endo perio rudman Flashcards
the most frequent cause of persistence of positive cultures from a root canal is?
improper drug therap
contaminated culture medium
overinstrumentation of the root canal
sepage of salivainto the area of operation
d
the diagnosis of early necrotizing ulcerative gingivitis is BEST made in the basis of?
a. biopsy
b. low grade fever
c. exfoliative cytology
d. bacteriologic examination
e. unceration of the interdental papillae
f. ulceration in the alveolar mucosa
e
the apical cyst is BEST diagnosed on the basis of
a. symptomatology
b. fitulous opening
c. excisional biopsy
d. pain to percussion
e. radiographin findings
c
curettage refers to
a. soft tissue debridement of the gingival wall of a periodontal pocket
b. removal of calcified deposits fom the gingival sulcus and/or periodontal pocket
c. scaling and/or planning of the root surface
d. removal of dental plaque from the coronal surfaces of teeth
a
in recurrent necrotizing ulcerative gingivitis,exacerbations and remissions which occur are based to a significant extent upon?
a. excessive smoking
b. stressfull episodes
c. the amount of suppuraton present
d. an increase in the tyes of caausative organisms
b.
premature contacts of the dentitions are MOST harmful if the patient ?
a. has maligned teeth
b. wears a partial denture
c. clenches and grinds his teeth
d. consumes a high nondetergent diet
c
the MOST effective means to eliminate canal infection is
a. systemic antibiotic coverage
b. complete debridement of he root canal
c. canal medicatio with a nonspecific drug
d. canal medication with a multiple antibiotic preparation
b
an apical lesion that develops an an acue exacerbation of a chronic or suppurative apical oeriodontitis is called
a. an apical cyst
b. a phoenix abscess
c. an acute apical abscess
d. a chronic apical abscess
e. acute apical periodontitis
b.
ideal extent of root canal filling is?
a. beyond the apical foramen to allow for subsequent shrinkage of he material
b. approx. 2 mm short of the radiograhic apex usually at the constriction
c. to the dentinocemental junction
d. to the end of canal
c.
the MOST common area for the location of a periapical osteofibrosis is the _____ region.
a. maxillary anterior
b. mandibular anterior
c. maxillary posterior
d. mandibular posterior
b.
the invested cone technique is SOMETIMES helpful in obliterating canals when the apex
a. is narrowand constricted
b. has an exaggerated curvature
c. is inclompletely developed and is wide
d. is wider than the cervical third of the root
e. is wider than the middle third of the root
c.
new odontoblst are derived from
a. histiocytes
b. lymphocytes
c. endothelial cells
d. undifferentiated mesenchymal cells of the pul
e. cell dvision of existing odontoblast in the pulp
d
the MOST difficult pulpal or periapical pathosis to diagnose is
a. chronic suppurative apical periodontitis
b. acute apical abscess
c. internal resorption
d. chronic pulpitis
e. necrotic pulp
d.
the FIRST change in the epithelial attachment as a result of inflammation is
a. migration
b. detachment
c. ulceration
d. proliferation
d
radiograph of periapical areas of rarefraction are IMPORTANT in diagnosis because they demonstrate
a. the existence of an infective process
b. variations in densities of structures
c. when the periapical and pulpal areas have been rendered sterile
d. the size of periapical lesions and therefore distiguish between a cyst and granuloma
b.
Attraction or fixation of microorganisms in areas of im\nflammation is known as
a. diapedesis
b. anachoressis
c. synthrophism
d. focal infection
b
polymorphonuclear leukocytes contain packets of biologicaly active enzymes which may play an important role in inflammatory periodontal disease. these packets are termed a. cristae b. lysosomes c. lysozymes d. mitochondria e. endoplasmic reticutlum f. none of the above
b
which of the ff is INCORRECT about the surgical flap design for a root resection of a maxillary lateral incisor?
a. flap must be mucoperiosteal in nature
b. free margin must be wider than the base
c. free margin should include attached gingival
d. flap should be wide enough to include at least one tooth on each side of the involved tooth
b
which of the ff is NOT a diagnostic feture for occlusal trauma?
