Cohen Mcqs

8/16/2019 Cohen Mcqs

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1. A cold test best localizesa. pain of pulpal origin.b. periodontal pain.c. pulp

necrosis.d. referred pain

2. Anesthetic testing is most eective in localizing paina. to a specic tooth.b.

to the mandible or maxilla.c. across the midline of the face.d. to a posterior

tooth.

3. Dental history tainga. is less important than x!ray examination.b. has as

its principal goal to identify the oending tooth.c. principally assesses

intensity of pain.d. focuses heavily on the "uality of pain.

#. $ercussion testinga. dierentiates pain of periodontal origin.b. stimulates

proprioceptive bers in the periodontal ligament.c. indicates tooth fracture.d.

must be performed %ith a blunt instrument.

&. Areas of rarefaction are evident on x!ray examination %hena. the tooth is

responsive to cold.b. the tooth is responsive to heat.c. a tooth fracture has

been identied.d. the cortical layer of bone has been eroded.

'. An area of rarefaction in the lo%er premolar area indicatesa. denitepathology.b. torus mandibularis.c. possible mental foramen.d. root fracture.

(. $ercussion) palpation) and thermal testinga. are not to be performed on

patients %ith pacemaers.b. should involve testing of contralateral teeth for


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comparison.c. are best compared %hen using ipsilateral teethd. obviate

radiographs.

*. +rreversible pulpitis is often dened bya. a moderate response to

percussion.b. a strong painful response to cold that lingers.c. a strong painful

response to cold.d. a response to heat.

,. -edical history of heart disease is signicanta. and contraindicates

endodontic treatment.b. for referred pain to the left mandible indicating

possible myocardialinfarction.c. and indicates the need for premedication%ith antibiotics.d. and contraindicates local anesthetic %ith epinephrine.

1. /he best approach for diagnosis of odontogenic pain isa. x!ray

examination.b. percussion.c. visual examination.d. a stcp!by!stcp se"uenced

examination and testing approachfollo%ing the same procedure.

11. 0alcication of the pulpa. is a response to aging.b. does not relate to the

periodontal condition.c. precedes internal resorption.d. indicates the

presence of additional canals.

12. lectric pulp tests should not be performed on patients %hohave aa.

hearing aid.b. hip implant.c. dental implant.d. pacemaer.

13. A false!negative response to the pulp tester may occura. primarily in

anterior teeth.b. in a patient heavily premedicated %ith analgesics)


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narcotics)alcohol) or tran"uilizers.c. most often in teenagers.d. in the

presence of periodontal disease.

1#. A test cavitya. is the rst test in diagnostic se"uence.b. often results in a

dull pain response.c. is employed only %hen all other test ndings are

e"uivocal.d. should be performed %ith local anesthetic.

1. $ulpal pain response isa. dull and throbbing %hen carried by A!delta

myelinated nervebers.b. dull and throbbing %hen carried by A!delta

unmyelinatednerve bers.c. "uic and sharp %hen carried by A!deltamyelinated nerve bers.d. "uic and sharp %hen carried by A!delta

unmyelinated nervebers.

2. $ulpal pain response isa. dull and throbbing %hen carried by myelinated 0

bers.b. dull and throbbing %hen carried by unmyelinated 0 bers.c. "uic

and sharp %hen carried by myelinated 0 libers.d. "uic and sharp %hen

carried by unmyelinated 0 bers.

3. onspecilic biochemical mediators area. pyruvic acid) prostaglandins) and

aspartic acid.b. arachidonic acid and the complement system.c. histamine)

bradyinin) prostaglandins) and leuotriencs.d. arachidonic acid and

serotonin.

#. europeptides such as substance $ and calcitonin gene!relatedpeptide

045$6a. are released from capillaries.b. arc released from sensitized

nerves.c. are not part of the in7ammatory cycle.d. are found in the absence

of pain and in7ammation.


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&. /rigeminal neuralgia diers from odontogenic pain by beinga. continuous

and dull.b. sharp and shooting.c. sharp) shooting) repetitive) and triggered.d.

dull and throbbing.

'. -axillary sinusitis associated %ith acute tooth paina. is a seasonal

phenomenon.b. can involve the entire "uadrant up to the midline.c. can

involve the mandible.d. is initiated by psychogenic factors.

(. $ain is most commonly referred froma. lo%er anterior teeth to ipsilatcral

upper molars)b. lo%er molars to upper anteriors.c. posterior molars to the

opposing "uadrant or to other teeth insame "uadrant.d. upper molars to the

contralateral lo%er "uadrant

*. 8dontogenic symptoms are elicited primarily by the follo%ingprovoing

stimuli9a. thermal heat) cold6) percussion) palpation.b. postural changes.c.

pain follo%ing exertion.d. barometric changes.

,. +n the presence of an intense in7ammatory process) nerve blocin:ections

are rendered less eective o%ing toa. distance to source of irritation.b. p;

changes of in7ammation.c. length of needle)d. prior use of analgesics.

1.


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11. >ocalized s%elling as an extension of pulpal diseasea. re"uires antibiotic

therapy alone.b. re"uires analgesics.c. is managed using incision) drainage)

and an ind%elling drain.d. resolves %ithout treatment.

12.


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the trigger area.c. %ith lysis of the terminal nerve endings.d. %ith

anticonvulsant drugs.

#. 0luster headache diers from migraine in beinga. unilateral and involving

the teeth.b. principally a female complaint.c. unilateral and involving the

eye.d. bilateral.

&. Acute maxillary sinusitisa. results in referred pain to a single tooth.b.

results in referred pain to the orbit and maxillary posterior teeth.c. is

exacerbated by cold testing.d. is usually a noninfectious process.

'. Degenerative :oint disease most oftena. results in posterior displacement

of the meniscus.b. results in irreversible pulpitis.c. allo%s for %ide mouth

opening.d. can lead to adhesions and arthritic changes.

(. /-@ pain can bea. sharp) lancinating and electrical.b. exacerbated by :a%

closing.c. the result of tpsilateral maxillary odontalgia.d. found in males.

*. Atypical facial pain can be treated most eectively bya. microvascular

decompression.b. radio fre"uency gangliolysis.c. A+Ds.d. tricyclic

antidepressant drugs.

,. $hantom tooth pain or dcaerentation paina. can occur brie7y after tooth

extraction.b. is simply a peripheral phenomenon.c. can occur for an extended

period after pulp extirpation.d. is managed by analgesics.


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1. A denite diagnosis of facial causalgia can be madea. by lidocaine

inltration.b. by use of analgesics.c. by use of ipsilateral stellate ganglion

bloc.d. by observation of symptoms

1. $atients %ith rheumatic heart disease shoulda. be premeditated %ith

antibiotics per American ;eart Associationguidelines.b. be premedicated %ith

psychosedation.c. be premedicated %ith nonsteroidal antiin7ammatory

drugs.d. postpone elective endodontic therapy.

2. Diabetes patients in need of endodontic therapya. should not receive

elective therapy.b. should maintain normal insulin and meal schedules.c. do

%ell %ith intracanal steroid therapy.d. heal as %ell as nondiabetics.

3. $atients %ith ;+B infection) including A+D)a. should be premedicated %ithanalgesics.b. are at less ris from root canal therapy than from extraction.c.

are at less ris from extraction than from root canal therapy.d. have fe%er

complications during and after treatment.

#. $regnant patients in the rst trimestera. should receive the normal x!ray

dose for endodontic therapy.b. are not candidates for electronic apex

locators.c. should delay use of x!ray until the second trimester.d. are not at

ris from pharmacologic intervention.

&. $atients taing daily steroid therapy e.g.) for systemic

lupuserythematosus6a. may demonstrate adrenocorticoid depression.b.


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respond %ell to stress.c. are candidates for intracanal corticosteroid

therapy.d. do not re"uire antibiotic premedication.

'. xtra canalsa. are rarely found in molar teeth.b. are often found in molar

teeth.c. if not found) have little eect on the success of endodontictherapy.d.

are often found in upper canines.

(. /reatment considcrations6 for referral arca. poor oral hygiene.b. a patient

%ho breas appointments.c. calcied and curved root canals.d. a patient %ho

does not have dental insurance.

*. Dierentiate bet%een external and internal root resorptiona. internal

resorption is contiguous %ith the canal) and externalresorption is

superimposed on x!ray examination.b. internal resorption appears

superimposed) and external resorptionappears contiguous %ith the canal on

x!ray examinationc. the apex iocator is very useful.d. internal resorption is

larger in size.

,. 0ro%n and root perforationsa. are not treatable by surgical intervention.b.

heal after routine root canal therapy.c. can respond to a matrix of

hydroxyapatite and seal %ith glassionomer.d. respond %hether or not

cro%nCroot is sealed.

1. /he prognosis is compromiseda. %hen patient presents %ith pain.b. %hen

patient experiences interappointment pain.c. %ith class +++ mobility and loss of

bone support.d. for molar teeth.


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11. /he se"uence of therapy recommended for emergency treatmentisa.

caries control) pulpCperiodontal) oral surgery.b. oral surgery) caries)

pulpCperiodontal.c. pulpCperiodontal) caries control) extraction.d.

pulpCperiodontal) oral surgery) caries control.

12. ingle!visit root canal therapya. is an unacceptable procedure.b. should

be performed %ith apicoectomy.c. is an acceptable and successful

procedure.d. re"uires antibiotic premedication.

