Post Test Flashcards
Which of the following is characteristic of sensory fibers of the pulp? They
a. Can selectively differentiate thermal stimuli
b. Have special neuronal endings that are specific for proprioception
c. Are nonselective to all stimuli indicating only pain when the threshold has been exceeded
d. Non of the above
e. All of the above
c. Are nonselective to all stimuli indicating only pain when the threshold has been exceeded
Which of the following sensory response can be elicited from a tooth after root canal therapy?
a. Tactile sensation
b. Thermal sensation
c. Sensitivity to EPT
d. Sensitivity to sweets
a. Tactile sensation- PDL
Most probable reason for root canal therapy of a mandibular incisor having a relatively high failure rate is the
a. High incidence of two canals
b. High incidence of accessory canals
c. Common distal curvature of the root
d. High incidence of pulpal calcific degenerations
e. Narrow mesiodistal dimension of the root canal
a. High incidence of two canals
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❌
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 re-enter 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
During a routine radiographic evaluation, you notice bone loss extending from the cementoenamel junction to the apex of tooth #21. Further evaluation reveals that probing depths are above normal limits all around the tooth however, at one point the probe drops precipitously to an even greater depth. Vitality test is
negative. This patient may require
a. Extensive periodontal treatment followed by vitality re-assessment
b. Endodontic treatment only
c. Endodontic treatment followed by periodontic treatment
d. Root end surgery
c. Endodontic treatment followed by periodontic treatment
A 30 year old male complains of throbbing pain in the upper right quadrant. The pain is spontaneous and usually lasts several hours. All tests are within normal limits except radiographs, which show large carious lesion in the maxillary 1st premolar. After evacuation of all caries, a 2mm exposure is produced. The most probable diagnosis is
a. Necrosis
b. Internal resorption
c. Reversible pulpitis
d. Irreversible pulpitis
e. Hyperplastic pupitis
d. Irreversible pulpitis
The efferent nerves found in the distal pulp are
a. Somatic motor fibers
b. Sympathetic postganglionic fibers
c. Parasympathetic postganglionic fibers
d. Both somatic motor and autonomic postganglionic fibers
e. Epicritic fibers
b. Sympathetic postganglionic fibers
NOTES:
AFFERENT= NOCICEPTORS
A patient complains of a dull pain in the area of maxillary right molar and premolar region. There is no radiographic evidence of pathosis or sensitivity to percussion; however, the teeth in the quadrant respond weakly to the electric pulp tester and respond within normal limits to other tests. The correct procedure is:
a. Pulpotomy
b. Extraction
c. Root canal treatment
d. Further observation
e. Pulpectomy
d. Further observation
Most frequent cause of persistence of positive cultures from a root canal is
a. Improper drug therapy
b. Contaminated culture medium
c. Overinstrumentation of the root canal
d. Seepage of saliva into the area of operation
d. Seepage of saliva into the area of operation
The invested cone technique is sometimes helpful in obliterating canals when the apex
a. Is narrow and constricted
b. Has an exaggerated curvature
c. Is incompletely 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. Is incompletely developed and is wide
A common change seen in the pulpal tissue during the aging process is
a. An increase in cellular components
b. The development of new capillary buds in the apical portion of the pulp
c. An increase in the number and thickness of collagen fibers
d. A decrease in the pulp response to thermal changes
e. The loss of dystrophic mineralizations
c. An increase in the number and thickness of collagen fibers
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 test. This finding indicates
a. Pulpectomy
b. Apexification
c. CaOH pulpotomy
d. Delay for the purpose of re-evaluation
d. Delay for the purpose of re-evaluation
A 36 years old male presents with severe pain to biting on tooth #18. In the past 2 days, the pain has increased to the point where it constantly hurts and the patient cannot and does not want to eat. Clinically, a recently placed mesial-occlusal-distal inlay is present in #18 and mesio-occluso-distal onlay on #19.
Radiographically no pathology is noted. The patient refuses to let you touch the tooth until anesthetic is administered. Possible diagnosis and etiology may be
I. Reversible pulp disease, hyperocclusion
II. Reversible pulp disease, restorative procedures
III. Irreversible pulp disease, marginal leakage
IV. Irreversible pulp disease, vertical fractures
V. Irreversible Pulp disease, restorative procedures
a. 1
b. 1 & 2
c. 3 & 4
d. 3 & 5
e. 4 & 5
e. 4 & 5
A 50 year old male presents with pain in the area of tooth #30. The pain has been present off and on for 3 months with increasing severity that is now bothering his sleeping. There are no medical problems. On radiographic examination, there are no apparent lesions; however, a disto-occlusal amalgam is present. Palpation is negative and percussion evokes a positive response. The electric pulp test gives a reading of 4. The treatment of choice is to
a. Perform pulpotomy or pulpectomy
b. Wait for further symptoms or remission
c. Prescribe analgesics and adjust the occlusion
d. Remove amalgam and replace with ZOE temporary
e. Refer the patient to a periodontist
a. Perform pulpotomy or pulpectomy
A patient presents with localized, fluctuant swelling associated with tooth #28. The patient complains of extreme pain upon biting. You establish the tooth and establish good drainage. You should also consider
a. Prescribing saline rinses
b. Relieving occlusion
c. Closing the tooth
d. Incising and draining soft tissue
e. All of the above
e. All of the above
A cold test reveals a lingering pain. You ask the patient to raise her hand until the pain subsides. The patient raises her hand for about 8 seconds. What does this data suggest?
