Professional Documents
Culture Documents
pulp
necrosis.d. referred pain
10. The best approach for diagnosis of odontogenic pain isa. x-ray
examination.b. percussion.c. visual examination.d. a stcp-by-stcp sequenced
examination and testing approachfollowing the same procedure.
11. Calcification 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. Electric pulp tests should not be performed on patients whohave aa.
hearing aid.b. hip implant.c. dental implant.d. pacemaker.
14. A test cavitya. is the first test in diagnostic sequence.b. often results in a
dull pain response.c. is employed only when all other test findings are
equivocal.d. should be performed with local anesthetic.
1. Pulpal pain response isa. dull and throbbing when carried by A-delta
myelinated nervefibers.b. dull and throbbing when carried by A-delta
unmyelinatednerve fibers.c. quick and sharp when carried by A-delta
myelinated nerve fibers.d. quick and sharp when carried by A-delta
unmyelinated nervefibers.
2. Pulpal pain response isa. dull and throbbing when carried by myelinated C
fibers.b. dull and throbbing when carried by unmyelinated C fibers.c. quick
and sharp when carried by myelinated C libers.d. quick and sharp when
carried by unmyelinated C fibers.
13. To assess pain intensity, the most useful measure isa. how much
analgesia the patient requires.b. how well the patient eats and sleeps.c. zero
to ten verbal analogue scale.d. the patient's own words.
14. Pain can most frequently be expected as a result ofa. pulpitis.b. a nonvital
tooth.c. an overinstrumented root canal system.d. after routine endodontic
therapy.
the trigger area.c. with lysis of the terminal nerve endings.d. with
anticonvulsant drugs.
7. TMJ pain can bea. sharp, lancinating and electrical.b. exacerbated by jaw
closing.c. the result of tpsilateral maxillary odontalgia.d. found in males.
9. Phantom tooth pain or dcafferentation paina. can occur briefly after tooth
extraction.b. is simply a peripheral phenomenon.c. can occur for an extended
period after pulp extirpation.d. is managed by analgesics.
4. Pregnant patients in the first 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
risk from pharmacologic intervention.
6. Extra canalsa. are rarely found in molar teeth.b. are often found in molar
teeth.c. if not found, have little effect on the success of endodontictherapy.d.
are often found in upper canines.
10. The prognosis is compromiseda. when patient presents with pain.b. when
patient experiences interappointment pain.c. with class III mobility and loss of
bone support.d. for molar teeth.
1. It has been established thata. exposure to HIV is more likely than exposure
to hepatitis Bvirus.b. transmission of tuberculosis is primarily blood-borne.c.
HIV is less fragile than the hepatitis B virus.d. each patient should be
2. Endodontic filesa. are disposed of after one use.b. arc considered reusable
sharps.c. may be picked up by hand before decontamination.d. may be
disposed of in "generic refuse."
10. The buccal object rule statesa. that the object farther from the buccal
surface appears to movein the direction opposite the movement of the tube
head.b. that the object closest to the buccal surface appears to movein the
same direction as the tube head.c. that the object closest to the buccal
surface appears to movein the direction opposite that of the tube head.d.
that objects closest to the lingual surface appear on the filmto move in the
direction opposite the movement of thecone.
11. With the cone moved to the distal and facing towards the mesial,the
mesiobuccal root of the first molara. will be projected mesially on the film.b.
will be projected distally on the film.c. will not move.d. appears to move
lingually.
2. Once the pulp chamber has been opened, canal orifices are locatedwitha. a
periodontal curette.b. a spoon excavator.c. an inverted cone bur.d. an
endodontic pathfinder.
4. Fourth canals are usually found ina. maxillary first premolars.b. maxillary
second premolars.c. maxillary first molars.d. mandibular premolars.
5. The fourth canal is often found ina. the mesiobuccal root of the maxillary
firsf molar.b. the mesial root of the maxillary first premolar.c. the palatal root
of the maxillary first molar.d. the dtstobuccal root of the maxillary first molar.
6. Entry into a maxillary central incisor is madea. below (apical to) the
cingulum in the direction of the long axisof the tooth.b. just coronal to the
cingulum in the direction of the long axisof the tooth.c. to include the
marginal ridges.d. with a slow-speed bur.
9. The maxillary first molara. has a palatal root that curves lingually.b- has a
distobuccal root with two canals ending in a commonorifice.c. should be
approached for endodontic treatment with the assumptionthat two canals
exist in the mesiobuccal root.d. should be approached for endodontic
treatment with the assumptionthat one canal exists in the mesiobuccal root.
