Exam 9 June 2015, questions and answers PDF

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ENDO MCQs Which of the ff tests is the least useful in endodontic diagnosis of children? a. Percussion b. Palpation c. Electric pulp test d. Cold test

A patient complains of a slight tooth ache that has been ‘’on and off’’ for a week. The tooth in question is 46. Which of the ff teeth would be optimum to use as a baseline? a. 47 – virgin b. 36 – primary cavitation on the occlusal c. 16 – full gold crown d. 45 – occlusal amalgam

Irreversible pulpitis pain in which of the ff site is most likely to radiate to the ear? a. Maxillary premolar b. Maxillary molar

c. Mandibular premolar d. Mandibular molar

An 8-year-old boy received a traumatic injury to a maxillary central incisor. One day later, the tooth did not respond to vitality tests. This finding dictates need for a. Pulpectomy b. Apexification c. Calcium hydroxide pulpotomy d. Delay for the purpose of re-evaluation

Which of the following periapical conditions is often associated with a vital pulp? a. Periapical cyst b. Periapical scar c. Condensing osteitis d. Chronic apical periodontitis A 13-year-old female presents with intermittent pain in tooth #47. The pain comes and goes, sometimes is severe, and lasts more than 2 hrs. The tooth hurts slightly on biting, and she has noticed tenderness in the vestibule next to the tooth. A radiograph shows a

large restoration with a deep base and the presence of immature root development. Diagnosis and treatment are a. Reversible pulpitis/excavation and placement of eugenol b. Irreversible pulpitis/pulp extirpation, initiate RCT c. Reversible pulpitis/occlusal adjustment and onbservation d. Irreversible pulpitis/pulpotomy and apexification procedures

A patient complains of recent severe pain to percussion. The most likely cause is a. Acute periradicular periodontitis b. Chronic periradicular periodontitis c. Reversible pulpitis d. Irreversible pulpitis

Generalized malaise and elevated body temperature are most frequently associated with a. Acute pulpitis b. Acute apical abscess c. Necrotic pulp d. Chronic apical periodontitis

Which condition is an apical lesion that develops as an acute exacerbation of a chronic apical abscess? a. Periapical cyst b. Phoenix abscess c. Periapical granuloma d. None of the above

Which of the ff is the most difficult pulpal or periapical pathosis to diagnose? a. Necrotic pulp b. Chronic pulpitis c. Internal resorption d. Acute apical abscess e. Chronic suppurative apical periodontitis

Which of the ff lesions is most common? a. Acute apical abscess b. Chronic osteomyelitis

c. Chronic apical periodontitis d. Suppurative apical periodontitis e. Any of the above

A patient presents with all the characteristics of pulpal pathosis. Radiographic examination reveals no evidence of caries or restoration. What is the probable diagnosis? a. Condensing osteitis b. Vertical fracture c. Periodontal abscess d. Secondary occlusal trauma

During the preparation of tooth #37, you find that you have created a mechanical exposure of MB pulp horn. The tooth had been properly isolated with rubber dam and all the decay has been removed. The patient is 13 yrs old and has no history of symptoms with his tooth. Radiograph reveals no apparent pathology although the root apices are not fully formed. Treatment of choice consists of a. Indirect pulp cap with CaOH  amalgam restoration b. Direct pulp cap with CaOH  amalgam restoration c. Direct pulp cap with ZOE  amalgam restoration

d. Pulpotomy with CaOH

Which of the ff statements best describes pulpal A-delta fibers when compared to C fibers? a. Larger unmyelinated nerve fibers with slower conduction velocities b. Larger myelinated nerve fibers with faster conduction velocities c. Smaller myelinated nerve fibers with slower conduction velocities d. Smaller unmyelinated nerve fibers with faster conduction velocities

The most common route for MOs and their toxic by-products to reach the pulp tissue is a. Hematogenious anachoresis b. Direct extension through an open cavity or carious lesion c. Through exposed dentinal tubules ff cavity preparation d. From the extension of periapical extension from adjacent, infected teeth

Severity of the course of periapical infection depends upon the a. Resistance of the host b. Virulence of the organism c. Number of organisms present d. All of the above

Strict anaerobes commonly isolated from root canals include a. Veillonella b. A-hemolytic streptococci c. Bacteroides d. Lactobacilli The most effective means to eliminate canal infection is a. Systemic antibiotic coverage b. Complete debridement of the root canal c. Canal medication with a nonspecific drug d. Canal medication with a multiple antibiotic preparation

The 02 taper on hand K-files is a. 0.2mm increase in diameter per 1mm increase in length b. 0.02mm increase in diameter per 1mm increase in length c. 0.2mm increase in diameter per 2mm increase in length d. 0.02mm increase in diameter per 2mm increase in length

Aqueous EDTA (ethylenediaminetetraacetic acid) is primarily used to a. Dissolve organic matter

b. Dissolve inorganic matter c. Kill bacteria d. Prevent sealer from extruding out of the canal space

The primary function of a root canal sealer is to: a. Prevent discoloration b. Fill space between solid core material and pulp canal wall c. Stimulate healing in apical region d. Seal dentinal tubules

