MOSBY Flashcards
Which of the following tests is the least useful in endodontic diagnosis of children?
A. Percussion
B. Palpation
C. Electric pulp test
D. Cold test
C. Electric pulp test
Irreversible pulpitis pain in which of the following sites is most likely to radiate to the ear?
A. Maxillary premolar
B. Maxillary molar
C. Mandibular premolar
D. Mandibular molar
D. Mandibular molar
NOTES:
Max CI, LI: Forehead region
Max C, PM1: Nasolabial area
Max PM2: Temporal region
Max M: Zygomatic, parietal, and occipital regions of head
Mand M: Ear, angle of jaw, or posterior regions of neck
Mandibular CI, LI, C, PM: Mental region of mandible
Max and Mand M: Opposing quadrant or to other teeth in the same quadrant
Which of the following diagnostic criteria is least reliable in the assessment of the pulpal status of the primary dentition?
A. Swelling
B. Electric pulp test
C. Spontaneous pain
D. Internal resorption
B. Electric pulp test
Which of the following can be viewed on a conventional radiograph?
A. Buccal curvature of roots
B. Gingival fibers
C. Calcification of canals
D. Periodontal ligament
C. Calcification of canals
Which of the following most likely applies to a cracked tooth?
A. The direction of the crack usually extends mesiodistally.
B. The direction of the crack usually extends faciolingually.
C. Radiographic exam is the best way to detect it.
D. A and C only.
E. B and C only.
A. The direction of the crack usually extends mesiodistally.
Which is the most likely to cause pulp necrosis?
A. Subluxation
B. Extrusion
C. Avulsion
D. Concussion
C. Avulsion
NOTES:
Subluxation: The tooth is LOOSENED but not displaced
Extrusion: The tooth is PARTIALLY extruded from its socket.
Avulsion: The tooth is COMPLETELY extruded from its socket.
Concussion: NO DISPLACEMENT, normal mobility, sensitive to percussion.
Which of the following statement(s) is(are) true regarding treatment of a tooth presenting with a sinus tract?
A. Treat with conventional root canal therapy.
B. Antibiotics are not needed.
C. The sinus tract should heal in 2 to 4 weeks after conventional root canal therapy.
D. If the tract persists post-root canal therapy, do root-end surgery with root-end filling.
E. All of the above choices are true.
E. All of the above choices are true.
NOTES:
Antibiotics are not needed, since the infection is localized and draining. If the tract does not heal within a few weeks, root-end surgery may be required.
Features of focal sclerosing osteomyelitis often include:
A. A nonvital pulp test.
B. A history of recent restoration of the tooth in question.
C. A radiolucent lesion which, in time, becomes radiopaque.
D. NOTA
B. A history of recent restoration of the tooth in question.
Once the root canal is obturated, what usually happens to the organism that had previously entered periradicular tissues from the canal?
A. They persist and stimulate formulation of a granuloma.
B. They are eliminated by the natural defenses of the body.
C. They reenter and reinfect the sterile canal unless root-end surgery is performed.
D. They will have been eliminated by various medicaments that were used in the root canal.
B. They are eliminated by the natural defenses of the body.
The major objectives of access preparation include all of the following except which one?
A. The attainment of direct, straight-line access to canal orifices.
B. The confirmation of clinical diagnosis.
C. The conservation of tooth structure.
D. The attainment of direct, straight-line access to the apical portion of the root.
B. The confirmation of clinical diagnosis.❌
Which of the following best describes the anesthetic effects of a posterior superior alveolar nerve block?
A. Pulpal anesthesia of the maxillary second and third molars.
B. Pulpal anesthesia of the maxillary first molar.
C. Pulpal anesthesia of the maxillary first and second premolars.
D. Pulpal anesthesia of the second premolar.
A. Pulpal anesthesia of the maxillary second and third molars.
Which one of the following cannot be observed on a conventional radiograph?
A. Canal calcification of tooth #15.
B. Buccal curvature of the mesial root of tooth #30.
C. Type of canals of tooth #21.
D. Open apex of tooth #8.
B. Buccal curvature of the mesial root of tooth #30.❌
The indications for periradicular surgery include all of the following except which one?