10. Mandibular incisorsa. often have two separate apical foramina.b. two of
five can have two separate canals.c. average 19 mm in length.d. arc less
likely to be perforated labially than lingually duringaccess preparation.
11. Mandibular premolarsa. can have more than one canal 12% to 23% of the
time.b. are less prone to acute exacerbations.c. rarely present complex
mechanical problems.d. arc. on average, 19 mm long.
12. Multiple 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 mandibular
firstmolar.d. are accessible for mechanical instrumentation.
13. The mandibular first molara. has a fourth canal two-thirds of the time.b.
has a fourth canal half the time.c. is the most difficult to treat.d. has a fourth
6. The projected success of creating patency relies principally ona. the choice
of file type.b. irrigation.c. the first instrument to reach the apical terminus.d.
the second instrument to reach the apical terminus.
13. Blood 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.
14. Filing with a Hedstrom file results ina. effective cutting on insertion.b.
effective cutting on withdrawal.c. a lack of tactile sensation.d. narrower canal
preparations.
17. Radicular access can be achieved bya. first using a Gatcs-Gliddcn drill
throughout half the canallength.b. after instrumentation to no. 10, employ
the Gates-Gliddendrill.c. after instrumentation to no. 25, employ the GatesGliddendrill.d. avoid Gates-Glidden drills when possible.
18. Furcal perforation is often the result ofa. oversized radicular access
preparations.b. use of Hedstrom files.c. natural occurrence.d. use of K-type
files
5. Tug-back is achieved and the canal is ready for fillinga. when the guttapercha has extended beyond the apex.b. when the gutta-percha is easily
removed from the root canal.c. when the gutta-percha placed to apical
constriction exhibits resistanceon removal.d. after cementation.
6. Calcium hydroxide root canal sealersa. are the most biocompatible.b. are
7. The "string-out test" for root canal sealer is achieved when, usinga spatula,
the cement can be raised from the glass slaba. Vi inch.b. 2 inches.c. 1 inch.d.
3 inches.
5. A dentist may legallya. refuse to treat a new 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 who has an outstanding balance on hisaccount.
6. If a patient who is HIV seropositive requests that the dentist notinform the
staff of his condition, the dentist shoulda. refuse to treat the patient.b. tell the
staff in private, then treat the patient using extra precautions.c. not teil the
staff, but treat the patient with great caution.d. not tell the staff and require
the patient to sign a private guaranteethat the patient will be liable if
someone contracts thevirus.
7. If a patient swallows a file and the dentist had not placed a rubberdam, the
dentist shoulda. offer to pay for any medical expenses incurred as a result.b.
not offer to pay for medical expenses, which is an admissionof guilt.c. nol
mention who should pay medical expenses and try to inferthat the patient is
to blame (e.g., sudden movement, difficultcase).d. apologize for the mishap,
and suggest that the patient have medicalevaluation only if a problem
develops as a result.
8. An endodontist may be held liable whoa. informs the patient that her
general practitioner is performingsubslandard care (the general practitioner
may hold the endodontistliable).b. fails to disclose to the patient and/or
referring dentist evidentpathosis other than the tooth they are treating.c. fails
to locate a very small canal that is not evident radiographlcally.d. mistakenly
initiates treatment on the wrong tooth in a difficultdiagnosis situation.
6. Fibroblastsa. are the least numerous cells of the pulp.b. are capable of
giving rise to cells that may differentiate intomacrophages.c. increase in
numbers as blood vessels and nerves decrease withage.d. undergo active
differentiation in the pulp, as do fibroblasts ofother connective tissues.
7. The pathways of pulpal inflammation and infection arc stronglyi nilue need
bya. the two structural proteins in the pulp: collagen and elastin.b. denial
materials that depress pulpal metabolic activity.c. the state of polymerization
of the ground substance componentsin the pulp.d. osmotic pressures as
regulated by proteoglycans.
10. The nerve fibers of the pulp area. mainly myelinated fibers at the time of
tooth eruption.b. easily damaged by inflammation.c. only sensory.d. unevenly
distributed throughout the pulp.
13. Volume of blood flow in the pulpa. is least in the regions of the pulp
horns.b. is greater in the root portion than in the crown portion.c. is greater
than the blood flow in most visceral organs.d. is largely under the control of
the adrenergic sympathetic system.