13. 8ne!appointment endodontic therapy is not indicated fora. fractured

anterior teeth %here aesthetics is a concern.b. patients re"uiring sedation or

operating room procedures.c. cases %ith severe anatomical and procedural

di=culties.d. %hen the patient is physically unable to return for completion.

1#. $atients scheduled for retreatmenta. may expect to have less

interappointment pain.b. should expect successful resolution.c. should expectsurgical intervention.d. may complain of thermal response on an ad:acent

tooth.

1&. urgical retreatment is indicateda. for a persistent area of rarefaction at

the apex of a retreatedtooth.b. for the development of severe periodontal

pocet formation.c. for :uvenile diabetes patients.d. before routine endodontic

retreatment.

1. +t has been established thata. exposure to ;+B is more liely than exposure

to hepatitis virus.b. transmission of tuberculosis is primarily blood!borne.c.

;+B is less fragile than the hepatitis virus.d. each patient should be


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considered potentially infectious.

2. ndodontic lesa. are disposed of after one use.b. arc considered reusablesharps.c. may be piced up by hand before decontamination.d. may be

disposed of in Egeneric refuse.E

3. /o prevent cross!contamination after exposure of the x!ray lma. gloves

arc super7uous.b. overglovcs are placed over contaminated gloves.c. dispose

of lm pacet in generic refuse.d. disinfect %ith sodium hypochlorite.

#. +nformed consent information for endodontic therapy excludesa.

alternatives to recommended treatment.b. procedure and prognosis.c. a

description of 8;A regulations.d. foreseeable and material riss.

&. 5adiographic exposure for purposes of endodontic therapya. has no place

for fast) sensitive speed lm.b. is minimized %ith 5adioBisio4raphy.c. is

unnecessary.d. does not re"uire informed consent.

'. F!ray units should bea. optimally capable of utilizing ( Bp.b. pointed in

shape.c. collimated to reduce exposure level) not to exceed ( cm atthe sin

surface.d. collimated to reduce exposure level) not to exceed , cm atthe sin

surface.

(. /he American ;eart Association recommends for prophylacticantibiotic

coveragea. penicillin B rather than amoxicillin)h. amoxicillin rather than


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penicillin B)c. Ge7ex rather than penicillin.d. cephalosporins rather than

erythromycin.

*. 5adiographic contrast can be directly aected by alteringa.

milliamperage.b. exposure time.c. ilovoltage.d. angulation.

,. An osteolytic lesion visualized on a radiograph could be mistaenfora.

granuloma.b. cyst.c. cementoma.d. all of the above.

1. /he buccal ob:ect rule statesa. that the ob:ect farther from the buccal

surface appears to movein the direction opposite the movement of the tube

head.b. that the ob:ect closest to the buccal surface appears to movein the

same direction as the tube head.c. that the ob:ect closest to the buccal

surface appears to movein the direction opposite that of the tube head.d.

that ob:ects closest to the lingual surface appear on the lmto move in the

direction opposite the movement of thecone.

11. Hith the cone moved to the distal and facing to%ards the mesial)the

mesiobuccal root of the rst molara. %ill be pro:ected mesially on the lm.b.

%ill be pro:ected distally on the lm.c. %ill not move.d. appears to move

lingually.

12. /o enhance tooth isolation to prevent contaminationa. isolation %ith

cotton rolls is used.b. anticholinergic and systemic antibiotic drugs are

used.c. isolation %ith rubber dam is used.d. direct access %ill achieve the

goal.


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13. /o enhance cro%n preparation and retention) cro%n lengtheningis

completed bya. electrosurgery in the presence of infrabony defects.b.

conventional gingivectomy in the presence of infrabony defects)c. laser

surgery in the presence of infrabony defects.d. apicaily positioned 7ap)reverse bevel in the presence of infrabonydefects.

1. +nfection control proceduresa. that protect against monilial infection

protect against ;B)b. that protect against ;B should protect against ;+B.c.

that protect against ;+B should protect against ;B)d. are controlled %ith the

use of the rubber dam.

2. 0olor change in a process indicator strip indicatesa. verication of

sterilization.b. verication of completed sterilization cycle.c. a change in

p;.d. a need to reprocess.

3. /he organism least resistant to thermal inactivation isa) bacterial spores.b)virus.c. treptococcus mutans.d. spirochete.

#. 5apid!speed autoclavesa. re"uire at least 3 minutes for sterilization.b.

re"uire no antirust prctreatment.c. destroy cloth products.d. produce

veriable sterilization.

&. 0hemiclavea. corrodes instruments.b. solution can be recirculated.c.

sterilization is veriable.d. does not aect heat!sensitive materials.


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'. Dry heata. provides corrosion protection for dry instruments.b. re"uires

only 3 minutes.c. has no mercury vapor eect.d. does not destroy heat!

sensitive materials.

(. 0hairside dry heat glass bead or salt sterilizationa. is veriable.b. serves as

an emergency bacup.c. re"uires a brief time to %arm up.d. can sterilize a

large number of instruments.

*. 4lutaraldehydca. re"uires a short period of sterilization.b. is relatively

noncorrosive.c. results in veriable sterilization.d. is nonirritating and

nontoxic.

,. /he sterilizera. is eective if the process indicator changes color.b. should

be checed %eely %ith a biologic indicator.c. should be checed daily %ith a

biologic indicator.d. should be checed for sterilization of bacteria rather

thanspores.

1. 4utta!percha is best sterilized ina. an autoclave.b. dry heat.c. &.&I

sodium hypochlorite for 1 minute.d. paraformaldehyde for 1 minute.

1. Gasahara and colleagues reported thata. accessory canals arc capable of

being cleaned mechanically alleast 'I of the time.b. over 'I of teeth

examined sho%ed accessory canals that%ere impossible to clean

mechanically.c. apical foramina %ere located at the apex *I of the time.d.

canals terminate in the shape of a delta #&I of the time.


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2. 8nce the pulp chamber has been opened) canal orices are located%itha. a

periodontal curette.b. a spoon excavator.c. an inverted cone bur.d. an

endodontic pathnder.

3. Access cavity preparation of anterior teetha. is completed using a G!type

le.b. often can result in lateral cervical or root surface perforations.c. often

can result in labial cervical or root surface perforations.d. arc initiated using a

no. ' or * round bur.

#.


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*. Bertucci and colleagues describe thata. &I of the maxillary second

premolars have one canal at theb. maxillary second premolars that have t%o

canals have t%o distinctapical foramina.c. (&I of maxillary second premolars

have one canal at theapex.d. accessory canals are more prevalent inmaxillary second premolarsthan in incisors.

,. /he maxillary rst molara. has a palatal root that curves lingually.b! has a

distobuccal root %ith t%o canals ending in a commonorice.c. should be

approached for endodontic treatment %ith the assumptionthat t%o canals

exist in the mesiobuccal root.d. should be approached for endodontic

treatment %ith the assumptionthat one canal exists in the mesiobuccal root.

1. -andibular incisorsa. often have t%o separate apical foramina.b. t%o of

ve can have t%o separate canals.c. average 1, mm in length.d. arc less

liely to be perforated labially than lingually duringaccess preparation.

11. -andibular premolarsa. can have more than one canal 12I to 23I of the

time.b. are less prone to acute exacerbations.c. rarely present complex

mechanical problems.d. arc. on average) 1, mm long.

12. -ultiple accessory foraminaa. are more often present at the apex of the

mandibular incisor.b. are more often present in the furcation of the maxillary

premolar.c. arc more often present in the furcation of the mandibularrstmolar.d. are accessible for mechanical instrumentation.

13. /he mandibular rst molara. has a fourth canal t%o!thirds of the time.b.

has a fourth canal half the time.c. is the most di=cult to treat.d. has a fourth


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canal one!third of the time.

1#. Hhen a calcied root canal cannot be located or instrumenteda.extraction is the treatment of choice.b. retrograde and replantation

procedures should be considered.c. the dentist must proceed %ith the

understanding that an unexploredor unlled canal is %orse than a

perforationd. it is no longer accessible to bacterial infection.

1. 5oot canal morphology should bea. conical.b. cylindrical.c. three

dimensional.d. predictable.

2. /o achieve the ob:ectives of vertical condensation) it is necessaryto

producea. a cylindrical canal.b. a conical canal.c. a tapering conical canal.d. a

straight canal.

3. /o contain gutta!percha %ithin the canal) instrumentation shouldresult ina.

cleaning beyond the anatomic apex.b. cleaning beyond the radiographic

apex.c. a cylindrical canal shape.d. the narro%est cross!sectional diameter at

the terminus.

#. /o avoid external transportation of the root canala. precurve instruments.b.

use large instruments.c. avoid the use of sodium hypochlorite.d. use vigorousinstrumentation.

&. According to the precepts of vertical condensation technology.the apical


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foramen should bea. as large as practicable.b. as small as practicable.c.

oval.d. circular.

'. /he pro:ected success of creating patency relies principally ona. the choice

of le type.b. irrigation.c. the rst instrument to reach the apical terminus.d.

the second instrument to reach the apical terminus.

(. 5eentry andCor reuse of previously utilized instruments isa. capitulation.b.

recapitulation.c. cleaning and shaping.d. re%oring.

*. +rrigation of the root canal achievesa. debridement.b. dissolution of

tissues.c. elimination of microbes.d. all of the above.

,. ach time the canal is 7ushed an appropriate volume of irrigantisa. 3 ml.b.

1 ml.c. 1 to 2 ml.d. # ml.

1. Debridement is most eectivea. in large "uantitiesb. %hen used %ith

recapitulation.c. %hen it remains in the canal bet%een appointments.d. :ust

prior to lling.