a. pulp necrosis
b. symptomatic irreversible pulpitis
c. reversible pulpitis
d. symptomatic apical periodontitis
c. reversible pulpitis
NOTES:
Reversible pulpitis= <10 seconds
Irreversible pulpitis= >10 seconds
During the excavation of a very deep lesion on tooth #30 on a 8 year old patient, you initially found large amounts, of mushy decayed tooth structure over a leathery, demineralized dentin. The tooth is asymptomatic and has given all signs that it is vital. Treatment contemplated should include
a. Total excavation; if no exposure, apply base and restore
b. Total excavation; if a pulp exposure is present, do DPC
c. Total excavation, if a pulp exposure is present, perform pulpotomy
d. Application of cavity sealer over the leathery dentin, followed by restoration with amalgam
e. Application of CaOH and/or ZOE over the leathery dentin and restoration with amalgam
e. Application of CaOH and/or ZOE over the leathery dentin and restoration with amalgam
During the preparation of tooth #31 to receive a MO amalgam, you find that you have inadvertently created a mechanical exposure of the mesiobuccal pulp horn. The tooth had been properly isolated with a rubber dam and all the decay has been removed. The patient is 13 years old and has no history of symptoms with this tooth. The radiograph reveals no apparent pathology although the root apices are not fully formed. Treatment of choice consists of
a. An indirect pulp cap with CaOH followed by an amalgam restoration
b. An indirect pulp cap with ZOE followed by an amalgam restoration
c. A direct pulp cap with CaOH followed by an amalgam restoration
d. A direct pulp cap with ZOE followed by an amalgam restoration
e. A pulpotomy with CaOH placed over the vital stumps to allow for continued root growth
c. A direct pulp cap with CaOH followed by an amalgam restoration
NOTES:
CaOH- immature apex
❌ZOE- cytotoxic
Yesterday, you did a pulpotomy on an emergency patient with severe pain on tooth #30 caused by irreversible inflammation of a vital pulp. Today the patient has called with moderate severe pain. You should
a. Prescribe antibiotics
b. Prescribe antibiotics and analgesics
c. Inform the patient it will probably go away
d. Have the patient return and perform complete pulpectomy
e. Have the patient return, open the tooth and leave it open
d. Have the patient return and perform complete pulpectomy
How should a vital 2nd permanent molar with a 2mm exposure on a 12 year old patient be treated?
a. Apexification
b. DPC
c. IPC
d. Extract
e. Apexogenesis
a. Apexification
NOTES:
Apexification: >2mm
Apexogenesis: <2mm
In doing vital pulpotomy on a young, immature permanent tooth, the hemorrhage after pulp amputation could not be controlled with cotton pellets even after several minutes. What is the next step in completing this treatment?
a. Control the hemorrhage with hemostatic agents
b. Apply formocresol with cotton pellets at the amputation site
c. Perform the amputation at a more apical level
d. Stop the procedure and close the tooth with an interim restoration
c. Perform the amputation at a more apical level
With a mechanically exposed pulp, the best prognosis is offered by:
a. Pulpotomy
b. Direct pulp capping
c. Indirect pulp cap
d. Pulpectomy and root canal treatment
e. Resection
d. Pulpectomy and root canal treatment
The absence of which layer of dentin predisposes to internal resorption by cells present in the pulp?
a. Mantle dentin
b. Circumpulpal dentin
c. Predentin
d. Secondary dentin
e. Tertiary dentin
c. Predentin
The desired response after root canal treatment on a tooth with periapical lesion are the following, except
a. Deposition of apical cementum
b. Regeneration of alveolar bone
c. Apical seal
d. Regeneration of dentin
d. Regeneration of dentin❌
Extending no. 10 file with a 0.02 taper 1.0mm beyond the apical foramen will result in which of the following?
a. It opens the apical foramen to a minimum diameter of 0.12mm
b. It increases the post-operative discomfort to occlusal forces
c. It reduces the percentage of change from a no. 10 file to a no. 15 file by 50%
d. It eliminates the natural constriction of the foramen and increases the chance for an overfill.
a. It opens the apical foramen to a minimum diameter of 0.12mm
Which of the following statements regarding Hedstrom files are accurate?