15. Pulpal calcificationsa. may compromise the pulpal blood supply.b. arc of
no significance in root canal therapy.c. have an organic matrix of collagen in
all sizes.d. occur only after eruption.
17. Growth factors arc likely to be involved in tooth formation. Whatis at least
one probable function of these factors?a. Signaling epithclial-mescnchymal
interactions.b. One of the eruptive forces located in the apical region, jc.
Disruption of Hcrtwig's epithelial root sheath.d. Collagen maturation in the
dental papilla.
18. The cell type to which the dendritic cell is most similar is:a. fibroblast.b. tlymphocyte.c. mesenchymal cell.d. macrophage.
19. Lymphatics in the dental pulpa. have not been demonstrated.b. would not
be necessary because of the extensive vascular network.c. cannot be
demonstrated morphologically because they areidentical to venules.d.
participate in the removal of tissue fluids.
21. When the pulp is injured it responds with inflammation. Whydoes it not
have good capability for recovery if badly damaged?1. It has no collateral
blood supply.2. It lacks lymph drainage.3. Pulp C.T. cells are incapable of
mitosis.4. It is encased in a noncompliant environment.a. 1 & 2b. 1 &3c. 1
&4d. 2 & 3
1. In acute inflammation, the first cells to pass through the bloodvessel walls
into the tissue area. eosinophils.b. lymphocytes.c. monocytes.d.
polymorphonuclear neutrophils (PMNs).
2. Following monocyte white cell migration from the vessel to thetissue, the
9. The periapical lesion that would most likely contain bacteriawithin the
lesion isa. apical abscess.
14. The cytokine, interleukin-1 (IL-1), has been identified in the inflamedpulp
and inflamed periapical lesion. One important functionis toa. result in bone
resorption.b. neutralize bacterial endotoxins.c. inhibit inflammation.d.
promote phagocytosis by macrophages.
15. The intracanal medication that has the best potential for effectivenessas
an antimicrobial agent sealed in the canal isa. formocresol.b, 5.25% sodium
hypochlorite.c, steroids.d. calcium hydroxide.
17. Regarding the presence of bacteria, most studies show thai the ;majority
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 flora.d. bacteria free.
1. The endodontic broach is used toa. locate the orifices of the root canals.b.
remove pulp tissue from the pulp spaces.c. smooth the walls of root canals.d.
enlarge the root canal spaces.
2. The basic difference between K-type files and reamers isa. the number of
spirals or flutes per unit length.b. the geometric cross section.c. the depth of
the flutes.d. the direction of the spirals.
7. The Hedstrom file is most commonly used toa. flare the canal.b. establish a
circular preparation.c. prepare post space.d. locate canal orifices.
9. Some studies have reported that the most important aspect of irrigationis
thea. quantity of irrigant.b. chelating action of the solution.c. size of the
needle.d. type of irrigant.
11. With time and with exposure to light and air, gutta-perchaa. does not
change its physical properties significantly.b. will decompose and lose mass.c.
becomes more brittle.d. alters, but can be restored by freezing.
that Cavita. does not have as much compressive strength.b. does not seal as
well with time.c. is more susceptible to thermal changes.d. shrinks while
setting.
9. Pulpal blood flow is most increased bya. impression taking using modeling
compound with copperbanding.b. fabrication of acrylic temporary
restoration.c. rubber base impression.d. hydrocolloid impression.
11. The smear layer on dentin walls acts to prevent pulpal injury bya.
reducing diffusion of toxic substance through the tubules.b. resisting the
effects of acid etching of the dentin.c. eliminating the need for a cavity liner
or base.d. its bactericidal activity against oral microorganisms.
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 Inflammation.
17. Of the following, which is the best way to prevent pulp damageduring
cavity preparation?a. Retain the smear layer.b. Use diamond burs with a
brush stroke.c. Use adequate air coolant.d. Use adequate water coolant.
18. Which is the major reason why class 11 restorations with compositeis
damaging to the pulp?a. Microleakage at the occlusal.b. Microleakage at the
gingival margin.c. Toxic chemicals are released from the composite and
diffuseinto the pulp.d. Polymerization shrinkage distorts the material at the
occlusaland opens gaps which results in recurrent caries.
19. A pulp has been damaged and is inflamed because of deep cariesand
cavity preparation. What material placed on the floor of thecavity aids the
pulp in resolving the inflammation?a. Ca(OH)2b. ZnOE base.c. Steroid
formulations.d. There is no medication or material that actively promotes
pulphealing.