11. 5emoval of the smear layera. is accomplished %ith irrigation.b. eectively

reduces the microbial population.c. is unnecessary for eective cementation

during root canal lling.d. is necessary for success.


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12. iologic rationale dictatesa. overinstrumentation.b. undcrinstru

mentation.c. that the %oring length stop at the apical constriction.d. partial

pulp removal.

13. lood at the tip of a paper point removed from the root canalindicatesa.

possible hematoma.b. possible incomplete irrigation.c. possible incomplete

instrumentation.d. possible root perforation.

1#.


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1*.


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irritating to the periapical tissue.c. should be used exclusively.d. prevent

postobturation pain.

(. /he Estring!out testE for root canal sealer is achieved %hen) usinga spatula)

the cement can be raised from the glass slaba. Bi inch.b. 2 inches.c. 1 inch.d.

3 inches.

1. Hhich of the follo%ing statements is trueJa. Alteration of records is

forbidden.b. Alteration of records is permitted if dated.c. Additions to records

are forbidden.d. Additions to records are permitted if dated.

2. tandard of care) as dened by courts.a. re"uires absolute perfection.b.

describes %hat a reasonably careful and prudent clinician %oulddo under

similar circumstances.c. does not allo% for individual variations of

treatment.d. is e"uivalent to customary practice.

3. /he doctrine of informed consent does nota. re"uire that a patient be

advised of reasonably foreseeable rissof treatment.b. re"uire that the

patient be advised of reasonable alternatives.c. re"uire that the patient

forfeit his right to do as he sees t %ithhis o%n body.d. re"uire that the

patient be advised of the conse"uences of nontreatment.

#. /o mae sure a dentist to %hom one refers a patient is not consideredto be

an agent of the referring dentist) the referring dentistshoulda. verbally inform

the patient of that fact.b. inform the patient in %riting.c. enter a disclaimer in

the patient?s record.d. inform the patient that the referral is a suggestion only.


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&. A dentist may legallya. refuse to treat a ne% patient despite severe pain

and infection.b. be bound to sec former patients on recall after treatment is

completed.c. discharge a patient from his practice at any time.d. refuse to

treat a patient %ho has an outstanding balance on hisaccount.

'. +f a patient %ho is ;+B seropositive re"uests that the dentist notinform the

sta of his condition) the dentist shoulda. refuse to treat the patient.b. tell the

sta in private) then treat the patient using extra precautions.c. not teil the

sta) but treat the patient %ith great caution.d. not tell the sta and re"uire

the patient to sign a private guaranteethat the patient %ill be liable if

someone contracts thevirus.

(. +f a patient s%allo%s a le and the dentist had not placed a rubberdam) the

dentist shoulda. oer to pay for any medical expenses incurred as a result.b.

not oer to pay for medical expenses) %hich is an admissionof guilt.c. nol

mention %ho should pay medical expenses and try to inferthat the patient is

to blame e.g.) sudden movement) di=cultcase6.d. apologize for the mishap)

and suggest that the patient have medicalevaluation only if a problem

develops as a result.

*. An endodontist may be held liable %hoa. informs the patient that her

general practitioner is performingsubslandard care the general practitioner

may hold the endodontistliable6.b. fails to disclose to the patient andCor

referring dentist evidentpathosis other than the tooth they are treating.c. fails

to locate a very small canal that is not evident radiographlcally.d. mistaenly

initiates treatment on the %rong tooth in a di=cultdiagnosis situation.

,. 8f the follo%ing) the dentist?s best approach to avoiding legal actionby

patients is toa. tell all patients that heCshe the dentist6 docs not carry

malpracticeinsurance.b. attend 0ontinuing ducation courses fre"uently to


22/69

remain informedof current techni"ues.c. refer all ma:or patient complaints to

peer revie%.d. demonstrate genuine interest in the %elfare of each patient.

1. lood vessels become established in the dental papillaa. before the

formation of the cervical loop.b. during the bud stage of t o o t h formation.c.

during the bell stage of tooth formation.d. during the cap stage of tooth

formation.

2. 5oot development beginsa. before enamel formation.b. concurrently %ith

enamel formation.c. after completion of enamel formation.d. before ;ert%ig?sepithelial root sheath formation.

3. /he cell!rich zonea. is more prominent in the radicular p u l p than in the

coronalpulp.b. exhibits increased mitotic activity f o l l o % i n g d e a t h of o

d o n t o blasts.c. is the result of the central migration of c e l l s from the

peripheryfollo%ing completion of dentin formation.d. contains mainly

macrophages and e n d o t h e l i a l cells and fe%

#. Although similar in function) the odontoblast diers from the osteoblastand

cemcntoblast ina. morphologic characteristics.b. ultrastructurc.c. matrix

production.d. being a protein!secreting cell.

&. /he extent to %hich the odontoblast process extends out%ard indentina.

has been sho%n conclusively in recent years.b. varies %ith the age of the

tooth.c. depends on continued mitotic activity of the odontoblast.d. is

unrelated to the eects on the pulp of restorative procedures.


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'.


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12. $ainful pulpitis associated %ith an in7amed or degenerating pulpa. is

caused by a decrease in intrapulpal pressure.b. results from a reduction of

nerve cell permeability.c. is associated %ith stimulation of A bers.d. is most

liely due to nociceptive 0!bcr activity.

13. Bolume of blood 7o% in the pulpa. is least in the regions of the pulp

horns.b. is greater in the root portion than in the cro%n portion.c. is greater

than the blood 7o% in most visceral organs.d. is largely under the control of

the adrenergic sympathetic system.

1#. A healthy dental pulp responds to an in:ury bya. developing an eective

collateral circulation to transport in7ammatoryelements to the area.b.

decreasing in blood 7o% throughout the pulp.c. initiating an in7ammatory

response) usually follo%ed by partialor complete necrosis.d. forming

reparative dentin at the pulpal surface correspondingto areas of irritation.

1&. $ulpal calcicationsa. may compromise the pulpal blood supply.b. arc of

no signicance in root canal therapy.c. have an organic matrix of collagen in

all sizes.d. occur only after eruption.

1'. 0alcic metamorphosisa. is caused by increased activity of

odontoblasts.b. may lead to complete obliteration of the pulp space.c. usually

occurs in association %ith a constricted apical foramen.d. histologically

resembles aceliular cementum.

1(. 4ro%th factors arc liely to be involved in tooth formation. Hhatis at least

one probable function of these factorsJa. ignaling epithclial!mescnchymal

interactions.b. 8ne of the eruptive forces located in the apical region) :c.

Disruption of ;crt%ig?s epithelial root sheath.d. 0ollagen maturation in the


25/69

dental papilla.

1*. /he cell type to %hich the dendritic cell is most similar is9a. broblast.b. t!lymphocyte.c. mesenchymal cell.d. macrophage.

1,. >ymphatics in the dental pulpa. have not been demonstrated.b. %ould not

be necessary because of the extensive vascular net%or.c. cannot be

demonstrated morphologically because they areidentical to venules.d.

participate in the removal of tissue 7uids.

2. Hhat %ould be the closest estimate of the number of tubules

exposed%ith a full cro%n preparation of average depth that %ouldhave a

surface area of 1 mm2Ja. &b. &)c. &.d. &))

21. Hhen the pulp is in:ured it responds %ith in7ammation. Hhydoes it not

have good capability for recovery if badly damagedJ1. +t has no collateral

blood supply.2. +t lacs lymph drainage.3. $ulp 0./. cells are incapable of

mitosis.#. +t is encased in a noncompliant environment.a. 1 K 2b. 1 K3c. 1

K#d. 2 K 3

1. +n acute in7ammation) the rst cells to pass through the bloodvessel %alls

into the tissue area. eosinophils.b. lymphocytes.c. monocytes.d.polymorphonuclear neutrophils $-s6.

2.


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monocyte becomes aa. neutrophil.b. basophil.c. macrophage.d. histiocyte.

3. +n the in7ammatory process) %hich of the follo%ing cell typesfunction asphagocytesJa. -acrophages and lymphocytes.b. >ymphocytes and

neutrophils.c. $lasma cells and basophils.d. eutrophils and macrophages.

#. Hhich of the follo%ing results may be expected follo%ing surgery%hen

both the buccal and lingual cortical plates have beenlostJa. Anylosis.b. car

tissue formation.c. 8steosclerosis.d. ormal bone regeneration.

&. A foreign body reaction is characterized by the presence ofa. neutrophils.b.

plasma cells.c. giant cells.d. broblasts.

'. Acute osteomyelitis is typically characterized bya. a draining sinus tract.b.

a large diuse radiolucency.c. necrotic bone.d. cellulitis.

(. / lymphocytes arise as immature cells in thea. bone marro%.b. thymus.c.

lymph nodes.d. in7ammatory lesion.

*. Hhich of the follo%ing %ould predominate in the zone of irritationJa.

acteria.b. 0hronic in7ammatory cells.c. 0apillary buds.d. ecrotic elements.


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,. /he periapical lesion that %ould most liely contain bacteria%ithin the

lesion isa. apical abscess.

1. -ost root canal infections involvea. a single obligate anaerobic species.b.

multiple anaerobic species only.c. mixed aerobic and anaerobic

microorganisms.d. multiple aerobic species only.

2. tudies have demonstrated a correlation bet%een clinical and

radiographicsigns and symptoms of periapical pathosis and thepresence ofa.

treptococcus mutatis.b. $revvtella melaninogenicus.c. taphylococcus

aureus.d. no specic microorganisms6.

