126762809 endodontic mcq 1 pdf PDF

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Mid year Exam                                               ...

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!Mid!year!Exam!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!2011!.1! !! Endo!! MID!YEAR!EXAM!2011!

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! ! The!sympathetic!nerve!fiber!originates!from!which!of!the!following!structures:! a) Ragh!magnus.! b) Stallet!ganglion.! c) Subcaudalis!nucleus.! d) Trigeminal!ganglion.! The!normal!interstial!pulpal!pressure!is!approximately:! a) 1#5!mm!Hg.! b) 6?10!mm!Hg.! c) 13#15!mm!Hg.! d) 15#35!mm!Hg.! Which!of!the!following!mediators!released!by!central!end!of!nociceptors:! a) Glutamate.! b) Serotonin.! c) Interleukin!1.! d) Norepinephrin.! In!wihch!of!the!following!structure,!the!Modulation!of!dental!pain!occurs:! a) Thalamus.! b) Ragh!magnus.! c) Trigeminal!ganglion.! d) Dental!pulp!and!periapical!tissue.! Which!of!the!following!nerve!fibers!are!responsible!for!pulpal!pain!transmission:! a) A!beta!and!C!nerve!fibers.! b) A!delta!and!C!nerve!fibers.! c) A!beta!and!A!delta!nerve!fibers.! d) A!alpha!and!A!delta!nerve!fibers.! Which!of!the!following!is!the!percentage!of!beta!nerve!fibers!present!in!the!dental! pulp:! a) 1/2!%.! b) 5!%.! c) 10!%.! d) 13!%.! Which!of!the!following!is!the!percentage!of!sympathetic!nerve!fibers!present!in!the! dental!pulp:! a) 5#6!%.! b) 9?10!%.! c) 20#30!%.! d) 35#40!%.! Which!of!the!following!structure!is!rich!with!propreoceptors:! a) Dentin!layer.! b) Periapical!area.! c) Dental!pulp!stroma.! d) Odontoblastic!layer.!

2! ! ! ! 9# Which!of!the!following!structure!is!rich!with!C!nerve!fibers:! a) Dentin!layer.! b) Cell!free!zone.! c) Dental!pulp!stroma.! d) Odontoblstic!layer.! 10# Which!of!the!following!terms!is!defined,!as!"Pain!is!perceived!due!to!a!non#noxious! stimulus!which!does!not!normally!provoke!pain":! a) Allodynia.! b) Perception.! c) Modulation.! d) Hyperalgesia.! 11# Which!of!the!following!nerve!fibers!has!the!low!threshold!nociceptors:! a) A!alpha!nerve!fiber.! b) A!beta!nerve!fiber.! c) A!delta!nerve!fiber.! d) C!nerve!fiber.! 12# Which!of!the!following!nerve!fibers!transmit!the!dental!pain!without!modulation:! a) A!beta!nerve!fiber.! b) A!delta!nerve!fiber.! c) A!beta!and!A!delta!nerve!fibers.! d) C!nerve!fibers.! 13# Which!of!the!following!nerve!fibers!is/are!not!activated!with!external!dental!stimuli:! a. A!beta!nerve!fiber.! b. A!delta!nerve!fiber.! c. A!beta!and!A!delta!nerve!fibers.! d. C!nerve!fibers.! 14# The!stressed!pulp!is!defined!as!the!pulp!that!is!subjected!over!the!years!to:! a) Several!dental!treatments.! b) Caries!and/or!dental!trauma.! c) Diseases!and!dental!procedures.! d) Endodontic!&!re#endodontic!treatment.! 15# Sensory!fibers!of!the!inferior!alveolar!nerve!synapse!with!secondary!order!neuron!in! which!of!the!following!structure:! a) Hypothalamus.! b) Stellate!ganglia.! c) Gasserian!ganglion.! d) Subnucleucs!caudalis.!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! ! 16# !!Which!of!the!following!nerve!fibers!has!a!rule!in!pain!modulation:! a) A!delta!nerve!fiber.! b) C!nerve!fiber.! c) Sympathetic!nerve!fibers.! d) Parasympathetic!nerve!fibers.! ! ! ! ! ! !