a. loss of alveolar bone
b. increase in tooth mobility
c. periodontal pocket formation
d. increased width of the periodontal ligament space
c
after a thorough prophylaxis, a new plaque formation is intiated FIRST by which of the ff organisms?
a. floating in saliva which detach directly to the tooth surface
b. in pits,fissures, cracks, perikymata or margins of restorations which were not removed
c. migrating onto the tooth from adjacent gingiva
d. or food which become wedge around teeth
b.
the basis for normal gingival color is all of the following EXCEPT?
a. thickness of gingiva
b. degree of keratinization
c. subpapillary venous plexus
d. absolute amount of reduced hemoglobin
a.
trauma from occlusion is LEAST likely to affect
a. bone
b. cementum
c. epithelial attahment
d. periodontal ligament
c.
severity of the course of a periapical infection depends upon the
a. resistance of the host
b. virulence of the organism
c. number of organism present
d. only A. and B above
e. all of the above
e.
root canal therapy was completed on tooth #14 and the crown was restored with a gold onlay two weeks go. the patient now complains that the ooth fells long and hurts whn he bites. he cannot chew on that side.evaluation of the circumstances should BEGIN with
a. thermal testing
b. percissing tooth
c. electric pulp testing
d. radiographic examination
b
localized gingival hypertrophy may COMMONLY resut from?
a. smoking
b. chemical burns
c. intake of dilantin sodium
d. vigorous horizontal toothbrushing
e. local irritant plus hormonal imbalance
e.
gingival bleeding, which is asso. whith chronic marginal gingivitis, occurs because the
a. lack of vitamin C affects capillary permiability
b. epithelial attachment is estroyed and vessels from the periodontal ligament are injured
c. periodontium is easily injured by toothbrushing
d. epithelium of soft tissues wall of the gingival sulcus contains micro-ulcerations
d.
sterilized endodontic instrument will be freeof ALL viable
a. microorganisms
b. spore formning and nonspore foming bacteri pathogenic to man except the spore formers
c. bacteriapathogenic to man except the spore formers
d. bacteria except the spore formers
e. bacteria except the thermophils
a.
gingivitis during pregnancy results from an
a. increase in loal irritation by an altertion of the saliva
b. alteration of tissue response to local irritation
c. overgrowth of tissue which is unrelated to local irritation
d. all of the above
b
the distal surfaces of the most poeterior teeth in the mouth are BEST cleansed by
a. toothbrush
b. stim-u-dents
c. yarn or floss
d. rubber tip stimulator
c
an EARLY effect of primary traumatic occlusions is
a. generalized alveolar bone loss
b. undermining resorption of alveolar bone
c. hemorrhage and thrombosis is the periodontal ligament
d. vertical pocket formation
c.
the Principal advantage in using sodium hypochlorite is that it
a. is a good chelating agent
b. is a strong germicidal agent
c. acts as local anesthetic agent
d. is a goo solvent for necrotic tissue
e. all of the above
d
in histologic terms, the inflammatory ulp response (pulpitis) caused by cutting a class 2 MOD preparstion maybe described as
a. mild
b. acute
c. severe
d. chronic
e. subacute
f. either A or E above
b.
the endodontic cavity preparation for anterior teeth is ALWAYS made on the
a. labial
b. buccal
c. lingual
d. incisal
e. occlusal
c
on a radiograph, the difference between a healthy pulp and one which is necrotic is that the ____ pulp appears ___.
a. necrotic: darker
b. necrotic: ighter
c. healthy: darker
d. healthy :lighter
e. none of the above
e.
removal of occlusal prematurities is indicated
a. before surgery for gross correction with fine adjustment after surgery
b. immediate after inflammation appwars
c. before the satrt of instrumentation
d. after tissue healing from surgery
a.
dental floss (unwaxed) helps in iterdental cleansing of
a. fixed bridgework
b. crowded teeth
c. dental plaque in the sulcus
d. impacted food below,the contact points
e. all of the above
e.
root planning is used in the treatment of
a. patients with marked gingival hyperplasia
b. patients with no furcation involvement
c. limited cases of periodontitis because it always leaves some niches on the cementum
d. all cases of periodontitis to remove cementum and prepare a favorabl environmen for healing
d.
