Endo1 Flashcards
Which of the following is a clinical diagnosis based on subjective and objective findings indicating that the vital inflamed pulp is incapable of healing and has the following additional descriptors: lingering thermal pain, spontaneous pain, and referred pain? • reversible pulpitis • asymptomatic irreversible pulpitis • symptomatic irreversible pulpits • none of the above
symptomatic irreversible pulpits
Which of the following is an inflammatory reaction to pulpal infection and necrosis characterized by rapid onset, spontaneous pain, tenderness of the tooth to pressure, pus formation and swelling of associated tissues? • symptomatic apical periodontitis • acute apical abscess • chronic apical abscess • asymptomatic apical periodontitis
acute apical abscess
Chronic Apical Abscess?
An inflammatory reaction to pulpal infection and necrosis characterized by gradual onset, little or no discomfort, and the intermittent discharge of pus through an associated sinus tract
Which of the following are related to vital teeth and usually do not warrant endodontic therapy? Select all that apply. • apical scar • cementoma • traumatic bone cyst • globulomaxillary cyst • radicular cyst
• cementoma (usually lower anterior teeth which are vital)
• traumatic bone cyst (teeth are vital, scalloped appearance)
• globulomaxillary cyst (between upper 2&3, teeth are vital)
in apical scar and radicular cyst, teeth are nonvital
The most superior of all other retrofilling material -- mineral trioxide aggregate (MTA) has all of the following advantages, EXCEPT two. Which TWO are not properties of MTA? • radiopaque • easy to manipulate • hydrophilic • biocompatible • not toxic • short setting time • induction of hard tissue formation
- easy to manipulate
* short setting time
blood contaminants of MTA
not adversely effected
Teeth that have ? and need to be retreated are the most common reason for an apicoectomy and a retrograde filling
posts in them
The earliest and most common symptom associated with an inflamed pulp is: • a dull throbbing pain on mastication • sensitivity to hot and/or cold stimuli • a persistent feeling of discomfort • mild bleeding • pain on percussion
sensitivity to hot and/or cold stimuli (thermal sensitivity)
The best method to elicit the most accurate thermal response is to ?. This is done because all other methods may stimulate the tooth at only one section of one surface.
individually isolate the suspected teeth with a rubber dam and then bathe each tooth in hot or cold water (usually stick of ice and warm stick of gutta percha are used)
Thermal tests may be false-negative in ?
immature, recently traumatized teeth or because of premedication with an analgesic
Although the percussion test does not indicate the health of the pulp, the sensitivity of the proprioceptive fibers does reveal ?
inflammation of the apical PDL
A positive response to percussion indicates ?
- not only the presence of inflammation of the PDL,
* but also the extent of the inflammatory process
A phoenix abscess is also known as a: • recrudescent abscess • granuloma • cyst • none of the above
recrudescent abscess (identical to those of an acute apical abscess, but a radiograph will show a large periapical radiolucency that indicates the presence of a chronic disease)
A phoenix abscess is always preceded by ?
asymptomatic apical periodontitis.
A massive invasion of pulpal contaminants to granuloma will result in the formation of ?
an acute abscess (phoenix abscess)
A granuloma or a cyst can only be differentially diagnosed by ?
histological examination.
Which of the following defines the difference between a chronic apical abscess and a periapical cyst/granuloma?
• chronic apical abscess is asymptomatic
• chronic apical abscess is symptomatic
• only histological examination can differentiate
• the border of the radiolucent lesion
only histological examination can differentiate
? of bone calcium must be altered before radiographic evidence of periapical breakdown occurs
30% to 50%
the best treatment of an acute apical abscess includes ? which will relieve the acute symptoms. This is followed at a later date by conventional root canal therapy
establishing drainage and debriding the canal system of necrotic tissue
A patient is diagnosed with symptomatic apical periodontitis and refuses treatment due to fear of needles. Your statement to the patient should include the fact that:
• eventually, the acute nature of the lesion will progress into a chronic and nonpainful lesion
• this lesion can progress into the bone causing osteomyelitis, a more severe condition
• the apical lesion has been there for years and the tooth needs treatment immediately
• none of the above
this lesion can progress into the bone causing osteomyelitis, a more severe condition (Osteomyelitis is not a particularly common disease. It is a serious sequela of periapical infection that often results in a diffuse spread of infection throughout the medullary spaces, with subsequent necrosis of a variable amount of bone)
Radiographically, acute osteomyelitis progresses ? and demonstrates little radiographic evidence of its presence until ?. At that time, diffuse lytic changes in the bone begin to appear. Note: A ? radiolucent appearance is evident.
- rapidly (more in mandible)
- the disease has developed for at least 1 to 2 weeks
- “moth-eaten”
The general principles of acute osteomyelitis treatment demand that ?
drainage be established and maintained and that the infection be treated with antibiotics to prevent further spread and complications.