3. Hhich mediators of in7ammation are considered also to be themain

mediators of pain in in7ammatory responsesJa. Basoactive amines.b.

Ginins.c. 0omplement.d. Arachidonic acid.

#. /he presence of %hich component of complement in the in7amedperiapcx

suggests that the complement system participates in thepathogenesisJa.

0+.b. 03.c. 0(.d. 0,.

&. Degranulation and release of histamine is usually stimulated bybridging

%hich of the follo%ing on the mast cellsJa. +gA.b. +g.c. +g4.d. +g-.

'. +dentication of lymphocytes in human periapical lesions hassho%na. an


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absence of lymphocytes)b! an absence of / lymphocytes.c. that / cells

outnumber cells.d. that cells outnumber / cells.

(. +n periapical lesions) suppressor / cells are associated %itha. acute

developing6 lesions.b. chronic lesions.c. healing lesions.d. foreign!body

lesions.

*. 5outine culturing of the root canal system is generally not practicedin

today?s treatment regimens becausea. it is time consuming.b. important

anaerobes cannot be recovered.c. standard 50/ techni"ues eectivelyeliminate the ma:ority ofmicroorganisms.d. microorganisms play a minor role

in endodontic pathosis.

,. Hhen antibiotic therapy is indicated before) during) or after rootcanal

treatment the drug of choice isa. clindamycin.b. erythromycin.c. penicillin.d.

metronidazole.

1. >ong!term administration of clindamycin is contraindicaled becauseof the

ris of developinga. severe gastrointestinal conditions.b. urticaria.c.

photosensitivity.d. hypersensitivity.

1L. Hhich one of the follo%ing is least liely to initiate an immuneresponseJa.ecrotic tissue.b. ndotoxins.c. Autologous collagen.d. Biable bacteria.

12. Hhat immunoglobulin predominates in a secondary humoral responseJa.


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+gA.b. +g4.c. +g-.d. +g.

13. levated levels of +g have been identied in a periapical granulomaaftercanal instrumentation. /his may represent %hich typeof hypersensitivity

reactionJa. /ype 1 immediate hypersensitivity6.b. /ype ++ immediate

cytotoxic hypersensitivity6.c. /ype +++ immune complex hypersensitivity6.d.

/ype +B delayed hypersensitivity6)

1#. /he cytoine) interleuin!1 +>!16) has been identied in the in7amedpulp

and in7amed periapical lesion. 8ne important functionis toa. result in boneresorption.b. neutralize bacterial endotoxins.c. inhibit in7ammation.d.

promote phagocytosis by macrophages.

1&. /he intracanal medication that has the best potential for eectivenessas

an antimicrobial agent sealed in the canal isa. formocresol.b) &.2&I sodium

hypochlorite.c) steroids.d. calcium hydroxide.

1'. 0oronal exposure of gutta!perchaCsealer obturation to bacteria hassho%n

that) throughout the canal) the bacteriaa. penetrate very "uicly 1 to 3 days6

throughout obturation defects.b. penetrate very slo%ly re"uires several

months6.c. do not penetrate.d. penetrate fairly "uicly 1 %ee to 1 month6.

1(. 5egarding the presence of bacteria) most studies sho% thai the Mma:ority

of periapical granulomas area. supportive of numbers of anaerobes

primarily.b. supportive of numbers of anaerobes only) primarily.c. supportive

of numbers of variable) mixed 7ora.d. bacteria free.


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1. /he endodontic broach is used toa. locate the orices of the root canals.b.

remove pulp tissue from the pulp spaces.c. smooth the %alls of root canals.d.

enlarge the root canal spaces.

2. /he basic dierence bet%een G!type les and reamers isa. the number of

spirals or 7utes per unit length.b. the geometric cross section.c. the depth of

the 7utes.d. the direction of the spirals.

3. /he ma:or determining factor that in7uences the e=cacy of rootcanal

debridement is thea. type of hand instrument used.b. irrigating solution.c.

internal pulp space anatomy.d. instrumentation techni"ue.

#. /he %oring portion of an endodontic condenser plugger6 isa. smooth)

tapered) and pointed.b. smooth) tapered) and 7at!ended.c. smooth) ofuniform %idth) and pointed.d. smooth) of uniform %idth) and 7at!ended.

&. -odication of the cross!sectional design of G!type les froms"uare to

rhomboid has resulted in signicantly greatera. torsional strength.b. tensile

strength.c. stiness.d. 7exibility.

'. ignicant deviations from circular canal preparations %ill occur%hen using

aa. G!type reamer %ith a reaming action.b. G!type reamer %ith a ling

action.c. G!type le %ith a reaming action.d. G!type le %ith a ling action.


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(. /he ;edstrom le is most commonly used toa. 7are the canal.b. establish a

circular preparation.c. prepare post space.d. locate canal orices.

*. /he temperature of the gutta!percha extruded from the

Elo%lemperalure)Ethermoplastic in:ection system isa. 1's 0.b. 1N 0.c. (N

0.d. #N 0.

,. ome studies have reported that the most important aspect of irrigationis

thea. "uantity of irrigant.b. chelating action of the solution.c. size of the

needle.d. type of irrigant.

1. ;ardening of zinc oxide!eugenol is due to thea. formation of zinc

eugcnolatc.b. presence of %ater.c. evaporation of eugenol.d. heat generated

during the chemical reaction.+nstruments) materials) and devices #13

11. Hith time and %ith exposure to light and air) gutta!perchaa. does not

change its physical properties signicantly.b. %ill decompose and lose mass.c.

becomes more brittle.d. alters) but can be restored by freezing.

12. /emporary canal medications are of various types. Hhich of thefollo%ingseems to satisfy more criteria as to desirable propertiesJa.


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that 0avita. does not have as much compressive strength.b. does not seal as

%ell %ith time.c. is more susceptible to thermal changes.d. shrins %hile

setting.

1#. An inherent disadvantage of the gutta!perchaCcarrier systems isa. the

carrier corrosion or disintegration products are toxic.b. di=culty in insertion.c.

potential problems in retreatment.d. no means arc available to prepare the

post space.

1&. /he 0anal -aster intracanal instrument has some disadvantagesoverconventional instruments in that the 0anal -astera. %ill enlarge the canal

unevenly.b. %ill result in more transportation if not precurved.c. is more

susceptible to breaage.d. cannot be utilized in all canal shapes.

1'. /hining in terms of design) %hich of the follo%ing size!&

endodonticinstruments made from the same steel %ould be mostsusceptible

to fracture separation6Ja. /riangular shaft le.b. "uare shaft reamer.c.

5homboid le.d. ;edstrom le.

1. /he most common dentin r e s p o n s e in the zone d e e p to c a r i e s isa.

increased permeability.b. alteration of collagen.c. dissolution of peritubular d

e n t i n.d. dentin sclerosis.

2. Although each carious lesion is individual and in7uenced by

multiplefactors) the caries process is g e n e r a l lya. continuous.b. rapid.c.

intermittent.d. slo%.


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3. 5elatively fe% bacteria are found in a pulp abscess because ofthea.

immune response of p u l p tissue.b. high tissue p; in the ad:acent

in7ammation.c. mechanical blocage of sclerotic d e n t i n.d. antibacterial

products of n e u t r o p h i l s.

#. ;yperplastic pulpitisa. occurs only in permanent m o l a r s.b. occurs %hen

there is no d a m a g e.c) is not invaded by bacteria.d) is predominantly acute

in7ammation

&. A periodontal ligament in:ection of 2I lidocaine %ith 191)epinephrine

%ill cause the pulp circulation toa. cease for about 3 minutes.b. remain the

same.c. increase maredly.d. decrease slightly.

'. 8f the follo%ing) the highest incidence of pulp necrosis is associated%itha.

class B preparations on root surface.b. inlay preparations.c. partial veneer

restorations.d. full cro%n preparations.

(. According to the hydrodynamic theory of dentin sensitivity) themovement

of 7uid through dentinal tubulesa. stimulates the sensory nerve bers of the

underlying pulp.b. displaces odontoblasts into the pulp tissue.c. has minimal

eect on the odontoblasts.d. results in the death of many odontoblasts.

*. Acid etching of dentin before insertion of the restorative materiala.

protects the pulp from bacterial invasion.b. enhances bacterial penetration of

the dentin.c. destroys odontoblastic processes in the tubules.d. decreases the

pulp response to the restorative material.


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,. $ulpal blood 7o% is most increased bya. impression taing using modeling

compound %ith copperbanding.b. fabrication of acrylic temporary

restoration.c. rubber base impression.d. hydrocolloid impression.

1. Dental tubules should be sealed before placement of restorationstoa.

allo% a calcium bridge to form in the pulp.b. reduce the pathogenicity of the

microorganisms.c. decrease the number of dentinal tubules.d. decrease the

permeability of underlying dentin.

11. /he smear layer on dentin %alls acts to prevent pulpal in:ury bya.

reducing diusion of toxic substance through the tubules.b. resisting the

eects of acid etching of the dentin.c. eliminating the need for a cavity liner

or base.d. its bactericidal activity against oral microorganisms.

12. A common histologic change in the pulp in response to moderatelydeep

dentin caries isa. chronic in7ammation.b. acute in7ammation.c.

vasoconstriction.d. increased numbers of odontoblasts.

13. Application of frictional heat to exposed dentin may result ina. severe

postoperative symptoms.b. vascular stasis or intrapulpal hemorrhage.c.

proliferation of cells in the cell!rich zone.d. invariably chronic +n7ammation.