!Mid!year!Exam!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!2011!.3! !! ! ! ! 17# Which!of!the!following!terms!is!referred!to!mechanisms!by!which!the!transmission! of!noxious!information!to!the!brain!is!reduced:! a) Allodynia.! b) Modulation.! c) Hyperalgesia.! d) Sensitization.! 18# Which!of!the!following!ions!is!essential!for!exocytosis!process:! a) Calcium!ions.! b) Sodium!ions.! c) Chloride!ions.! d) Potassium!ions.! ! 19# Exocytosis!is!defined!as:! a) Formation!of!synaptic!vesicles.! b) Exaggerated!response!of!nerve!fibers.! c) Reduction!in!the!threshold!level!of!nerve!fibers.! d) Action!potential!generated!of!nerve!membrane.! ! 20# Which!of!the!following!structures!is!responsible!for!pain!modulation!before!it!is!! Transmitted!to!the!cortex?! a) Interneuron,!Galia!and!descending!neuron.! b) Galia,!interneuron!and!projecting!neuron.! c) Central!terminal!of!primary!neuron,!interneuron!and!Galia.! d) Central!terminal!primary!neuron,!interneuron!and!projecting!neuron.! ! !!!!!!!!21.!The!hot!tooth!is!referred!to!that!tooth:! a)!Which!is!difficult!to!anesthetize.! b)!With!pink!spot!coronal!discoloration.! c)!With!large!reddish!mass!occupying!the!carious!cavity.! d)!Which!is!undergoes!excessive!blood!flow!during!inflammatory!reactions.! ! 22.!Which!of!the!following!is!responsible!for!symptoms!of!irreversible:! a)!Recruitment!of!immune!cells.!! b)!Increase!neutrophils!emigration.! c)!Vasodilatation!and!plasma!extravasations.!! d)!Stimulation!of!sympathetic!nerve!fibers.! ! 23.!Which!of!the!following!is!the!main!goal!of!emergency!treatment:! a)!Canal!disinfection.! b)!Management!of!flare?up.! c)!Proper!obturation!of!root!canal.! d)!Through!biomechanical!preparation.! ! !

4! ! ! 24.!A!patient!returns!2!days!following!routine!operative!procedure!and!composite! restoration!with!history!of!deep!caries!complaining!of!severe!sharp!pain!to!thermal! changes!particularly!cold!drink.!Thermal!testing!procedures!showed!sharp!momentary! response.!Percussion!and!palpation!tests!are!within!normal!range.! !The!proper!emergency!treatment!to!relief!the!patient's!complain!is:! a)!Check!the!marginal!seal!of!the!restoration!and!tooth!desensitization.! B)!Endodontic!access!and!pulp!extirpation!and!schedule!for!next!visit.! c)!Antibiotic!and!anti#inflammatory!prescription!and!schedule!for!next!appointment! d)!Removal!of!restoration!and!temporization!of!tooth!to!the!next!appointment.! ! 25.Which!of!the!following!cases!may!undergo!flare!up!after!single!visit!endodontic! treatment:! a)!Chronic!apical!abscess.! b)!Symptomatic!irreversible!! c)!Asymptomatic!irreversible!pulpitis.! d)!Asymptomatic!apical!periodontitis.! ! !!!!!!26.!The!pain!exerted!from!exposed!dentine!is!due!to:! a)!Thermal!changes!that!damage!the!C#fibers.! b)!Movement!of!fluid!inside!the!dentinal!tubules.! c)!Exposing!nerve!fiber!at!dentine#enamel!junction.! d)!Stimulation!of!the!inflammatory!mediator!that!stimulate!nerve!fibers.! ! 27.!Spontaneous!pain!in!irreversible!pulpitis!attributed!to:!! a)!Primary!Hyperalgesia.! b)!Periodical!sensitization!of!nociceptors.! c)!Inflammatory!mediators!and!neuropiptidis.! d.!All!of!the!above.! ! 28.!Which!of!the!following!patients!are!susceptible!to!sub!acute!bacterial!endocarditis! during!endodontic!procedure:! a)!Patients!with!uncontrolled!hypertension.! b)!Patients!with!a!history!of!rheumatic!fever.! c)!Patients!with!myocardial!infarction!within!the!past!6!month.! d)!Patents!with!myocardial!infarction!within!the!past!3!months.! 29.!Regarding!HIV/!AIDS!patients!a!vital!aspect!of!treatment!plan!is!to!determine:! a)!Platelet!count.! b)!Neutrophils!count.! c)!White!blood!cell!count.! d)!CD4!lymphocytic!count.! !