A. Procedural accidents during previous nonsurgical endodontic treatment.
B. Irretrievable separated files in the canals.
C. Failed nonsurgical endodontic treatment and persisting radiolucency.
D. Treatment for a nonrestorable tooth.
D. Treatment for a nonrestorable tooth.❌
Which of the following teeth has the most consistent number of canal(s)?
A. Mandibular incisor
B. Mandibular canine
C. Maxillary canine
D. Mandibular premolar
C. Maxillary canine
Which is not a property of sodium hypochlorite (NaOCl)?
A. Chelation
B. Tissue dissolution at higher concentrations
C. Microbicidal activity
D. Flotation of debris and lubrication
A. Chelation.❌
Initial instrumentation in endodontic treatment is done to the level of the _____.
A. Radiographic apex
B. Dentinoenamel junction
C. Cementodentinal junction
D. Cementopulpal junction
C. Cementodentinal junction.
While performing nonsurgical endodontic therapy you detect a ledge. What should you do?
A. Use a smaller instrument and get by the ledge.
B. Fill as far as you have reamed.
C. Use a small, round bur and remove the ledge.
D. Continue working gently with larger files to remove the ledge.
A. Use a smaller instrument and get by the ledge.
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
B. Apical third of root.
NOTES:
In general, the more subcrestally located the lesion, the better the prognosis.
Which of the following 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.
D. Both A and C are options.
NOTES:
Initial stage/ Cleaning and Shaping:
- attempt to remove the instrument
- attempt to bypass it
- prepare and obturate to the segment
Filling Stage
- Do not attempt removal and proceed to obturate
Which of the following is the most significant cause of ledge formation?
A. Infection
B. Remaining debris within the canal
C. No straight-line access
C. No straight-line access.
A classic teardrop-shaped periradicular lesion on a radiograph can be indicative of a vertical root fracture.
The prognosis of a vertical root fracture is hopeless, and the tooth should be extracted.
A. First statement is true, second is false.
B. First statement is false, second is true.
C. Both statements are true.
D. Both statements are false.
C. Both statements are true.
NOTES:
Vertical root fracture: teardrop- shaped, J-shaped, or halolike radiolucency.
The 02 taper on hand K-files is ___.
A. 0.2-mm increase in diameter per 1-mm increase in length
B. 0.02-mm increase in diameter per 1-mm increase in length
C. 0.2-mm increase in diameter per 2-mm increase in length
D. 0.02-mm increase in diameter per 2-mm increase in length
B. 0.02-mm increase in diameter per 1-mm
increase in length.
How should a vital second permanent molar with a 2.0-mm exposure on a 12-year-old patient be treated?
A. Apexification
B. Direct pulp capping
C. Indirect pulp capping
D. Extract
E. Apexogenesis
A. Apexification.
NOTES:
Apexification: >2mm
Apexogenesis: <2mm
At what stage is endodontic treatment considered complete?
A. When a temporary restoration is placed and the rubber dam removed.
B. When canals are seared off and plugged.
C. When the coronal restoration is completed.
D. When the patient is asymptomatic
C. When the coronal restoration is completed.
A patient complains of recent severe pain to percussion of a tooth. The most likely cause is _____.
A. Acute periradicular periodontitis
B. Chronic periradicular periodontitis
C. Reversible pulpitis
D. Irreversible pulpitis
A. Acute periradicular periodontitis
Which of the following statements regarding post preparation is incorrect?
A. The primary purpose of the post is to retain a core in a tooth with extensive loss of coronal structure.
B. The need for a post is dictated by the amount of remaining coronal tooth structure.
C. Posts reinforce the tooth and help to prevent vertical fractures.
D. At least 4 to 5 mm of remaining gutta-percha after post space preparation is recommended.
C. Posts reinforce the tooth and help to prevent vertical fractures.❌
Prolonged, unstimulated night pain suggests which of the following conditions of the pulp?
A. Pulpal necrosis
B. Mild hyperemia
C. Reversible pulpitis
D. Periodontal abscess
A. Pulpal necrosis
A nasopalatine duct cyst is located between _____.
A. Two maxillary central incisors
B. Maxillary central and lateral incisors
C. Maxillary lateral and canine
D. Maxillary canine and first premolar
A. Two maxillary central incisors
NOTES:
Nasopalatine duct cyst: a circular radiolucent area seen as a marked swelling in the region of the palatine papilla. It is situated mesial to the roots of the central incisors, at the site of the incisive foramen.