the BEST way to prevent periodontal disease is to
a. adjust bite
b. recall for treatment every six months
c. restore all teeth to ideal occlusion
d. provide combined fluoride treatment
e. maintain hih level of oral hygiene procedures
e
the MOST widely accepted method of preventing interprovimal plaque formtion is by frequent use of
a. stim- u- dents
b. perio aids
c. dental floss
d. a rubber stimulator
c
soft toothbrushers are favored for the periodontal patient because they
a. stay cleaner after use
b. are more flexible and allow the patient to reach more areas than harder brushes
c. may be used to reach the bottom of pockets for cleaning
d. cause less tooth abrasion than harder brushes
b
upon the FIRST recall, suppuration from the periodontal pocket indicated that
a. a sulcular epithelium is ulcerated and that minute abscesses are present in the connective tissue
b. occlusal trauma is the causative factor in forming the periodontal pocket
c. the pocket is caused by systemic factors
d. the tooth must be extracted
e. all of the above
a.
in root fractres of the apical one third 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 prothetic replacement
e. distend and fragment
b
the term “odontalgia” means
a. toothache
b. pulp atophy
c. removl of vital pulp
d. more than the normal complement of teeth
e. less than the normal complement of teeth
a
in cases involving conventional endodontics, the MOST frequent cause of failure is
a. external root resorption
b. apical overfiling of the canal
c. inadequate filling of accessory canals
d. incomplete obliteration of the main canal
e. thepresence of a co-existent periodontal lesion
d
a radicular cyst is always asso with
a. deep cavity
b. viatal tooth or teeth
c. perocoronal infection
d. non-vital tooth or teeth
e. none of the above
d
with a mechanically exposed pulp, the BEST prognosis is offered by
a. pulpotomy
b. direct pulp cap
c. indirect pulpcap
d. pulpectomy and root canal obturation
e. resection
d
radiographs of a 38 year old female revealed radioluscent areas around several of her mandibular teeth,all of which tested vital on the electric pulp tester
these areas represent
a. multiple ganulomas
b. periapical osteofibrosis
c. chronic periapical bscess
d. bone hypoplasias asso. with opalescent teeth
e. singular granulomas
b
in replanting an avulsed tooth, the MOST critical factor in preventing root resorption after replantation is
a. cleanliness of the root structure
b. time elapsed prior to replanting the tooth
c. filling the root canalprior to replantation
d. presence or absence od an open apical foramen
splinting the tooth with a wire arch bar immediately
b
a periapical cyst can be differentially diagnosed from a periapical granuloma on the basis of
a. histopathology
b. vitality testing
c. transillumnation
d. radiographic evidence
e. a complete intraoral examination and history
a
a patient has pain in the mandibular first molar. the tooth is sensitive to both thermal stimuli and biting. also, clinical examination reveals a bifurcation involvement with 4-5mm pockets adjacent to both roots. treatment indicted would be
a. periodontal scaling and curettage
b. periodontal scaling, curettage and surgery
c. pulpotomy followed by periodontal therapy
d. endodontic treatment combined with periodontal therapy
e. endodontic therapy only
d
gutta percha cones are BEST disinfected by immersing them for 20 minutes in
a. xylol
b. eugenol
c. eucalyptol
d. quarternary ammonium compounds
e. alcohol
d
the minimally accceptable restoration for an endodontically treated maillary first premolr is (an)
a. onlay
b. MOD amalgam
c. full-cast crown
d. occlusal amalgam
e. half -cast crown
a.
undermining resorption or resorption ocurring from the marrow space toward the periodontal ligament is asso. with
a. uneruption teeth
b. nutritional disturbances
c. an overactive parathyroid gland
d. overzelous use of toothpicks or interdental stimulators
e. necrosis causing resorption of bone on the pressure side in ocllusal traumatism
e.
histologic examination of the tissues in desquamative gingivitis would reveal
a. hyperkeratosis
b. elongation of rete pegs
c. loss of basement membrane
d. no inflammatory response
e. agreegations of giant cells
c
the MOST harmful premature occlusal contacts usually exist on the
a. working side, the facial include of the maxilalry facial cusps or the lingual incline of the mandibular lingual cusps
b. non- working side,the facial include of the maxillary lingual cusp, or the lingual incline of the mandibular facial cusps
c. lingual surface of the maxillry anteriors
d. labial surface of th madibular anteriors
e. labial surface of the maxillay anteriors
b.