!Mid!year!Exam!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!2011!.5! ! ! 30.!In!patients!with!a!history!of!malignancy!endodontic!treatment!could!be!performed! when:! a)!Granulocyte!count!is!less!than!2000/mm3!and!platelet!count!is!less!than! 50,000/mm3.! b)!Granulocyte!count!is!less!than!2000/mm3!and!platelet!count!is!greater!than! 50,000/mm3.! c)!Granulocyte!count!is!greater!than!2000/mm3!and!platelet!count!is!greater! than!50,000mm3.! d)!Granulocyte!count!is!greater!than!2000/mm3!and!platelet!count!is!less!than! 50,000mm3.! 31.!Endodontic!treatment!is!contraindicated!when:!! a)!The!canal!appears!to!be!calcified.!! b)!A!large!periapical!lesion!is!present.! c)!The!patient!has!no!motivation!to!maintain!the!tooth.! d)!The!tooth!needs!periodontal!crown!lengthening!before!restoration.! 32.!Vasoconstrictors!are!contraindicated!in:! a)!Asthmatic!patient.! b)!HIV/AIDS!patients.! c)!Uncontrolled!diabetic!patients.! d)!Patients!with!recent!coronary!bypass!graft!(less!than!3!m.).! 33.Electronic!apex!locators!may!be!useful!in!which!of!the!following!condition:! a)!Patients!with!prosthetic!implants.! b)!Patients!with!psycastric!disorder.! c)!Patients!in!the!first!trimester!of!pregnancy.! d)!Patients!with!implanted!cardiac!pacemaker.! 34.!Prophylactic!antibiotic!are!recommended!in!which!of!the!following!patients:!! a)!Patient!with!uncontrolled!hypertension.! b)!Patient!with!uncontrolled!hyperthyroidism.! c)!Patient!with!refractory!cardiac!arrhythmias.! d)!Patient!with!a!history!of!multiple!cardiac!abnormalities.! !35.Single#visit!root!canal!treatment!is!indicated!in!case!of:! !a)!Necrotic!pulps!with!apical!abscess.!! !b)!Symptomatic!irreversible!pulpitis!with!apical!periodontitis.! !c)!Asymptomatic!irreversible!pulpitis!with!apical!periodontitis.! !d)!Symptomatic!irreversible!pulpitis!without!any!apical!changes.! ! ! ! ! ! !

6! ! ! ! !36.When!treating!vital!cases!multi#visits,!scheduling!between!visit!should...! a.!2#3!days.! b.!5?7!days.! c.!10#12!days.! d.!2!weeks.! !37.!In!concomitant!pulpal!and!periodontal!lesions:! !a.!Endodontic!lesion!had!a!sinus!tract!draining!pus.! !b.!Periodontal!disease!has!a!progressive!nature!with!formation!of!osseous!defects.!! !c.!There!are!two!independent!endodontic!and!periodontal!lesions!around....!tooth.!!!!! d.!There!are!two!separate!endodontic!and!periodontal!disease!affecting!the!...! Communicated!to!each!other.! !!!38.!In!which!of!the!following!endodontic!periodontal!lesions,!pulp!testing!is! positive:! a.!Primary!periodontal!lesion.! b.!Primary!endodontic!lesion!with!secondary!periodontal!involvement.! c.!Primary!periodontal!lesion!with!secondary!endodontic!involvement.! d.!True!combined!lesion.! !!!!!!!!!!!!39.!In!primary!endodontic!with!secondary!periodontal!lesions,!the!treatment!plan! is:! a.!Periodontal!treatment!only.! b.!Proper!root!canal!treatment.! c.!Endodontic!treatment!first!followed!by!periodontal!treatment.! d.!Periodontal!treatment!followed!by!proper!root!canal!treatment.! 40.The!prognosis!of!endodontic!periodontal!lesion!depends!on:! a.!Type!of!affected!tooth.! b.!Type!of!pulpal!inflammation.! c.!Amount!of!periapical!bone!loss.! d.!Severity!of!periodontal!involvement.! 41.!Pulpal!inflammation!reaches!the!periodontal!areas!through:! a.!Pulp!horns.! b.!Large!carious!lesion.! c.!Deep!periodontal!pocket.! d.!The!apical!foramen!and!accessory!canals.! ! ! ! !