Severity of the course of a periradicular infection depends upon the _____.
A. Resistance of the host
B. Virulence of the organisms
C. Number of organisms present
D. Both A and B only
E. All of the choices are true
E. All of the choices are true
Informed consent requires that the patient be advised of the following except for which one?
A. The benefits of endodontic treatment
B. The cost of endodontic treatment
C. The risks of endodontic treatment
B. The cost of endodontic treatment
Which of the following 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
B. Larger myelinated nerve fibers with faster conduction velocities
When compared to the bisecting-angle technique, the advantages of the paralleling technique in endodontic radiology include all of the following except_____.
A. A significant decrease in patient radiation
B. A more accurate image of the tooth’s dimensions
C. That it is easier to reproduce radiographs at similar angles to assess healing after treatment
D. The most accurate image of all the tooth’s dimensions and its relationship to surrounding anatomic structure
A. A significant decrease in patient radiation❌
The primary reason for designing a surgical flap with a wide flap base is _____.
A. To avoid incising over a bony protuberance
B. To obtain maximum access to the surgical site
C. To maintain an adequate blood supply to the reflected tissue
D. To aid in complete reflection
C. To maintain an adequate blood supply to the reflected tissue
The apical portion of maxillary lateral incisor usually curves to the _____.
A. Facial
B. Palatal
C. Mesial
D. Distal
D. Distal
Aqueous EDTA 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
B. Dissolve inorganic matter
A noncarious tooth with deep periodontal pockets that do not involve the apical third of the root has developed an acute pulpitis. There is no history of trauma other than a mild prematurity in lateral excursion. What is the most likely explanation for the pulpitis?
A. Normal mastication plus toothbrushing has driven microorganisms deep into tissues with subsequent pulp involvement at the apex.
B. During a general bacteremia, bacteria settled in this aggravated pulp and produced an acute pulpitis.
C. Repeated thermal shock from air and fluids getting into the deep pockets caused the pulpitis.
D. An accessory pulp canal in the gingival or the middle third of the root was in contact with the pockets
D. An accessory pulp canal in the gingival or the middle third of the root was in contact with the pockets
On a radiograph, the facial root of a maxillary first premolar would appear distal to the lingual root if the _____.
A. Vertical angle of the cone was increased
B. Vertical angle of the cone was decreased
C. X-ray head was angled from a distal position relative to the premolar
D. X-ray head was angled from a mesial position relative to the premolar
D. X-ray head was angled from a mesial position relative to the premolar
NOTE:
SLOB RULE
Same=Lingual
Opposite =Buccal
If a canal is ledged during instrumentation, the best way to handle the problem is to _____.
A. Continue instrumenting at the ledge. Although it may take some time, you will eventually bore your way to patency in the periodontal ligament space.
B. Immediately stop and fill to where the ledge begins.
C. Bind your irrigating needle in the canal and use short bursts of irrigant to loosen any debris blocking the canal. This will reopen the natural canal.
D. Prebend the tip of a small file, lubricate, and try to negotiate around the ledge.
E. Place citric acid or EDTA in the canal to soften the dentin. A small Gates Glidden or other rotary can be used to bypass the ledge.
D. Prebend the tip of a small file, lubricate, and try to negotiate around the ledge.
Which of the following factors affects long-term prognosis of teeth after perforation repair?
A. Size of the defect.
B. Location of the defect.
C. Time elapsed between the perforation and its repair.
D. All of the choices are true.
D. All of the choices are true.
Which of the following statements best describes treatment options for a separated instrument (e.g., finger spreader) at the filling stage of treatment?
A. Immediately attempt to remove the instrument.
B. Do not attempt removal and proceed to obturate.
C. Attempt to bypass the obstructed instrument.
D. Both A and C are options.
B. Do not attempt removal and proceed to obturate.
NOTES:
Initial stage/ Cleaning and Shaping:
- attempt to remove the instrument
- attempt to bypass it
- prepare and obturate to the segment
Filling Stage
- Do not attempt removal and proceed to obturate
Endodontically treated posterior teeth are more susceptible to fracture than untreated posterior teeth. The best explanation for this is _____.