when two canals are detected in the same root , the most frequent and reliable method for determining the apical termination of each is by
a. a tactile sensation
b. varying the vertical angulation to separate the canals radiographically
c. varying the horizontal angulation to separate the canals radiographically
d. all of the above
e. none of the above
c.
the precursor of the dental pulp during tooth formation is kown as the a. golgi zone b. dental lamina c. dental papilla d. hertwigs sheath outer enamel epith
c.
Defence cells of the pulp include:
a. fibroblast
b. polycytes
c. histiocytes
d. kupfers cells
e. all of the above
c
a patient complains of a dull pain i the area of the maxillary right molar and premolar region. there is no rediographic evidence of pathosis or sensitiviy to percussion : however , the teeth in the quadrant respond withi normal limits to other test. the correct procedure is:
a. pulpotomy
b. extraction
c. root canal therapy
d. further observation
e. pulpectomy
d.
a patient complains of limited pain in the upper right quadrant caused by sweets and cold. Examination reveals a carious lesion on the second premolar. Vitality testing and radiographs are normal. the diagnosis is probably a. necrosis b. reversible pulpitis c. acute periapical abscess d. irreversible pulpitis e. chronic apical periodontitis
b.
which of the ff has as its MOST important objective the elimination of existing inflammation?
a. gingival surgery
b. muco gingival surgery
c. root planning and curettage
d. occlusal correctiong
e. splinting
c.
to successfully treat periodontitis, it is MOST essential to
a. reduce the occlusal trauma
b. reduce pocket depth to 1 or 2
c. make adequatte dietary nutritional adjustment
d. remove the colonized masses of microorganisms and calculus and prevent their recolonizing
e. reduce pocket depth to 1/2mm
d.
the purpose of periodontal dressing is to
a. prevent overgrowth of granulaton tissue by forming a matrix over the wound
b. make the patient comfortable after the periodontal surgery
c. protect the wound from foreign material
d. all of the above
e. none of the above
d.
in the treatment of a patient with periodontal disease , prognosis is POOR when
a. malocclussion is present
b. the patient is uncooperative
c. severe gingival inflammation is present
d. periodontal pockets 5mm in depth exist
e. all of the above
b.
the occurence of keratinization on the human gingiva is
a. dependent upon the functuional stimulation the attached gingiva receives
b. a reflection of inflammation in the underlying gingival connective tissue
c. variable factor directly related to age
d. lacking in gingival crevice
evident in the gingival crevice
d.
the instrument BEST suited for definitive root planning is the
a. hoe
b. file
c. scaler
d. chisel
e. crrete
f. none of the above
e.
it is generally accepted that the primary cause of inflammatory periodontal disease is a. dental plaque b. open contacts c. food impaction d calculus e. lysosomal enzymes
a
radiographs of periapicl areas of rarefrction are important in diagnosis becuse they demostrate
a. the existense of an infective process
b. variations in densities of structures
c. when pariapical and pulpal areas have been rendered sterile
d. the size of a periapical lesion, thus distinguishing between a cyst and granuloma
b
severity of the course of a periapical infection depends upon the
a. resistance ofthe host
b. virulence of the organism
c. number of organism present
d. all of the above
e. only A and B above
e
sterilized endodontic instruments will be free of alll viable
a. microorganism
b. spore-forming and non-spore forming bacteria pathogenic to man
c. bacteria pathogenic to man, except spore formers
d. bateria, except some viruses
e. bacteria, except thermophils
a.
bismuth compounds hve been included in some root canal filling materials because they are
a. radiopaque
b. germicidal
c. anodyne
d. adhesive
e. connective
a.
if corticosteroids are used as a component of root canal medicaments
a. microorganism are destroyed
b. leukocytic infiltration results
c. antibacterial action is enhanced
d. exacerbation of infection may occur
e. leukocytic infiltration will be inhibited
d.