20. A cusp fractures and exposes dentin but not the pulp. What isthe
probable response in the pulp?a. Severe damage with irreversible
inflammation.b. Mi Id-to-moderate inflammation.c. Pain but no
inflammation.d. No pulp response
10. A direct facial "padded" blow to the incisors is more likely tocausea.
enamel fracture.b. enamel-dcntin fracture.e. dentin fracture-pulp exposure,d.
luxation.
13. Displaced teeth that had pulp necrosis with root resorption andthen had
the appropriate endodontic treatmenta. often had continued resorption.b.
occasionally had ankylosis.c. had a high rate of success,d. usually developed
apical pathosis.
15. After replantation of an avulscd tooth that has air dried, comparingRCT
with immediate gutta-percha obturation vs. treatmentwith intracanal calcium
hydroxide, the researcha. shows that both arc doomed to failure.b. shows
that RCT/immediate GP has the best success.c. shows that calcium hydroxide
treatment first has the bestsuccess.d. as yet is inconclusive.
16. A primary tooth whose crown is displaced lingually and theroot faciallya.
is likely to damage the permanent successor.b. should be extracted.c. often
will ankylosc, with resulting displacement of theerupting successor.d.
generally requires no treatment and causes no damage tothe successor.
17. If a fully formed tooth has suffered an intrusive injury andthe crown is
partially exposed, what is the recommended treatment?a. Leave alone and
allow to erupt spontaneously.b. Splint for 7 to 10 days; watchful waiting.c.
Orthodontially reposition into correct alignment within 3to 4 weeks.d.
Reposition with forceps.
19. Alvused replanted teeth with incomplete root formationa. require pulp
removal if the extraoral period is more than 2hours.b. are prone to internal
resorption.c. are tested for revascularization with the electric pulp tester.d. in
most cases develop roots.
treatment,b. root canal therapy with gutta-percha.c. root canal therapy with
calcium hydroxide initially.d. extraction because there is likely to be pathosis.
23. The best way to treat a mature root fractured in the middleone third with
mobility and no response to pulp testing isa. to reposition segments, splint,
and monitor,b. to splint, begin access, pack with Ca(OH)-,.c. to extract
immediately, because restoration is impossible.d. to perform root canal
therapy, anchor segments togetherwith cast post, and restore.
5. Resorption following bleachinga. is a reason not to treat tctracyclinestained teeth with 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 309; hydrogen peroxide.d. docs not occur unless there is a history of
trauma.
9. The two major local causes of root resorption area. inflammation and
excessive pressure.b. inflammation and cementoclast-activating factor.c.
excessive pressure and increased pH of ground substance.d. cementoclastactivating factor and increased pH of groundsubstance.
10. As related to root resorption during orthodontic movement rootcanaltreated teeth area. more resistant to resorption.b. less resistant to
resorption.c. no different than untreated teeth.d. more prone to resorption if
there is a history of apical rootresorption as related to apical pathosis.
1. The 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.
anywhere along Ihc root, depending on the tooth in question.
10. Ferric subsulfatca. is used to identify the complete outline of the root.b. is
painted on the wall of the bony crypt to provide hemostasis.c. acts by causing
intravascular coagulation.d. All of the above.
11. All beveled root canal fillingsa. can be easily evaluated.b. leak.c. can be
hermetically sealed by retrofilling without a magnificationsystem.d. should be
rctrofilled only if there is an apparent incompletelysealed root canal system.
13. Ultrasonic root end preparationsa. eliminate the bevel.b. facilitate idea!
preparation.c. conserve root structure.d. All of the above.
15. The retrofilling material that offers the most advantages to dateisa.
amalgam and cavity varnish.b. composite resin.c. IRM orEBA.d.
polycarboxylate cement.
18. The 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.
6. Electronic dental anesthesia (EDA)a. has not been approved by the FDA for
intraoral pain control.b. can be used without local anesthesia for pulp
extirpation.c. has been successful as a technique for post-endodontic
surgerypatient management.d. has not been successful as an adjunct in
treating "hot" mandibularmolars.The management of pain and anxiety 583
10. The usual range of temperatures for bleaching vital teeth with aheat or
light source isa. 100 to 115 degrees.b. 115 to 140 degrees.c. 140 to 160
degrees.d. 160 to as high as the patient can tolerate.
12. Which of the following is not necessary for vital bleaching?a. Patient
wears safety glasses.b. Local anesthesia.c. Pumice prophylaxis.d. Polish teeth
after last treatment.
