Summer Final

Question 1

When should you restore a carious class V lesion?

a. When the tooth is Sensitive
b. When the lesion is in the esthetic zone
c. When it is an abfractive lesion
d. Always, if it is restorable

Answer 1

d. Always, if it is restorable

Question 2

2. What determines the type of preparation used for a class V lesion?
   a. Whether or not a rubber dam is used
   b. The location of the lesion
   c. The type of lesion
   d. The type of restorative material to be used

Answer 2

d. The type of restorative material to be used

Question 3

3. Studies show that occlusive forces alone will cause abfractive lesions.
   a. True
   b. False

Answer 3

b. False

Question 4

4. Which is not a reason to restore a NCCL’?
   a. When the tooth is significantly sensitive
   b. When the etiologic factors are uncontrolled
   c. When there is a threat to the strength of the tooth
   d. When the lesion is esthetically acceptable

Answer 4

d. When the lesion is esthetically acceptable

Question 5

5. All of the following are likely to indicate the need for restoration of a cervical
   notch except one. Which one is the exception?
   a. Patient age
   b. Esthetic concern
   c. Tooth is symptomatic
   d. Tooth is deeply notched axially

Answer 5

a. Patient age

Question 6

6. A cervical lesion should be restored if it is
   a. Carious
   b. Very sensitive
   c. Causing gingival inflammation
   d. All Of the above

Answer 6

All Of the above

Question 7

Which of the following terms refers to tooth structure loss in the cervical area secondary to biomechanical loading?

a. Abfraction
b. Abrasion
c. Attrition
d. Corrosion

Answer 7

a. Abfraction

Question 8

Match each condition of tooth loss with the most closely linked type of tooth loss.
A. Mechanical wear secondary to abnormal forces (i.e. tooth brushing)
B. Normal tooth wear
C. Wear secondary to chemical presence_
D. Tooth loss in the cervical area secondary to biomechanical loading

I Abfracion
II Attrition
III Corrosion
IV Abrasion

Answer 8

I Abfracion→ → → → →D
II Attrition→ → → → →B
III Corrosion→ → → → → C
IV Abrasion→ → → → → A

Question 9

From the following list, select the reasons to consider the restoration of abraded or eroded (noncarious) cervical lesions. (Choose four).
A. Caries develops in the lesion.
B. The defect is shallow and does not compromise the structural integrity of the tooth.
C. Intolerable sensitivity exists and is unresponsive to conservative desensitizing
D. The defect contributes to a phonetic problem.
E. The area is to be involved in the design of a removable partial denture.
F. Teeth are endodontically treated.
G. The patient desires an esthetic improvement.

Answer 9

A
C
E
G

Question 10

In the contemporary order of tooth preparation, which of the following principles of tooth preparation should be accomplished first?
A. Outline form
B. Convenience form
C. Caries removal
D. Resistance form

Answer 10

B. Convenience form

Question 11

In the contemporary order of tooth preparation, outline form, resistance form, and retention form become irrelevant.
True
False

Answer 11

false

Question 12

Minimally invasive dentistry is meant to halt or delay the typical restorative cycle.
True
False

Answer 12

True

Question 13

It is more important to remove the central caries prior to removal of the peripheral caries.
True
False

Answer 13

False - From Caries Removal Slide in Minimally Invasive Dentistry Lecture

Question 14

Class V amalgam restorations rarely require retention grooves, but if they are used, they are placed at the incisoaxial and gingivoaxial line angles.
Both statements are true
Both statements are false
The first statement is true, the second statement is false
The first statement is false, the second statement is true

Answer 14

Both statements are false

Question 15

All of the following are true concerning a Class V amalgam preparation, except:
A. The outline form is determined primarily by the location of the free gingival Margin
B. The mesial, distal, gingival, and incisal walls of the cavity preparation diverge Outward
C. The retention form is provided by the gingival retention groove along the gingivoaxial line angle and the incisal retention groove along the incisoaxial line angle.
D. Retention grooves for a class V amalgam are ONLY placed in inciso-oaxial line angle.