generalized malaise and elevated body temperature are most frequently asso. with
a. acute pulpitis
b. acute apical abscess
c. necrotic pulp
d. chhronic apical periodontitis
e. acute apical periodontitis
b.
aging of the pulp is evidence by an increase in
a. vascularity
b. cellular elements
c. fibrous element of the pulp
d. noncalcified ares within the pulp
e. non-cellular elements
c.
more than one main canal occurs a significant percent of the time in the
a. maxillary first molar distobuccal root
b. maxillary first mola lingual root
c. mandibular central incisor
d. all of the above
e. only A and B above
c.
the efferent nerves found in the distal pulp are
a. somatic motor fibers
b. . sympahetic postganglionic fibers
c. parasympathetic postganglionic fibers
d. both somatic motor and autonomic postganglionic fibers
e. epicritic fibers
b.
when the root canal instruments (files and reamers) are sterilized in a glass bed sterilizer at 450 degree F , they sholud be placed in the sterilizer for
a. 2 seconds
b. 5 seconds
c. 10 seconds
d. 20 seconds
e. 30 seconds
c
most useful in differentiating between an acute apical abscess and the acute periodontal abscess is
a. palpation
b. radiographs
c. anesthetic test
d. percussion test
e. pulp vitality test
e.
necrotic pressure areas undermining bone resorption and endosteal bone formation re all asso. with
a. juveile perodontitis (periodontosis)
b. periodontal cyst
c. periodontal abscess
d. primary occlusal trauma
e. chronic destructive periodontitis
d.
gingival curettage is indicated in the treatment of . inflamed and edematous gingiva b. fibrotic gingiva c. bleeding gingiva d. all of the above e. none of the above
a.
flossing should be perforemed
a. daily
b. beginning when the teeth first erupt
c. several times a week
d. whenever food become impacted
e. when periodontal disease is present
a.
an example of acute inflammatory gingival enlargement is MOST likely to be seen in a patient exhibiting
a. periodontal cyst
b. pregnancy gingivitis
c. dilantin hyperlasia
d. hereditay fibromatosis
e. interstitiall gingivitis
b
unilateral matication, will tend to result in
a. greater accumulation of plaque on the unused side
b. greater accumulation of plaque on the used side
c. a greater degree of periodontal disease on the used side
d. heavier and more densebone support on the unused side
e. less accumulation of paque on the unused side
a
unttrastructural and biochemicl studies have shown that plaque microorganisms produce substances wich separatevthem from one another and form a matrix for further laque accumulation. this " matix is made up of dextrans (glucans) and a. levans b . mucoproteins c. disaccharides d. lipoproteins e. monosaccharides
a.
a traumatized tooth ith a necrotic pulp shows a periapical area of rarefraction radiographically. the pulpal arrea is closed. viable microorganism might be cultured from the canal in aprox. what percentage of the cases?
a. 10 percent
b. 30 percent
c. 40 percent
d. 80 percent
e. 100 percent
d
five hours ago, a 7 year old fell of his bicycle. he fractures his maxillary right cental incisor in the level of the gingivs. the exposed pulp is still vital. what is the treatment of choice for this tooth?
a. pulp cap
b. pulpotomy
c. pulpectomy
d. extraction
e. pulpefaction
b.
what is the responsed of a normal pulp to the application of intense het or cold?
a. no response by a normal pulp
b. pian which last for 30-60 seconds
c. feeling of warmth or coldness on the tooth
d. pain which last for 10-15 minutes after the stimulatus is removed
e. pain which last for only a short time after the stimulus is removed
e.
histologically, the denetal pulp most closely resembles what type of tissue?
a. nerve tisuue
b. vascular tissue
c. granulation tissue
d. loose connective tissue
e. subarachnoid tissue
d.
ideslly what control tooth or teeth should be tilized testing a suspected pulpally involved tooth?
a. adjacnt teeth only
b. suspected tooth only
c. opposong teeth and adjacent teeth
d. contralateral tooth and opposing teeth
e. adjacent teeth and contralateral teeth
e.
which of the ff test is MOST accurate o differ entiate granuloma, chronic alveolar abscess and radicular cyst?
a. biopsy
b. percussion
c. thermal test
d. electric pulp test
e. radiographic examinatin
a.