An acute apical abscess will not respond to pulp vitality tests.
An acute apical abscess is only observed in association with a necrotic pulp.
• both statements are true
• both statements are false
• the first statement is true, the second is false
• the first statement is false, the second is true
both statements are true
Emergency treatment of acute apical abscess includes ?
establishing drainage (ideally through the canal) and prescribing antibiotics (only if indicated by systemic signs and elevated temperature) and analgesics.
When diffuse swelling exists, the swelling has dissected into fascial spaces. The most important objective is ?
the removal of the irritant via canal debridement or extraction of the offending tooth. Swelling may be incised and drained followed by drain insertion and systemic antibiotics
Condensing Osteitis is a diffuse radiopaque lesion representing a localized bony reaction to a low-grade inflammatory stimulus, usually seen at apex of tooth.
Reversible pulpitis is a clinical diagnosis based upon subjective and objective findings indicating that the inflammation should resolve and the pulp return to normal.
• both statements are true
• both statements are false
• the first statement is true, the second is false
• the first statement is false, the second is true
both statements are true
A 7-year-old boy arrives at the office with a complaint that tooth #8 is draining pus into his mouth. The tooth had been traumatized earlier. The vitality tests reveal no response. What is the treatment of choice? Select all that apply.
• extraction
• apexogenesis / pulpotomy
• pulpectomy
• periodontal surgery to remove sinus tract
• it is only necessary to give the child analgesics and antibiotics for pain and infection
• apexification
• pulpectomy
• apexification
The goal of apexification is to induce further root development in a pulpless tooth by stimulating the formation of a hard substance at the apex, so as to allow obturation of the root canal space. Apexification may be required after pulpectomy if the apex of the tooth is open. Remember: Apex closes 2-3 years after eruption
The patient of apexification is recalled after ?
3 months to see if apexification has taken place. If not, a fresh supply of paste is placed. If apexification has occurred, conventional root canal therapy is instituted.
All of the following statements regarding adjuncts to endodontic treatment are true EXCEPT one. Which one is the EXCEPTION?
•transplanted teeth with partial root development have a better prognosis than do those with developed roots
• orthodontic extrusion is commonly indicated prior to implant placement
• intentional replantation is a viable alternative to endodontic surgery
• a major disadvantage of endodontic implants is the lack of an apical seal
intentional replantation is a viable alternative to endodontic surgery (Intentional replantation is not a substitute for endodontic surgery whenever endodontic surgery can be performed)
Which of the following is the most characteristic radiographic evidence of a vertical root fracture?
• a persistent periodontal defect
• a radiolucent halo surrounding the root of the fracture
• a radiopaque lesion at the sight of the fracture
• a visible fracture when transillumination is used
a radiolucent halo surrounding the root of the fracture (Also, persistent periodontal defects are often caused by vertical root fractures; however, this is not radiographic. Radiographs (without first wedging the tooth) rarely will show vertical fractures.)
A patient complains of a slight tooth ache that has been "on and off" for a week. The tooth in question #18. Which of the following teeth would be optimum to use as a baseline? • #19 -virgin • #15 - primary cavitation on occlusal • #3 - full gold crown • #30 - occlusal amalgam
19 -virgin
electric pulp tester (EPT) checks the sensibility of a tooth by stimulating nerve endings with ? in voltage
a low current and high potential difference (it stimulates the A-delta sensory fibers in the pulp)
If a patient’s medical history reveals that a cardiac pacemaker has been implanted, the use of an electric pulp tester is ?
contraindicated
The main concept of the cone shift technique is that as the vertical or horizontal angulations of the x-ray tube head changes, the object buccal or closest to the tube head moves to ? the side of the radiograph when compared to the lingual object.
• same
• opposite
opposite
A disadvantage of the cone shift technique is that it results in ?, which is directly proportional to cone angle
blurring of the object
Your practice is involved with a local minor hockey team, the Millwrights. A player gets hit with a stick, and his central incisors are intruded. Which of the following is the least useful examination procedure? • soft tissue exam • hard tissue exam • radiograph • vitality test • percussion test
vitality test (This test is contraindicated. The percussion test is usually not performed because of its pain. However, the vitality test will give you a truly false reading, because of temporary paresthesia in the area)
? require endodontic treatment more often than any other tooth, while ? have the highest endodontic failure rate.
• mandibular first molars, maxillary first molars
• mandibular first molars, maxillary second molars
• maxillary second molars, mandibular first molars
• maxillary first molars, mandibular first molars
mandibular first molars, maxillary first molars
In mandibular first molars, you must look for the fourth canal if ?
the first-found canal in the distal root lies more toward the buccal instead of being located in the center
- Maxillary molars have ? outline of the chamber
* Mandibular molars have ? outline of the chamber
- a triangle
* a trapezoidal