13. The barrier material for bleaching pulpless teeth should bea. IRM.b.
dental sealant.c. glass ionomer cement.d. zinc oxyphosphate.
14. Cervical resorption in bleached pulpless teeth may result froma. bleach
placed apical to the CEJ.b. tooth becoming pulpless before patient reaches
age 25.c. a defect in the CEJ.d. all of the above.
17. With nightguard vital bleachinga. the reported success rate is 75%.b.
fluorosed teeth are the least responsive.c. the bleaching agent is 10%
carbamide peroxide.d. patients wiih removable partial dentures can wear the
nightguardonly at night.
11. Composite coresa. are anticariogenic.b. should be used only in teeth with
significant remaining structure.c. are dimensionally stable.d. all of the above.
12. Which endodontically treated teeth always require a dowel, acore, and
crown?a. Fixed partial denture abutments.b. Removable partial denture
abutments.C- Individual teeth.d. None of the above.
13. The ferrulea. significantly reduces the incidence of fracture.b. must not
terminate on restorative material.c. is a metal band encircling the external
dimension of the residualtooth.d. all of the above.
14. For dowel space preparationa. gutta-percha is removed using heat, rotary
instruments, or solvents.b. gutta-percha removal should be done 48 hours or
more afterroot canal filling.c. intimate contact of the dowel and dentin is not
necessary forpassive dowel systems.d. to refine the dowel space dowel drills
must be used in a dentalhandpiece.
15. Regarding cementation of the dowela. zinc phosphate and glass ionomer
cements increase resistanceto fracture.b. zinc phosphate and resin cements
inhibit marginal leakage.c. retention is greatest when both the dowel and
canal are coaledwith cement.d. the dowel is seated with finger or biting
pressure.
nentteeth is thata. the thickness of dentin between the pulp and enamel is
greaterin primary teeth.b. the enamel is thicker on primary teeth.c. the pulp
chamber is comparatively smaller in primary teeththan in permanent teeth.d.
the pulp horns arc higher in primary molars than in permanentmolars.
4. Indirect pulp therapya. is indicated only in the treatment of teeth with deep
cariouslesions in which 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 ZOE over the remainingcaries and
permanently restoring the tooth with amalgam.d. All of the above.
13. Access openings on primary incisorsa. arc from the facial surface.b. are
from the lingual surface.c. are from the incisal surface.d. differ in location for
maxillary and mandibular incisors.
14. Apexification is the treatment of choice for a permanent toothwith a wideopen apex whena. the pulp is necrotic.b. there is a history of spontaneous
pain with a carious exposure.c. there is a large mechanical exposure with
profuse pulpal bleeding.d. All of the above.
4. Cracked teetha. are rare in geriatric patients.b. will not have pulpal or
periodontal disease unless the cause ofpulpal irritation is evidentc. with
periapical disease and normal pocket depths have an excellentprognosis
following root canal therapy.Geriatric endodontics 689d. when associated
with periodontal pockets have a poor prognosis.
9. Which of the following aspects of the root canal filling is not afactor in
determining whether an endodontic failure should be retreatedor surgically
treated?a. time since obturation.b. apical extension of filling material.c.
density of filling material.d. type of filling material.
17. The Masscrann kit technique for removing solid objectsa. is not time
consuming.b. is more successful in posterior teeth than in anterior ones.c.
requires frequent radiograph monitoring.d. is better than the ultrasonic
technique.
Self-assessment questions
9. Which of the following aspects of the root canal filling is not afactor in
determining whether an endodontic failure should be retreatedor surgically
treated?a. time since obturation.b. apical extension of filling material.c.
density of filling material.d. type of filling material.
17. The Masscrann kit technique for removing solid objectsa. is not time
consuming.b. is more successful in posterior teeth than in anterior ones.c.
Chapter 10: Records and Legal Responsibilities Chapter 18: EndodonticPeriodontal RelationsId 6a lb 5d2b 7a 2a 6a3c 8b 3d 7d4d 9d 4b 8c5b
Chapter 16: Traumatic Injuries 2b 7alc 6b lla I6d 21d 3d 8d2a 7b 12d 17c 22a
4d 9c3c 8b 13c 18d 23a 5c 10c4c 9a 14c 19a5c ]0d l5d 20a Chapter 25:
Endodontic Failures and Re-treatmentlb 6d lie 16b2c 7b 12a 17c3d 8c 13b4a
9a 14a5d 10