A. Moisture loss
B. Loss of root vitality
C. Plastic deformation of dentin
D. Destruction of the coronal architecture
D. Destruction of the coronal architecture
There is a horizontal root fracture in the middle third of the root of tooth 10 in an 11-year- old patient. The tooth is mobile and vital. How should this be treated?
A. Extract.
B. Pulpectomy immediately and splint.
C. Splint and observe.
D. Do nothing and follow-up in 10 to 14 days.
C. Splint and observe.
Which of the following is the best radiographic technique to identify a suspected horizontal root fracture in a maxillary anterior central incisor?
A. Multiple Water’s projections
B. Multiple angulated periapical radiographs in addition to a normal, parallel-angulated, periapical radiograph
C. A panoramic radiograph
D. A reverse Towne’s projection
B. Multiple angulated periapical radiographs in addition to a normal, parallel-angulated, periapical radiograph
An 8-year-old boy received a traumatic injury to a maxillary central incisor. One day later, the tooth failed to respond to electric and thermal vitality tests. This finding dictates _____.
A. Pulpectomy
B. Apexification
C. Calcium hydroxide pulpotomy
D. Delay for the purpose of re-evaluation
D. Delay for the purpose of re-evaluation
Twisting a triangular wire best describes the manufacturing process of a _____.
A. Reamer
B. Barbed broach
C. Hedström file
D. K-Flex file
A. Reamer
NOTES:
K-file &K-reamer
- the oldest instruments for cutting and machining dentin.
- made from a steel wire that is ground to a tapered square or triangular cross section and then twisted to create either a file or a reamer
File
- has more flutes per unit length than does a reamer
K-FlexTM file
- a modification of the shape of the K-file, with a noncutting tip design.
Direct pulp cap is recommended for teeth with _____.
A. Carious exposures
B. Mechanical exposures
C. Calcification in the pulp chambers
D. Closed apices more than teeth with open apices
B. Mechanical exposures
Which of the following is the treatment of choice for a 7-year-old child with a nonvital tooth 30 with buccal sinus tract?
A. Gutta-percha filling
B. Gutta-percha filling followed by root-end surgery
C. Extraction
D. Apexogenesis
E. Apexification
E. Apexification
Which of the following is the main side effect of bleaching an endodontically treated tooth?
A. External cervical resorption
B. Demineralization of tooth structure
C. Gingival inflammation
A. External cervical resorption
What is the safest recommended intracoronal bleaching chemical?
A. Hydrogen peroxide
B. Sodium perborate
C. Sodium hypochlorite
D. Carbamide peroxide
B. Sodium perborate
Pulp capping and pulpotomy can be more successful in newly erupted teeth than in adult teeth because _____.
A. A greater number of odontoblasts are present
B. Of incomplete development of nerve endings
C. An open apex allows for greater circulation
D. The root is shorter
C. An open apex allows for greater circulation
Zinc oxide eugenol is a good temporary restoration because _____.
A. It is less irritating
B. It has increased strength over other restorations
C. It provides a good seal
D. It is inexpensive
C. It provides a good seal
During a routine 6-month endodontic treatment recall evaluation, you note a marked decrease in the radiographic size of the periradicular radiolucency. Which of the following is the most appropriate treatment plan?
A. Extraction.
B. Nonsurgical endodontic retreatment.
C. Recall the patient in another 6 months.
D. Surgical endodontic retreatment
C. Recall the patient in another 6 months.
What is the radiographic sign of successful pulpotomy in a permanent tooth?
A. Open apex
B. That the apex has formed
C. Loss of periradicular lucency
D. No internal resorption
B. That the apex has formed
Which of the following statements is not true regarding internal root resorption?
A. It happens rarely in permanent teeth.
B. It appears as an asymmetrical “moth-eaten” lesion in radiographs.
C. Chronic pulpal inflammation is the primary cause.
D. Prompt endodontic therapy will stop the process.
B. It appears as an asymmetrical “moth-eaten” lesion in radiographs.❌
It appears as a SYMMETRICAL lesion in radiographs.
NOTES:
INTERNAL ROOT RESORPTION
- The margins are sharp, smooth, and clearly defined.
- The walls of root canal appear to balloon out.
- Usually symmetrical.
EXTERNAL ROOT RESORPTION
- The margins are less well-defined, ragged and irregular.
- “Moth-eaten” appearance.
- Usually asymmetrical.