1#. ;ypersensitivity is best relieved or controlled bya. opening tubules to

permit release of intrapulpal pressure.b. root planing to remove surface

layers that arc hypersensitive.c. applying antiin7ammatory agents to exposed


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dentin.d. blocing exposed tubules on the dentin surface.

1&. Deeper cavity preparations have more potential for pulpdamagebecause1. tubule diameter and density increaseM therefore) there is

increasingpermeability.2. there is more vibration to pulp cells.3. odontoblastic

processes are more liely to be severed.a. 1 only.b. 3 only.c. 1 and 3.d. 2 and

3.

1'. /he pulp generally begins to sho% histologic changes of in7ammationas

soon as caries has entereda. the dentin.b. the enamel.c. the pulp.d. thereparative irregular secondary6 dentin.

1(. 8f the follo%ing) %hich is the best %ay to prevent pulp damageduring

cavity preparationJa. 5etain the smear layer.b. Ose diamond burs %ith a

brush stroe.c. Ose ade"uate air coolant.d. Ose ade"uate %ater coolant.

1*. Hhich is the ma:or reason %hy class 11 restorations %ith compositeis

damaging to the pulpJa. -icroleaage at the occlusal.b. -icroleaage at the

gingival margin.c. /oxic chemicals are released from the composite and

diuseinto the pulp.d. $olymerization shrinage distorts the material at the

occlusaland opens gaps %hich results in recurrent caries.

1,. A pulp has been damaged and is in7amed because of deep cariesand

cavity preparation. Hhat material placed on the 7oor of thecavity aids the

pulp in resolving the in7ammationJa. 0a8;62b. Pn8 base.c. teroid

formulations.d. /here is no medication or material that actively promotes

pulphealing.


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2. A cusp fractures and exposes dentin but not the pulp. Hhat isthe

probable response in the pulpJa. evere damage %ith irreversible

in7ammation.b. -i +d!to!moderate in7ammation.c. $ain but no

in7ammation.d. o pulp response

1. +f several teeth are out of alignment follo%ing trauma) themost reasonable

explanation isa. luxation.b. subluxation.c. alveolar fracture.d. contusion.

2. +nitial vitality testing of traumatized teeth is most useful toa. establish a

baseline for comparison %ith future testing.b. determine %hether or not root

canal treatment is indicated.c. determine if the blood supply to the pulp is

compromised.d. predict the prognosis.

3. +nitial radiographic examination of dental in:uries that includelip

lacerationsa. reveals hairline root fractures.b. reveals facial!lingual diagonal

root fractures.c. may reveal foreign ob:ects in the lips.d. should includeocclusal vie%s.

#. 5ubber dam application for the placement of a restoration atthe

emergency appointmenta. usually is not advisable.b. is absolutely essential.c.

usually is possible.d. is dictated by the restorative material.

&. Hhich of the follo%ing radiographic lm exposures is best fordiagnosing

root fractures in the apical thirdJa. $arallel.b. isecting angle.c. 8cclusal.d.

$anoramic.


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'. /he initial priority in treatment of a horizontal root fracture%ith signicant

mobility isa. preservation of the pulp.b. reduction and immobilization.c. root

canal therapy.d. calcium hydroxide pulp therapy.

(. /o prevent the onset of in7ammatory resorption) the matureintruded tooth

musta. be allo%ed to reerupt.b. have the pulp removed %ithin 1 to 2 %ees.c.

have the pulp removed after the tooth is in position.d. have an immediate

root canal lling completed.

*. +n7ammatory resorption is the mechanism ofa. re:ection of autogenous

protein.b. eliminating infected calcied tissue.c. scar tissue formation.d.

se"uestration of bone.

,. 0omparing dental trauma in boys and girls9a. /he rate of trauma is

increasing more rapidly in girls.b. 4irls have more in:uries as the result of

sttights.c. oys have more in:uries in the maxilla) girls in the mandible.d.+n:uries are common in boys) rare in girls.

1. A direct facial EpaddedE blo% to the incisors is more liely tocausea.

enamel fracture.b. enamel!dcntin fracture.e. dentin fracture!pulp exposure)d.

luxation.

11. Apulpotomy coronal pulp removal6 is indicated %hen thereis a cro%n

fracture and pulp exposure anda. root formation is incomplete and the cro%n

is fractured inthe cervical one!third.b. the pulp has been exposed longer than

+ %ee.c. the puip is hypersensitive to cold.d. any portion of the fracture

extends to the root.


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12. onunion of a root fracture and in7ammatory response frompulp necrosis

is indicated radiographically bya. a periapical lesion.b. mared separation of

the segments.c. root resorption ad:acent to the fracture.d. %idening of the

fracture and resorption of ad:acent bone.

13. Displaced teeth that had pulp necrosis %ith root resorption andthen had

the appropriate endodontic treatmenta. often had continued resorption.b.

occasionally had anylosis.c. had a high rate of success)d. usually developed

apical pathosis.

1#. Hhich medium of storage for an avulscd tooth is best for

prolonecdperiodsJa. -il.b. Distilled %ater.c. ;an?s balanced salt solution.d.

$atient?s saliva.

1&. After replantation of an avulscd tooth that has air dried) comparing50/

%ith immediate gutta!percha obturation vs. treatment%ith intracanal calcium

hydroxide) the researcha. sho%s that both arc doomed to failure.b. sho%s

that 50/Cimmediate 4$ has the best success.c. sho%s that calcium hydroxide

treatment rst has the bestsuccess.d. as yet is inconclusive.

1'. A primary tooth %hose cro%n is displaced lingually and theroot faciallya.

is liely to damage the permanent successor.b. should be extracted.c. often

%ill anylosc) %ith resulting displacement of theerupting successor.d.

generally re"uires no treatment and causes no damage tothe successor.


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1(. +f a fully formed tooth has suered an intrusive in:ury andthe cro%n is

partially exposed) %hat is the recommended treatmentJa. >eave alone and

allo% to erupt spontaneously.b. plint for ( to 1 daysM %atchful %aiting.c.

8rthodontially reposition into correct alignment %ithin 3to # %ees.d.

5eposition %ith forceps.

+. +f calcic metamorphosis reduction in canal space6 is

observedradiographically follo%ing a displacement) the treatmentisa.

immediate root canal treatment.b. root canal treatment only if the tooth is

unresponsive topulp tests.c. root canal treatment only if the tooth discolors.d.

nothing unless signs and symptoms of periapical pathosisdevelop in the

future.

1,. Alvused replanted teeth %ith incomplete root formationa. re"uire pulp

removal if the extraoral period is more than 2hours.b. are prone to internal

resorption.c. are tested for revascularization %ith the electric pulp tester.d. in

most cases develop roots.

2. Hhich is most liciy to result in severe pulp damage necrosis6Ja.

+ntrusion displacement.b. >ateral displacement)c. namel!dentin fracture.d.

0ervical one!third root fracture.

21. +n a tooth that has been in:ured) a dramatic or distinct colorchange to

purple or dar gray after a fe% %ees is usuallyindicative ofa. internal

hemorrhage that is reversible.b. internal resorption that is irreversible.c.internal resorption that is reversible.d. pulp necrosis.

22. A nonmobilc. asymptomatic root fracture %ith evidence of hypeic a lei

cation of the pulpal space of the coronal generallyre"uiresa. no further


40/69

treatment)b. root canal therapy %ith gutta!percha.c. root canal therapy %ith

calcium hydroxide initially.d. extraction because there is liely to be pathosis.

23. /he best %ay to treat a mature root fractured in the middleone third %ith

mobility and no response to pulp testing isa. to reposition segments) splint)

and monitor)b. to splint) begin access) pac %ith 0a8;6!).c. to extract

immediately) because restoration is impossible.d. to perform root canal

therapy) anchor segments together%ith cast post) and restore.

1. +nternal resorptiona. radiographical+y is often confused %ith externalreplacementresorption9b. is associated %ith systemic disease.c. is usually

associated %ith trauma.d. usually results only if odontoblasts andCor

predentin layer islost or altered.

2. tudies of internal resorption have sho%na. histologic dierences in the

process in primary and permanentteeth.b. no dierence in rate of progression

of the process in primaryand permanent teeth.c. normal pulp is replaced by a

periodontal!lie connective tissue.d. resorption of dentin and no deposition of

mineralized tissue.

3. xternal resorption may be found in %hich one of the follo%ingsystemic

diseasesJa. ;ypoparathyroidism.b. Diahetes.c. >euemia.d. $arinson?s

disease.

#. Apical external resorption) as related to periapical pathosis)a. re"uires

surgical intervention apicoeetomy6.b. is usually associated %ith a necrotic

pulp.c. is initially treated %ith conventional root canal treatment) althoughthis


41/69

has a "uestionable outcome.d. is usually irreversible) has a poor prognosis)

and re"uires extraction.

&. 5esorption follo%ing bleachinga. is a reason not to treat tctracycline!

stained teeth %ith root canaltherapy and internal bleaching.b. may be due to

erosion of dentin exposed at the cervical line.c. is related to the use of heat

and 3,M hydrogen peroxide.d. docs not occur unless there is a history of

trauma.

'. 8rthodontic treatment resorption is most prevalent ina. maxiilaryincisors.b. mandibular incisors.c. maxillary premolars)d. mandibular

premolars.

(. Avulsed teeth replanted %ithout pulpectomy usually exhibita.

revascularization of pulp space.b. surface resorption.c. in7ammatory

resorption.d. anylosis.