!Mid!year!Exam!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!2011!.7! !! ! ! !!42#Concurrent!endodontic!and!periodontal!treatment:! a.!May!complicate!the!tooth!condition.! b.!Fails!to!replace!defective!bony!lesions.! c.!May!save!an!apparently!hopeless!tooth.! d.!Requires!no!checking!of!the!apical!seal!of!root!canal!filling.! ! 43#!A!33!year!old!female!patient!is!suffering!from!repeated!swelling!related!to!her!right! central!and!lateral!incisors.!Clinically,!deep!palatal!pocket!with!extensive!attachment! loss!was!detected!related!to!the!lingual!aspect!of!the!lateral!incisor.!The!pulp!test!was! +ve!and!radio!graphically!massive!bone!loss!was!evident!along!the!whole!root!of!that! lateral!incisor.!The!diagnosis!of!such!condition!could!be:! a) b) c) d)

Marginal!periodontitis!related!to!upper!anterior!teeth.! Chronic!apical!periodontitis!related!to!necrosed!lateral!incisor.! Primary!periodontal!lesion!with!secondary!endodontic!involvement.! Localized!periodontal!disease!related!to!a!developmental!groove!defect.! ! 44#!A!22!year!old!male!patient!came!to!the!clinic!complaining!of!a!localized!swelling! with!a!sinus!draining!pus!related!to!badly!decayed!36.!The!patient!has!good!oral! hygiene.!Probing!yields!narrow!isolated!pocket!and!radiografically!periapical!bone!loss! is!evident.!The!most!possible!diagnosis!of!that!case!is:!

a) Periodontal!bifurcation!involvement.! b) Chronic!periapical!abscess!with!secondary!periodontal!involvement.! c) Asymptomatic!irreversible!pulpitis!with!chronic!periapical!abscess.! d) Asymptomatic!irreversible!pulpitis!with!asymptomatic!apical!periodontitis.! ! !45#!Which!of!the!following!is!the!most!important!in!determining!if!the!lesion!of! periodontal!origin!or!pulpal!origin?! a) b) c) d)

Percussion.! Pulp!testing.! Periodontal!probing.! A!periapical!radiograph.! ! 46#!Proper!application!of!shifting!technique!allows!the!dentist!to:!

a) b) c) d) ! ! !

Determine!the!mesiodistal!fractures.! Determine!the!intra#coronal!pulp!stones.! Distinguish!between!objects!that!are!resembled.! Distinguish!between!various!types!of!resorption.!

8! ! ! ! 47#!The!Cone#Beam!Computes!Tomography!scans!(CBCT)!shows!a:! a) Dimensions!showed!with!regular!radiographs.! b) Higher!accuracy!for!detecting!pulp!calcification.! c) Dimensions!not!showed!with!regular!radiographs.! d) Higher!accuracy!for!detecting!horizontal!root!fracture.! 48#!Digital!Subtraction!Radiography!used!in!Endodontic!for:! a) Endodontic!obturation!follow?up.! b) Hard!tissue!gaining!or!loosing!minerals.! c) Evaluating!soft!tissue!healing!after!treatment.! d) Histopathological!diagnosis!of!pulpal!disease.! 49#!Loupe!magnifications!in!endodontics!varied!from:! a) b) c) d)

2!x!to!8!x.! 10!x!to!16!x.! 25!x!to!30!x.! 40!x!&!more.! ! 50#!The!precision!&!triad!of!microsurgery!includes:! a) Magnification,!resolution!&!field!width.! b) Types!of,!microscope,!lenses!&!micro!instruments.! c) Field!depth,!illumination,!&!angle!of!declination.! d) Micro!instruments,!illumination!&!magnification.! 51#!The!split#dam!technique!is!indicated!when!attempting!to!isolate!a:! a) b) c) d)

Fully!erupted!tooth.! Single!isolated!tooth.! Prepared!tooth!for!retrograde!surgical!restoration.! Tooth!insufficient!coronal!structure!or!badly!broken?down!tooth.!

