treatment is to restore:
  5. Question 5
    Moderate
    This injury is recognized clinically by:

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Patient case: A mobile midface after high-energy trauma
0 of 5 answered, 0 correct
Patient
Male, 40 years old
Chief Complaint
Facial swelling and a bite that has changed after a high-energy facial impact.
Background and/or Patient History
  • High-energy midface impact
  • Malocclusion, periorbital ecchymosis, and a maxilla that moves when tested
  • Patient otherwise being stabilized
Allergies
NKDA
Medications
  • None
Current Findings
  • Mobile maxilla, malocclusion, and periorbital ecchymosis suggesting a Le Fort fracture
  • Level to be determined clinically and radiographically
  1. Question 1
    Moderate
    A mobile maxilla with malocclusion and periorbital ecchymosis suggests a:
  2. Question 2
    Hard
    If the fracture is a horizontal one above the apices separating the maxillary alveolus and palate, it is:
  3. Question 3
    Hard
    A finding that raises concern for a higher-level (II or III) fracture is:
  4. Question 4
    Moderate
    The appropriate disposition for a midface fracture is to:
  5. Question 5
    Moderate
    Le Fort III specifically denotes:

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Patient case: A flattened cheek and a numb cheek skin
0 of 5 answered, 0 correct
Patient
Male, 33 years old
Chief Complaint
Flattened cheek and numbness over the cheek after being hit in the face.
Background and/or Patient History
  • Direct blow to the cheekbone
  • Flattening of the malar prominence and numbness of the cheek/upper lip
  • Difficulty opening the mouth widely
Allergies
NKDA
Medications
  • None
Current Findings
  • Flattened cheek, infraorbital paresthesia, and limited opening suggesting a zygomaticomaxillary complex fracture
  • Periorbital ecchymosis present
  1. Question 1
    Hard
    A flattened cheek with infraorbital numbness and limited opening suggests a:
  2. Question 2
    Hard
    The numbness over the cheek and upper lip reflects involvement of the:
  3. Question 3
    Hard
    The limited mouth opening in a ZMC fracture is often due to:
  4. Question 4
    Moderate
    The appropriate disposition is to:
  5. Question 5
    Moderate
    Periorbital ecchymosis with a ZMC or midface fracture should prompt assessment of:

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Patient case: A cut lip and a missing front tooth
0 of 5 answered, 0 correct
Patient
Female, 19 years old
Chief Complaint
Cut lip and a missing front tooth after a fall.
Background and/or Patient History
  • Through-and-through lower lip laceration; a maxillary incisor is missing and not found
  • Possible the tooth is embedded in the lip, aspirated, or swallowed
  • Patient stable
Allergies
NKDA
Medications
  • None
Current Findings
  • Lip laceration with an unaccounted-for missing tooth
  • Need to locate the tooth before closing
  1. Question 1
    Moderate
    Before suturing the lip, the clinician must:
  2. Question 2
    Moderate
    Because the missing tooth is unaccounted for, the clinician must also consider that it was:
  3. Question 3
    Moderate
    An aspirated tooth is dangerous because it can:
  4. Question 4
    Moderate
    The laceration itself is managed by:
  5. Question 5
    Moderate
    Tetanus status is checked here because:

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Patient case: A jaw stuck open after a wide yawn
0 of 5 answered, 0 correct
Patient
Female, 52 years old
Chief Complaint
Cannot close her mouth after yawning widely.
Background and/or Patient History
  • Sudden inability to close after a wide yawn
  • The jaw is locked open; preauricular fullness
  • History of similar episodes
Allergies
NKDA
Medications
  • None
Current Findings
  • Bilateral TMJ dislocation: the condyles are anterior to the eminence and the patient is locked open
  • No fracture suspected
  1. Question 1
    Moderate
    Being locked open after a wide yawn, with the condyle anterior to the eminence, is a:
  2. Question 2
    Hard
    Reduction of this dislocation is achieved by:
  3. Question 3
    Moderate
    After reduction, the patient should be advised to:
  4. Question 4
    Moderate
    Her history of similar episodes indicates:
  5. Question 5
    Moderate
    The dislocation differs from a condylar fracture in that the dislocation:

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Dentoalveolar & Facial Trauma core recall

Refresh the anatomy facts these cases depend on: nerve numbers, foramina, functions, and lesion findings.

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