*. 0ementum is more resistant than bone to resorption. A theory asto %hy

this is true is thata. cementum is more mineralized than bone.b. cementum

contains an antiresorptivc factor.c. bone is vascularM cementum avascular.d.

liber patterns in cementum are dierent than in bone and tendto be more

resistant to ciast!typc cells.

,. /he t%o ma:or local causes of root resorption area. in7ammation and

excessive pressure.b. in7ammation and cementoclast!activating factor.c.

excessive pressure and increased p; of ground substance.d. cementoclast!

activating factor and increased p; of groundsubstance.


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1. As related to root resorption during orthodontic movement rootcanal!

treated teeth area. more resistant to resorption.b. less resistant to

resorption.c. no dierent than untreated teeth.d. more prone to resorption if

there is a history of apical rootresorption as related to apical pathosis.

11. >ateral in7ammatory root resorption is usuallya. related to a tooth in:ury

that damages the $D>.b. related to sterile pulp necrosis.c. irreversible.d.

successfully treated only if calcium hydroxide is placed in thecanal prior to

obturation.

12. 0linical features of early stages of lateral in7ammation root

resorptioninclude that usually it isa. associated %ith normal pulp testing)

visible radiographically.b. asymptomatic) not visible radiographically.0.

associated %ith no or abnormal6 response to pulp testing)symptomatic)d.

symptomatic) not visible radiographically.

3. 0ervical root resorption is in many or most6 casesa. of unno%n etiology.b.

related to a subluxation in:ury.c. associated %ith a necrotic) infected pulp.d.

unrelated to in7ammation in the cervical periodontium.

1#. /reatment of medium depth cervical root resorption usually re"uiresa.

root canal treatment alone.b. root canal treatment follo%ed by surgery.c.

surgery alone.d. surgery) follo%ed if necessary by root canal treatment.

1&. /hese clinical features of internal resorption usually includea. positive

response to pulp testing) visible in the pulp spacersdiographically.b. visible in

both the pulp space and as a defect in the ad:acentbone.c. symptomatic)


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visible radiographically in the pulp space.d. asymptomatic) visible

radiographically in he pulp space) variableresponse to pulp testing.

1'. +n the treatment of nonpcrlorating internal resorption)

calciumhydroxidemay be used in the canal primarily toa. sterilize the canal

space.b. remineraliC.e the resolved areas.c. aid in breaing do%n inaccessible

areas containing tissue.d. lo%er p; in the tissue to counteract the

dentinobiasts.

1(. A common histologic feature of replacement resorption is :a. areas offusion of bone %ith cemenlumCdcntin.b. in7ammation in the ad:acent

periodontium.c. pulp necrosis %ith bacteria deep into the tubules.d. areas of

necrotic bone and necrotic cementum.

+G. A treatment approach that %ill generally arrest replacement resorptionisa.

pulpectomy and placement of 0a8;62.b. surgery to expose and curette the

defect.c. pulpectomy and immediate obturation.d. nonexistent. /here is no

no%n eective treatment

1. /he highest percentage of lateral canals occursa. in the coronal third of the

root.b. in the middle third of the rootc. in the apical third of the root.d.

any%here along +hc root) depending on the tooth in "uestion.

2. /reatment of pulpal diseases that cause periodontal diseases

usuallyre"uiresa. endodontic treatment alone.b. both endodontic and

periodontal treatment.c. periodontal surgery and curettage.d. combined

pcriradicular and periodontal surgery.


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3. tudies on the eects of periodontal disease on the pulp havesho%na.

pathologic pulp changes.b. degenerative pulp changes.c. no pulp changes.d.

all of the above.

#. Hhich of the follo%ing statements concerning a sinus tract of pulpalorigin

is falseJa. /he tract is usually thinner than an infrabony periodontalpocet.b.

Bitality tests may evoe an unaltered) normal response.c. $ain is not often

present.d. +t can be traced to the source of irritation.

&. Hhich of the follo%ing statements concerning a primary endodonticlesion

%ith secondary periodontal disease is falseJa. /his condition occurs %ith long!

standing pulpal disease andchronic periapical drainage.b. 5adiographs may

sho%! generalized periodontal disease %ith angulardefects at the initial site of

endodontic involvement.c. 5esolution of the lesion re"uires both endodontic

and periodomtal therapy.d. +f appropriate endodontic therapy is performed all

bone loss %illheal.

'. +n a primary periodontic lesion %ith secondary endodontic involvementa.

there is a history of extensive periodontal disease.b. the pulp al%ays

responds to vitality tests.c. pain is usually absent.d. periodontal therapy

should precede endodontic therapy.

(. /he concomitant pulpal!pcriodontal lesiona. is another name for thecombined endodontic!periodontic lesion.b. re"uires either periodontal or

endodontic treatment.c. radiographically may simulate a vertical fracture.d.

depends for its prognosis on the success of periodontal treatment.

*. /he most common cause of root resection failures isa. progressive

periodontal disease.b. recurrent endodontic pathosis.c. root fracture.d. poor

oral hygiene.


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elf!assessment "uestions1. Onless the benet!ris ratio is high) surgeryshould be avoided bya. Ebrittle diabetics.Eb. dialysis patients.c.

immunocompromised patients.d. all of the above.

2. Hhich of the follo%ing statements regarding the presurgical%orup is

falseJa. +t is performed by the surgical assistant.b. /he patient is informed of

the nature of the procedure.e. /he patient?s medical history is revie%ed and

blood pressure ischeced.d. one of the above.

1 -aximum hemostasis is obtained by depositing anesthetica. into the

attached gingiva.b. into the papillae.c. into the alveolar mucosa.d. into all of

the above.

#. 2I >idocaine %ith 19&)16 pinephrinea. iscontraindicated in the

medically compromised patient.b. is administered after anesthesia is

obtained.c. provides anesthesia and analgesia.d. is deposited in multiple

in:ections into the vestibular tissuesapical to the root apices.

&. /he triangularCrectangular llap %ith suleular incisiona. provides the best

access of all 7aps.b. has no disadvantages.c. compromises the blood supplyto the hap.d. elevation begins at the :unction of the horizontal and

verticalincision.


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'. Hhich of the follo%ing statements concerning the

triangularCrectangular7ap %ith mucogingival incision is falseJa. /his 7ap is

eontraindicated %ith short roots.b. urvival of marginal gingiva depends on

secondary blood supp?y

c.ecause tissue reapproximation is simplied) sear formation isminimal.d. +t

is popular because marginal gingiva is undisturbed.

(. /he most common cause of lap in:ury isa. insu=cient extension of

releasing incisions.b. excessive tension by sutures.c. using undermining

elevation.d. improper retractor positioning.

*. Hhich of the follo%ing statements concerning apical curettage istrueJa.

Apical curettage is denitive treatment.b. ot all curetted soft tissue needs to

be submitted for biopsy.c. ony access should be enlarged to remove the

lesion in toto.d. -l of the above.

,. /he angle of the beveled resected roota. should be su=cient to provide

access to perform the rctropreparation.b. is rarely greater than it appears to

be.c. should be at #& degrees to the facial surface.d. All of the above.urgical

endodontics &'(

1.


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11. All beveled root canal llingsa. can be easily evaluated.b. lea.c. can be

hermetically sealed by retrolling %ithout a magnicationsystem.d. should be

rctrolled only if there is an apparent incompletelysealed root canal system.

12. Hhich of the follo%ing is not a re"uirement for retropreparations?1a. All

isthmus tissue must be removed.b. +n roots %ith one canal the shape is

usually round.c. +t must be parallel to the anatomic outline of the pulpal

space.d. +t must be at least 3 mm deep.

13. Oltrasonic root end preparationsa. eliminate the bevel.b. facilitate ideaL

preparation.c. conserve root structure.d. All of the above.

1#. 0haracteristics of an ideaL retrolling material include all of thefollo%ing

excepta. long!term sealing ability.b. unaected by moisture.c. slight

expansion on setting.d. nonresorbable.

1&. /he retrolling material that oers the most advantages to dateisa.

amalgam and cavity varnish.b. composite resin.c. +5- orA.d.

polycarboxylate cement.

1'. uturesa. do not impede %ound healing.b. ideally should be removed

after #* hours.c. are placed by proceeding from the attached tissue to the

unattachedtissue.d. All of the above.


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1(. $ostoperative care does not includea. continuous application of an ice

pac.b. chlorhexidene mouth rinses.c. %ritten postoperative instructions.d.

one of the above.

1*. /he operating microscope cana. enhance the ability of the surgeon to

inspect) prepare) and sealthe apex.b. be useful in patient education.c. provide

a permanent record for insurance purposes.d. All of the above.

elf!assessment "uestions1. /he duration of action of a local anesthetic can

be increased bya. increasing its lipid solubility.b. increasing its protein!binding

potential.c. decreasing its extra!neural tissue diusibility.d. increasing its

vasodilator activity.

2. +nade"uate anesthesia in some cases of in7amed or infected pulpsis due

toa. a decrease in the tissue p; around the involved tooth.b. availability of

more cations for binding at the receptor site.c. a larger proportion of the freebase.d. a smaller proportion of the cation.

3. upraperiostcal anesthesia isa. most eective in areas of infection.b.

generally used for pulpal anesthesia olE maxillary teeth.c. not eective for

primary teeth in the mandibular arch.d. eective in areas of dense cortical

bone.

#. /he infraorbital nerve bloc does not anesthetizea. the maxillary

premolar.b. the maxillary incisors.c. the palatal mucosa.d. the maxillary

cuspid.