! 52#!Canal!Projection!means!technique!that!facilitates:! a) Access!cavity!preparation!by!splitting!off!the!coronal!part!of!the!tooth.! b) Access!cavity!preparation!by!gaining!access!prior!to!rubber!dam!application.! c) Pre#endodontic!build!up!broken!down!coronal!&!radicular!structure!while!neglecting! individualized!access!to!the!canal.! d) Pre?endodontic!build!up!broken!down!coronal!&!radicular!structure!while! preserving!individualized!access!to!the!canal!by!using!Bonded!injectable! polymerizing!composites.! ! ! ! ! ! ! !

!Mid!year!Exam!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!2011!.9! !! ! ! 53#!In!taking!a!periapical!radiograph!of!a!two#rooted!mandibular!premolar!from!distal!to! mesial!horizontal!angle,!which!of!the!following!is!TRUE?! a) b) c) d)

The!lingual!root!will!move!distally!with!respect!to!the!buccal!root.! The!buccal!root!will!move!lingually!with!respect!to!the!lingual!root.! The!lingual!root!will!move!mesially!with!respect!to!the!buccal!root.! Both!roots!will!move!away!from!the!film.!

! 54#!One!of!the!benefits!of!using!magnifications!in!Endodontics!is!to:(B,C&D!are!all!correct! answers!but!if!we!should!only!choose!one,!I’ll!choose!B!which!will!lead!to!C!&D)! a) b) c) d)

Eliminate!pain.! Reduce!scar!formation.! Decrease!traumatization!of!tissue.! Increase!the!postoperative!healing!process.! ! 55#!The!quality!of!the!magnified!field!is!significantly!influenced!by!the:! a) b) c) d)

Lenses!material.! Image!sharpness!of!lenses.! Manufacture!trade!of!the!lenses.! Manufacture!trade!and!the!image!sharpness.! !

56#!Regarding!field!width:! a) It!is!limited!to!the!working!tooth!with!best!resolution.! b) The!larger!the!field!width;!the!less!teeth!you!can!see!when!looking!through!the! loupes.! c) A!smaller!field!makes!the!new!user!feel!more!secure!when!working!with!dangerous! instruments.! d) A!wider!field!makes!it!easier!to!establish!hand?and?eye!coordination!when!shifting! from!the!naked!eye!to!the!loupes!and!promotes!less!eye!fatigue.! 57#!Rubber!Dam!Clamps!or!Retainers:! a) Are!made!of!nickel!titanium.! b) Consists!of!a!jaw!and!two!bones.! c) Aid!in!adjacent!teeth!retraction.! d) Are!designed!for!all!types!of!teeth.! 58#!For!isolation!of!a!fractures!tooth!with!a!subgingival!margin:! a) b) c) d) !

Use!partial!isolation!without!rubber!dam!placement.! Use!a!customized!acrylic!retainer!in!conjunction!with!a!dam.! Use!modified!anterior!clamps!and!apply!them!toward!each!others.! Place!spots!of!temporary!filling!on!the!cervical!surface!of!the!tooth!to!act!as!a! scaffold!for!retaining!during!treatment.!