a. They are manufactured by machining a round cross sectional wire
b. They are effective when used in a reaming action
c. They are safer than K-files because external signs of
stress are more visible in changes in flute design
d. They are aggressive because of negative-rake angle that is parallel to the shaft
a. They are manufactured by machining a round cross sectional wire
NOTES:
Round (rHound): Hedstrom
Square (sKware): K-files
RAKE ANGLE:
(+) Positive Rake angle: Soft surfaces
(-) Negative Rake angle: Hard surfaces
The most common means to reduce root canal microbes:
a. Intracanal medication with multiple antibiotic preparations
b. Complete debridement of the root canal
c. Intracanal medication with a non-specific drug
d. Systematic medication
b. Complete debridement of the root canal
In an infected canal, the two most commonly found organism are
a. Streptococci
b. Lactobacilli and enterococci
c. Staphylococci and enterococci
d. Enterococci and streptococci
d. Enterococci and streptococci
When is an application of heater- injected gutta percha potentially beneficial?
a. When there is an open apex
b. When the clinician cannot master lateral condensation
c. When there are aberrations of irregularities of the canal
d. When the canals are curved and small after preparation
c. When there are aberrations of irregularities of the canal
The following statement are true regarding endogram, except
a. Conventional radiography and digital radiography may both be used in producing an endogram
b. Provide information on the extent of the internal restorative lesion
c. It is used to confirm the correct working length
d. Visualization of fractures and leaking restoration is attributed to the incorporation of hypaque in the irrigating solution
c. It is used to confirm the correct working length❌
Which of the following perforations has the poorest prognosis?
a. Perforation of a furcation of molar
b. Perforation of midroot area with a small file
c. Perforation slightly apical to the epithelial attachment
d. Perforation at the apex, 1mm from its radiographic termination
a. Perforation of a furcation of molar
A size 30 root canal file is broken 1mm short of the apex in distofacial canal of maxillary 2nd molar. The instrument can neither be removed not bypassed. The remaining pulp is vital. In this situation, the dentist should complete the root canal treatment and
a. Amputate the distofacial root
b. Perform apicoectomy of the distofacial root
c. Perform an apicoectomy and a retrofill of the distofacial root
d. Place the patient on recall for further evaluation
d. Place the patient on recall for further evaluation
All of the following statements regarding adjuncts to endodontic treatment are true, except:
a. Transplanted teeth with partial root development have a better prognosis than those with developed roots
b. Orthodontic extrusion is a common indication prior to implant placement
c. Intentional replantation is a viable alternative to endodontic surgery
d. To stabilize an intentionally replanted tooth, a very effective method is to ask the patient to close in centric occlusion for the remainder of the day
c. Intentional replantation is a viable alternative to endodontic surgery❌
There is a horizontal root fracture in the middle third or the root of tooth #10 in a 11 year old patient. The tooth is mobile and vital. How should this be treated?
a. Extraction
b. Pulpectomy immediately and splint
c. Splint and observe
d. Do nothing and follow up in 10-14 days
c. Splint and observe
What is the safest recommended intracoronal bleaching chemical?
a. Hydrogen peroxide
b. Sodium perborate
c. Sodium hypochlorite
d. Carbamide peroxide
b. Sodium perborate
NOTES:
NONVITAL (Intracoronal)
Dental office: Superoxol i.e.thermocatalytic
At-home: Sodium perborate “PEYBORIT” (i.e. walking bleach technique)
VITAL (Extracoronal)
Dental office: Superoxol
At-home: CARbamide peroxide (i.e. custom tray technique)
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 indicated by the amount of remaining coronal tooth structure
c. Posts reinforce the tooth and help to prevent vertical root fracture
d. At least 4-5mm of remaining gutta percha after post space preparation is recommended
c. Posts reinforce the tooth and help to prevent vertical root fracture❌
NOTES:
Posts increases the chance of vertcial root fracture
All of the following statements regarding inflammatory resorption of teeth are true, except:
a. Cervical root resorption does not occur exclusively and the cervical area of the root
b. The usual radiographic presentation of internal resorption is fairly uniform enlargement of the root
canal space
c. “pink” tooth is considered to be pathognomonic of replacement resorption
d. The pulp plays no role in cervical root resorption
c. “pink” tooth is considered to be pathognomonic of replacement resorption❌
“pink” tooth is considered to be pathognomonic of INTERNAL resorption
While cleaning and shaping the canal, your K-file (No. 25) separate in the canal. Your first attempt to retrieve it results in a broken instrument passing through the apex. How should you manage this case now?
a. Use a smaller H file to bypass it and try retrieving it
b. Use gates gidden drills to widen the canal and then try to retrieving it
c. Raise a flap and remove the instrument surgically followed by gutta-percha the canal
d. Extract the tooth as irreparable damage has occurred to the apex
c. Raise a flap and remove the instrument surgically followed by gutta-percha the canal
Which of the following is the treatment of choice for a 7 year old child with nonvital tooth 30 with a buccal sinus tract?
a. Gutta percha filling
b. Gutta percha filling followed by root end surgery
c. Extraction
d. Apexogenesis
e. Apexification
e. Apexification