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&. $artial anesthesia to the mesial of the mandibular rst molar canbe

alleviated bya. anesthetizing the motor bers of the mylohyoid nerve.b.

depositing anesthetic on the buccal side at the level of the mesialapex.c.

depositing anesthetic on the lingual side at the level of the apexof the second

molar.d. all of the above.

'. lectronic dental anesthesia DA6a. has not been approved by the


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11. 0ompared to diazepam Balium6) midazolam Bersed6a. provides an

amnesic eect)b. is not as potent.c. re"uires no local anesthetic for pain

control.d. provides a greater degree of sedation.

12. Hhich route of administration of conscious sedation re"uires noone to

escort the patient from the o=ceJa. 8ral.b. +ntravenous.c. +nhalation.d. one

of Qhe above.

elf!assessment "uestions1. Hhich of the follo%ing is not helpful in

determining if a patientis appropriate for bleachingJa. 5ecent periapical

radiographs.b. Bitality tests.c. /ransillumination.d. An intraoral camera.

2. /he most di=cult stains from dental treatment to bleach successfullyare

froma. amalgam restoration.b. root canal sealers.c) composite restorations.d)

gold restorations.

3. /eeth are most susceptible to tetracycline staining froma. four months in

utero to eight years of age.b. birth to seven years of age.c. seven months in

utero until the third molars are formed.d. anytime during life.

#. As described by @ordan and osman) third degree tetracyclinestaining isa.

dar gray or blue in color) %ith banding.b. dar yello% or gray in color.c. too

dar to bleach.d. light yello% or gray in color.


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&. -inocycline) in contrast to other tetracyclines)a. causes staining of

enamel.b. causes discoloration in teeth after calcication)c. chelates %ith

calcium to form tooth pigmentation.d. all of the above.

'.


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light source isa. 1 to 11& degrees.b. 11& to 1# degrees.c. 1# to 1'

degrees.d. 1' to as high as the patient can tolerate.

11. Hith vital bleachinga. both arches should be treated simultaneously.b.

treatment should proceed from the less discolored teeth to themost

discolored.c. incisal halves of teeth respond "uicer than cervical halves)d.

yello%!bro%n and gray stains are e"ually di=cult to remove.

12. Hhich of the follo%ing is not necessary for vital bleachingJa. $atient

%ears safety glasses.b. >ocal anesthesia.c. $umice prophylaxis.d. $olish teethafter last treatment.

13. /he barrier material for bleaching pulpless teeth should bea. +5-.b.

dental sealant.c. glass ionomer cement.d. zinc oxyphosphate.

1#. 0ervical resorption in bleached pulpless teeth may result froma. bleach

placed apical to the [email protected]. tooth becoming pulpless before patient reaches

age 2&.c. a defect in the [email protected]. all of the above.

1&. /he most common treatment for cervical resorption follo%ing

intracoronalbleaching isa. surgical repair.b. orthodontic extrusion.c.

extraction.d. calcium hydroxide therapy.

1'. Hhich of the follo%ing is not part of the bleaching procedure

forendodontieally treated teethJa. 5ubber dam isolation.b. Acid etching.c.


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uperoxoL or sodium perborate.d. A heat source.

1(. Hith nightguard vital bleachinga. the reported success rate is (&I.b.7uorosed teeth are the least responsive.c. the bleaching agent is 1I

carbamide peroxide.d. patients %iih removable partial dentures can %ear the

nightguardonly at night.

1*) Onno%ns about nightguard bleaching include all of the follo%ingexcepta.

longevityb. eects on restorations.c. e=cacy.d. none of the above.leaching

of vital and pulpless teeth '3

1,. $atient instructions during nightguard bleaching includea. replace

bleaching solution every 3 to # hours.b. %ear nightguard as long as

possible.c. discontinue treatment and contact /he dentist if teeth

becomehypersensitive.d. all of the above.

2.


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2. ndodontic access through existing cro%nsa. usually has no eect on

porcelain strength.b. does not cause separation of the porcelain veneer from

themetal substructure.c. often leads to excessive removal of coronal tooth

structure.d. should not be performed.

3. During the restorative examination prior to endodontic therapya. the

strategic value of the tooth is of minor signicance.b. a critical amount of

solid coronal dentin is re"uired.c. the ferrule has no eect on the incidence of

root fracture.d. if insu=cient tooth structure remains to %ithstand

functionalforces) the tooth should al%ays be extracted.

#. +n endodontically treated teetha. decreased strength is due to the loss of

coronal tooth structure.b) decreased strength is a direct result of the

endodontic treatmentc) mandibular teeth are stronger than maxillary teeth.d.

all of the above.

&. /he do%el functions primarilya. to retain the core material.b. to strengthen

the tooth.c. to distribute forces along the length of the root.d. to decrease the

ris of root fracture.

'. 4uidelines for do%el length in a tooth %ith normal periodontalsupport

includea. t%o thirds of the length of the canal)b. the coronal length of the

tooth.c. one half the bone!supported length of the tooth.d. all of the above.

(. Do%el features that contribute the greatest retention area. increased

length) parallel sides) and moderate diameter.b. increased length) taper) and

serrated surface.c. increased length) parallel sides) and serrated surface.d.


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increased length) taper) and smooth surface.

*. 0ompared to nicel!chrome do%els) titanium do%els area. stronger.b. lessradiopa"ue.c. more allergenic.d. more economical.

,. /he microleaage phenomenon is greatest %itha. composite resin core.b.

amalgam core.c. glass ionomer core.d. cast post and core.

1. Hhich material should be avoided in teeth %ith high estheticvalueJa.

0omposite resin.b. 4lass ionomers.c. Amalgam.d. 0ast post and core.

11. 0omposite coresa. are anticariogenic.b. should be used only in teeth %ith

signicant remaining structure.c. are dimensionally stable.d. all of the above.

12. Hhich endodontically treated teeth al%ays re"uire a do%el) acore) and

cro%nJa.


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1#.


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3. Hhich of the follo%ing diagnostic tests are usually reliable fordetermining

pulpal status in primary teethJa. /hermal pulp tests.b. lectric pulp tests.c.

$ercussion testing.d. one of the above.

#. +ndirect pulp therapya. is indicated only in the treatment of teeth %ith deep

cariouslesions in %hich there is no clinical evidence of pulpal degenerationor

periapical pathology.b. removes all the bacteria but not all the caries.c.

includes placing calcium hydroxide or P8 over the remainingcaries and

permanently restoring the tooth %ith amalgam.d. All of the above.

&. Direct pulp capping is recommended for primary teeth %itha. carious

exposures.b. mechanical exposures.c. calcication in the pulp chamber.d. All

of the above.

'. 0alcium hydroxidea. is the material of choice for direct pulp capping.b.

may cause calcication of the remaining pulp tissue.c. does not enter into the

formation of the dentin bridge.d. All of the above.

(.


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the area %here theformocresol %as applied.c. Development of a periradicular

radiolucency.d. >oosening of the tooth.

,.


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1#. Apexication is the treatment of choice for a permanent tooth%ith a %ide!

open apex %hena. the pulp is necrotic.b. there is a history of spontaneous

pain %ith a carious exposure.c. there is a large mechanical exposure %ith

profuse pulpal bleeding.d. All of the above.

elf!assessment "uestions1. $eriapical radiographs should be revie%eda.

before discussion of the chief complaint.b. after discussing the chief

complaint %ith the patient.c. :ust before the clinical examination.d. after

completing the clinical examination.

2. Hith aging)a. lateral canals become more clinically signicant.b. gingival

recession exposes cementum and dentin) %hich is lessresistant to decay.c.

the cementodentinal :unction moves closer to the radiographicapex %ith

continuous apical remodeling.d. All of the above.

3. Hhich pulp tests have limited diagnostic value in geriatric patientsJa.

lectric pulp tests.b. /est cavity.e. elective anesthesia)d. All of the above.

#. 0raced teetha. are rare in geriatric patients.b. %ill not have pulpal or

periodontal disease unless the cause ofpulpal irritation is evidentc. %ith

periapical disease and normal pocet depths have an excellentprognosis

follo%ing root canal therapy.4eriatric endodontics '*,d. %hen associated

%ith periodontal pocets have a poor prognosis.

&. +n geriatric patientsa. there is a direct correlation bet%een the degree of


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response toelectric pulp testing and the degree of in7ammation.b. there is a

reduced volume and increased neural component ofthe pulp.c. tooth

discoloration usually is not indicative of pulpal death.d. diuse pain of vague

origin is common.

'. +n the geriatric patient) %ith increasing age) radiographicallya. the

incidence of condensing osteitis increases.b. the incidence of odontogenic

and nonodontogenic cysts increases.c. the apical constriction is closer to the

radiographic apex.d. All of the above.

(. 5egarding endodontic treatment in aged patients.a. one appointment

procedures are advantageous.b. fre"uent appointments of short duration are

preferable.c. root canal treatment is more traumatic than extraction.d.

intraligamentary in:ection is the recommended techni"ue forobtaining

anesthesia.

*. /he fre"uency and intensity of discomfort follo%ing instrumentationis not

related toa. the amount of preparation.b. pulp or periapical status.c. %hether

or not the root canal is tilled at the same appointment.d. All of the above.

,. +n evaluating success and failure of endodontic therapy in agedpatients)

one must consider thata. the bone of the aged patient is more mineralized

than that ofa younger patient.b. overlooed canals are seldom a problem

because they are usuallycalcied.c. as long as 2 years may be necessary to

produce healing that%ould occur at ' months in an adolescent.d. coldsensitivity is the only symptom that may indicate a missedcanal.