10! ! ! 59#!Regarding!types!of!radiographs!used!in!Endodontics:! a) Periapical!(PA)!radiograph!shows!tooth!and!related!structures! b) Panoramic!radiograph!is!used!to!assess!the!individualized!teeth!and!related! structures! c) Occlusal!radiograph!provides!critical!information!on!the!cross!section!of!the!pulp! space! d) Bite#wing!radiograph!provides!critical!information!about!the!anatomic!apex!of!the! tooth!and!related!structures! 60#!When!performing!procedures!by!Surgical!Microscope!which!of!the!following!is!the!best! magnification?! a) X!2.5!and!X!6! b) X!6!and!X!8! c) X!10!and!X!16! d) X!30!and!X!40! 61#!Systemic!Radiographic!interpretation!starts!with:! a) b) c) d)

Pulp!space!and!ends!with!bone!proper! Bone!proper!and!ends!with!pulp!space! Root!surface!and!ends!with!pulp!space! PDL!space!and!ends!with!bone!proper.! ! 62#!The!advantages!of!Digital!Radiographic!Technique!includes:! a) Significant!reduction!in!the!number!of!films!used! b) Radiographic!images!are!obtained!within!minutes! c) Radiation!exposures!is!reduced!50%!!compared!with!conventional!film#based! radiography! d) Significant!reduction!in!the!processing!time!which!is!about!80?90%!compared!with! D?speed!film.! 63#!A!45#year#old!male!comes!to!your!office!complaining!of!severe!continuous!pain.!He! mentioned!that!he!cannot!chew!or!drink!cold!liquids!and!had!little!if!any!sleep!in!the!past!48! hours.!The!first!question!you!should!ask!to!determine!the!specificity!of!the!patient's!problem! is:! a) b) c) d) ! ! ! ! !

Can!you!localize!the!pain?! Do!you!have!any!swelling?! Does!the!pain!is!spontaneous?! Does!the!pain!is!intermittent?!

!Mid!year!Exam!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!2011!.11! ! 64#!A!22#yaer#old!female!presents!with!intermittent!severe!pain!in!tooth!#!36!that!began!2! days!ago.!The!pain!comes!and!goes!and!lasts!more!than!7!minutes.!The!tooth!hurts!on!biting.! During!clinical!examination,!tooth!#!36!responded!to!cold!test!using!Endo!ice!with!severe! pain!that!subside!after!10!seconds.!A!radiograph!shows!a!large!deep!amalgam!restoration! and!normal!PDL!space.!Percussion!test!reveals!tenderness!of!tooth!#!36.!Your!complete! endodontic!diagnosis!is:! a) b) c) d)

Irreversible!pulpitis!and!normal!periapical!tissue.! Reversible!pulpitis!and!symptomatic!apical!periodontitis.! Irreversible!pulpitis!and!symptomatic!apical!periodontitis.! Irreversible!pulpitis!and!asymptomatic!apical!periodontitis.!

! 65#!According!to!the!American!Board!of!Endodontics!meeting!2007,!condensing!Osteitis!is! considered!to!be!a!variation!of:! a) b) c) d)

Symptomatic!pulpitis.! Asymptomatic!pulpitis.! Symptomatic!apical!periodontitis.! Asymptomatic!apical!periodontitis.!

! 66#!Asymptomatic!apical!periodontitis!can!be!probably!diagnosed!by:! a) b) c) d)

Cold!test.! Radiograph.! Electric!pulp!test!(EPT).! Laser!Doppler!flowmetry.!

! 67#!One!of!the!following!diagnostic!tests!is!considered!to!be!a!true!vitality!test:! a) b) c) d)

CO2!snow.! Cavity!test.! Pulse!oximetry.! A!refrigerant!spry!(Endo#ice).!

! 68#!During!pulp!sensitivity!testing,!one!of!the!following!can!cause!false#negative!response! (i.e.!vital!teeth!respond!negative):! a) b) c) d) ! ! !

Anxious!patient.! Liquefaction!necrosis.! Recent!traumatized!tooth.! Contact!with!metal!restoration.!

12! ! ! ! 69#!A!15#year#old!male!presents!with!severe!diffuse!pain!in!the!maxillary!left!premolar! region.!Upon!visual!examination,!the!tissue!in!the!mucobuccal!vestibule!appears!inflamed.! Palpation!reveals!tenderness!over!the!apex!of!the!teeth!#24!and!#25.!Both!teeth!are!slightly! tender!to!percussion.!Radiographically!no!changes!are!notes.!Further!evaluation!and/or! treatment!should!consist!of:! a) b) c) d)

Selective!anesthesia!test.! Dismissing!the!patient!unt...