The primary purpose of the endodontic access opening is to a. Remove the coronal pulp tissue b. Allow for removal of the canal contents c. Establish a straight line access to the apical foramen d. Allow the enlargement of the coronal orifice

Which perforation location has the best prognosis? a. Coronal third of root b. Apical third of root

c. Chamber floor d. Middle third of root

Which of the ff statements best describes treatment options for a separated instrument at the initial stage of cleaning and shaping? a. Immediate attempt to remove the instrument b. Stop canal instrumentation, do not attempt removal, and obturate c. Attempt to bypass the obstructed instrument d. Both A and C are options

Which of the ff is the most significant cause of ledge formation? a. Infection b. Remaining debris within the canal c. No straight-line access d. Incorrect use of instruments

If a broken instrument passes partially through the apex, thus partly protruding into the periapical lesion, how do you manage it? a. Use a smaller H file to bypass it and try retrieving it b. Use gates glidden drills to widen the canal and then try retrieving it

c. Raise a flap and remove the instrument surgically followed by obturation d. Extract the tooth

Surgical Endodontics: Apicoectomy Indications: a. Persistent periradicular pathosis following endodontic treatment. b. A periradicular lesion that enlarges after endodontic treatment, as noted on follow-up radiographs or digital radiographic images. c. A marked overextension of obturating materials interfering with healing. d. Access for periradicular curettage, biopsy or to an additional root is necessary. e. Access for root-end preparation and root-end filling is necessary. f. When the apical portion of the root canal system of a tooth with periradicular pathosis cannot be cleaned, shaped and obturated.

In cases involving conventional endodontics, the most frequent cause of failure is a. External root resorption

b. Apical overfilling of the canal c. Inadequate filling of accessory canals d. Incomplete obliteration of the main canal e. The presence of a coexistent periodontal lesion

Which of the ff is not routinely used as root-end filling material? a. MTA b. Super EBA c. Amalgam d. Glass ionomer e. Composite resin

Trephination is a a. surgical opening created in soft tissue for the purpose of releasing exudate or decompressing the area of swelling b. surgical perforation of the alveolar cortical bone to release accumulated tissue exudate c. surgical procedure to remove diseased or reactive tissue and/or foreign material from the alveolar bone in the apical or lateral region surrounding an endodontically treated tooth

d. preparation of a flat surface by the excision of the apical portion of the root and any subsequent removal of attached soft tissue

Surgical Endodontics: Trephination Indications: * If a pathway is needed from hard tissue that can reasonably be expected to provide necessary drainage. * When pain is caused by accumulation of exudate within the alveolar bone. * When necessary to collect samples for bacteriologic analysis.

A 23-year-old patient came to your clinic because of a swelling in her gums. Findings are as follows: tooth #12 is nonvital, swelling is fluctuant and it approximates the apex of tooth #12, 5mm diffused radiolucency at the apex of tooth #12. What are your diagnosis and your proposed treatment? a. Necrotic, AAP / RCT b. Necrotic, CAP / RCT c. Necrotic, CAA / RCT d. Necrotic, CAA / I & D / RCT

Surgical Endodontics: I & D Indications: * If a pathway is needed in soft tissue with localized fluctuant swelling that can reasonably be expected to provide necessary drainage. *When pain is caused by accumulation of exudate within soft tissues. * When necessary to collect samples for bacteriologic analysis.

A patient walks into your office holding a cup with a tooth in it. What liquid would you LEAST hope the patient kept the tooth in? a. Milk b. Water c. Saliva d. Saline Five factors that are critical to the management of traumatic avulsion injuries: •Time–within 30mins –very little resorption; more than 2hrs –external root resorption •Storage media –milk, physiologic saline, saliva, HBSS •Tooth socket –within 30mins –no curettage, replant slowly with digital pressure; more than 2hrs –gently curette blood clot out of the alveolar socket, irrigate with saline

•Splint stabilization –7-10 days •Root surface –within 30min –should not be scraped, dried or manipulated with caustic chemicals; more than 2hrs –tooth is soaked in 2.4% fluoride solution at pH 5.5 for 20mins or more (to slow the resorptive process)

Which of the ff is not a key feature of replacement resorption? a. Lack of mobility b. Lack of PDL on x-ray c. Pink appearance d. Infra-occlusion In root fractures involving the apical 1/3 of permanent anterior teeth, the teeth usually a. Discolor rapidly b. Remain in function and are vital c. Undergo pulpal necrosis and become ankylosed d. Are indicated for extraction and prosthetic replacement

A patient has pain in tooth #36. The tooth is sensitive to both thermal stimuli and biting. Clinical examination reveals a large

composite restoration and a bifurcation involvement with 4-5mm pockets adjacent to both roots. Treatment indicated would be a. Periodontal scaling and curettage b. Scaling, curettage and surgery c. Pulpotomy followed by periodontal therapy d. Endodontic treatment combined with periodontal therapy

Instruments used for RCT are sterilized reliably by using a. Hot oil b. An autoclave c. Boiling water d. Cold sterilization e. A glass bead sterilizer...