1. ndodontic surgery in geriatric patientsa. re"uires more anesthetic and

vasoconstrictor than in youngerpatients.b. is usually indicated to establish


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drainage or for relief of pain.c. produces postoperative eechymosis more

commonly than inyounger patients.d. seldom re"uires the placement of a

retrograde lling.

elf!assessment "uestions1. Hhich of the follo%ing is not signicant in

evaluating treatmentresults?.?a. /he extension of lling material.b. /he

location of the treated tooth.c. /he obturation "uality.d. /he presence of

periapical pathosis before treatment.

2. +n evaluating treatment results) the consensus on the minimumperiod of

observation %asa. at least ' months.b. ' months to a year.c. at least 1 year.d.

at least 2 years.

3. $itfalls associated %ith radiographic interpretation of success orfailure

includea. change in angulation.b. lac of radiographic changes.c. personal

bias.d. All of the above.

#. Hhich of the follo%ing statements concerning radiographs istrueJa.

%elling and pain) necessitating incision and.drainage) mayoccur %ithout any

radiographic indication.b. At least 3I of the bone must be decalcied for a

lesion tobe evident radiographicaily.c. /he size of the lesion on the radiograph

is indicative of theactual amount of bone destruction.d. 0omplete denudation

of bone over the root apex is al%ays evidentradiographicaily.

&. Ondcrextending the access cavity preparation may lead toa. a missed

canal.b. breaage of endodontic instruments.c. discoloration of the cro%n.d.

All of the above.


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'. ony lesions that may be associated %ith vertical root fractureincludea. a

%idened periodontal ligament space on one or both sides ofthe root.b. a halo!

lie lesion around the root apex extending to midroot.c. an angular

periodontal defect extending apically from thecrcstal bone.d. All of the above.

(. ndodontic retreatmenta. is as technically challenging as original

treatment.b. has a poorer prognosis than original treatment.c. is performed

only on endodontic failures.d. has dierent ob:ectives than primary

treatment.

*. 0linically successful cases %ith radiographicaily unsatisfactoryobturationa.

should al%ays be retreated.b. should be retreated only if a ne% prosthetic

restoration isplanned.c. should be considered for retreatment or follo%!up if a

ne%prosthetic restoration is planned.d. should only be considered for follo%!

up if no ne% restorationis planned.

,. Hhich of the follo%ing aspects of the root canal lling is not afactor in

determining %hether an endodontic failure should be retreatedor surgically

treatedJa. time since obturation.b. apical extension of lling material.c.

density of lling material.d. type of lling material.

1. 5emoval of existing prosthetic restorations before retreatmenta. is al%ays

indicated.b. permits more radiographic information to be obtained.c. %ill not

aid in revealing a vertical fracture.d. All of the above.


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11. /o remove soft!settina pastes) they should initially be penetratedbya.

sonic instruments.b. ultrasonic instruments.c. routine endodontic

instruments.d. solvents.

12. 8verextended gutta!percha should be removeda. by pulling it out in one

piece.b. surgically.c. %ith rotary instruments.d. %ith solvents.

13. During retreatment he coronal portion of gutta!percha should bea.

dissolved %ith solvents.b. drilled out.c. removed by heat.d. removed using

ultrasonics.

1#. 0hloroforma. is the most eective gutta!percha solvent.b. is prohibited for

use in dentistry in most countries.c. has no adverse eects on clinicians.d. All

of the above.

1&. Hhich solvent) %hen heated) is as eective as chloroformJa. Fylene.b.

-ethyl chloroform.c. ;alothane.d. ucaiypol.

1'. /he techni"ue of choice for removing poorly condensed guttaperchaisa.

automated instrumentation.b. hand instrumentation.c. ultrasonic

instrumentation.d. rotary instrumentation.

1(. /he -asscrann it techni"ue for removing solid ob:ectsa. is not time

consuming.b. is more successful in posterior teeth than in anterior ones.c.

re"uires fre"uent radiograph monitoring.d. is better than the ultrasonic


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techni"ue.

elf!assessment "uestions

1. Hhich of the follo%ing is not signicant in evaluating treatmentresults?.?a.

/he extension of lling material.b. /he location of the treated tooth.c. /he

obturation "uality.d. /he presence of periapical pathosis before treatment.

2. +n evaluating treatment results) the consensus on the minimumperiod of

observation %asa. at least ' months.b. ' months to a year.c. at least 1 year.d.

at least 2 years.

3. $itfalls associated %ith radiographic interpretation of success orfailureincludea. change in angulation.b. lac of radiographic changes.c. personal

bias.d. All of the above.

#. Hhich of the follo%ing statements concerning radiographs istrueJa.

%elling and pain) necessitating incision and.drainage) mayoccur %ithout any

radiographic indication.b. At least 3I of the bone must be decalcied for a

lesion tobe evident radiographicaily.c. /he size of the lesion on the radiographis indicative of theactual amount of bone destruction.d. 0omplete denudation

of bone over the root apex is al%ays evidentradiographicaily.

&. Ondcrextending the access cavity preparation may lead toa. a missed


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canal.b. breaage of endodontic instruments.c. discoloration of the cro%n.d.

All of the above.

'. ony lesions that may be associated %ith vertical root fractureincludea. a

%idened periodontal ligament space on one or both sides ofthe root.b. a halo!

lie lesion around the root apex extending to midroot.c. an angular

periodontal defect extending apically from thecrcstal bone.d. All of the above.

(. ndodontic retreatmenta. is as technically challenging as original

treatment.b. has a poorer prognosis than original treatment.c. is performedonly on endodontic failures.d. has dierent ob:ectives than primary

treatment.

*. 0linically successful cases %ith radiographicaily unsatisfactoryobturationa.

should al%ays be retreated.b. should be retreated only if a ne% prosthetic

restoration isplanned.c. should be considered for retreatment or follo%!up if a

ne%prosthetic restoration is planned.d. should only be considered for follo%!

up if no ne% restorationis planned.

,. Hhich of the follo%ing aspects of the root canal lling is not afactor in

determining %hether an endodontic failure should be retreatedor surgically

treatedJa. time since obturation.b. apical extension of lling material.c.

density of lling material.d. type of lling material.

1. 5emoval of existing prosthetic restorations before retreatmenta. is al%ays

indicated.b. permits more radiographic information to be obtained.c. %ill not

aid in revealing a vertical fracture.d. All of the above.


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11. /o remove soft!settina pastes) they should initially be penetratedbya.

sonic instruments.b. ultrasonic instruments.c. routine endodontic

instruments.d. solvents.

12. 8verextended gutta!percha should be removeda. by pulling it out in one

piece.b. surgically.c. %ith rotary instruments.d. %ith solvents.

13. During retreatment he coronal portion of gutta!percha should bea.

dissolved %ith solvents.b. drilled out.c. removed by heat.d. removed using

ultrasonics.

1#. 0hloroforma. is the most eective gutta!percha solvent.b. is prohibited for

use in dentistry in most countries.c. has no adverse eects on clinicians.d. All

of the above.

1&. Hhich solvent) %hen heated) is as eective as chloroformJa. Fylene.b.

-ethyl chloroform.c. ;alothane.d. ucaiypol.

1'. /he techni"ue of choice for removing poorly condensed guttaperchaisa.

automated instrumentation.b. hand instrumentation.c. ultrasonicinstrumentation.d. rotary instrumentation.

1(. /he -asscrann it techni"ue for removing solid ob:ectsa. is not time

consuming.b. is more successful in posterior teeth than in anterior ones.c.


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re"uires fre"uent radiograph monitoring.d. is better than the ultrasonic

techni"ue

Ans%ers to elf!Assessment Ruestions

0haper 19 Diagnostic $rocedures 0hapter &9 $reparation for /reatmentla 'c

11a +d 'c 11a2b (b 12d 2b (b 12c3b *b 13b 3b *c 13d#b ,b 1#c #c ,d&d l8d

&b 1c

0hapter 29 8rofacial Dental $ain mergencies 0hapter '9 Armamentarium and

terilizationlc 'b lie lb 'a2b (c 12c 2b (b3c *a 13c 3a *b#b ,b 1#c #d ,b&c1c &c 1c

0hapter 39 onodontogenic


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0hapter #9 0ase election and /reatment $lanning ystemla 'b lid lc 'c lib

1'b2b (c 12c 2c (b 12c 1(c3b *a 13c 3d *d 13d 1*a#c ,c +#d #a ,c 1#b&a

1c 1&a &b 1b 1&c(3* +ssues in endodontics

0hapter ,9 8bturation of the 5oot 0anal ystem 0hapter 1(9 5oot

5esorptionla 'a la 'a 11a 1'c2c (c 2a (c 12b 1(a3d 3c *b 13c +*d#b #b ,a

1#d&c &c 1c 1&d

0hapter 19 5ecords and >egal 5esponsibilities 0hapter 1*9 ndodontic!

$eriodontal 5elations+d 'a lb &d2b (a 2a 'a3c *b 3d (d#d ,d #b *c&b

0hapter 1,9 urgical ndodontics

0hapter 119 $ulp Development) tructure) lc S nb Tbband


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0hapter 1#9 +nstruments) -aterials) and Devices Td 'd m) ilblb 'd lie 1'd 2c

(c 12b2a (a 12d 3b *b 13d3c *a 13a #a ,a 1#c#b ,a 1#c &a l8a.c 1&c&d 1a

1&c

0hapter 239 $ediatric ndodontic /reatment

Cohen Mcqs

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