Answer 15

C. The retention form is provided by the gingival retention groove along the gingivoaxial line angle and the incisal retention groove along the incisoaxial line angle.

Question 16

16. When preparing a Class V composite preparation, you have ______ rounded internal line angles because it is _________ to compress composite into them than amalgam.
    a. More, easier
    b. Less, harder
    c. More, harder
    d. Less, easier

Answer 16

c. More, harder

Question 17

A carious lesion is usually just ____to the contact.

Answer 17

gingival

Question 18

The facial wall of a class III prep is ___ to the lingual.

Answer 18

parallel

Question 19

The axial wall of a Class III prep is ___ to the proximal surface.

Answer 19

parallel

Question 20

The bevel on all accessible margins of a Class III prep is typically ____ mm.

Answer 20

0.5

Question 21

The pull through technique of placing a composite restoration refers to pulling the matrix toward the _________ margin just before curing.

Answer 21

Facial

Question 22

When preparing a class III or IV composite tooth preparation, which of the following statements regarding placement of retention form is false?
A. Placement of retention form often involves gingival and incisal retention.
B. Placement of retention form is placed at the axiogingival line angle regardless of the depth of the axial wall.
C. Placement of retention form may be needed in large preparations.
D. Placement of retention form is usually prepared with a No. 1/4 round bur. B is obviously wrong but isn’t this false too? ½ round burr??

Answer 22

B. Placement of retention form is placed at the axiogingival line angle regardless of the depth of the axial wall.

Question 23

Demineralized tooth structure cannot remineralize.
True
False

Answer 23

false

Question 24

It is more important to decrease sucrose quantity intake than to decrease sucrose frequency intake.

a. True
b. False

Answer 24

false

Question 25

When preparing a posterior tooth for a slot preparation, one should:
A.Pay little or no attention to retentive form.
B. Primarily consider silver amalgam to be the restorative material of choice.
C. Critically examine the fissures and central groove of the tooth, and ensure no Caries.
D. Always use a three in one bonding system as the adhesive.

Answer 25

C. Critically examine the fissures and central groove of the tooth, and ensure no Caries.

Question 26

The outline form of a cavity preparation incorporates aspects of all of the following, except:
A. Depth of the caries removal.
B. Final margin of the preparation
C. Peripheral extent of the lesion.
D. Should be smooth and flowing, following the anatomy and contour of the tooth.

Answer 26

A. Depth of the caries removal.

Question 27

The advantage of using lasers to prepare a tooth to receive a composite resin restoration is that the provider can often prepare the tooth without the need of anesthesia. The other advantage is that the laser will increase the ability to bond to the tooth structure.

a. Both statements are true
b. Both statements are false
c. The first statement is true, but the second statement is false
d. The first statement is false, but the second statement is true

Answer 27

ASD

Question 28

Bacterial plaque and biofilm are synonymous terms.
True
False

Answer 28

True

Question 29

Where are the three sites, on the tooth, where carious lesions most commonly begin?
________________________
______________
__

Answer 29

Pits & fissures
Just gingival to the contact
Smooth surfaces adjacent to the gingiva

Question 30

For each of the above sites, which specific procedure is best for preventing carious lesions from forming?
_____________________________
____________________________
_________________________

Answer 30

Sealants
Floss well
Toothbrushing

Question 31

The principal, initial buffer of resting saliva is:

a. Ca++
b. HCO3
c. H2PO4
d. H20

Answer 31

H2PO4

Question 32

Salivary flow increases times when stimulated (chewing), compared to the resting salivary flow rate.

a. 2-3
b. 4-5
c. 6-7
d. 10

Answer 32

4-5

Question 33

What is the chemical formula for Hydroxyapatite?

Answer 33

Ca10(PO4)6(OH)2 10Ca2+ + 6PO43- + 2 OH-

Question 34

The direct causes of carious lesions commonly forming in similar sites on the tooth are influenced by all of the following, except:
A. Hydroxyl ions, left unbuffered, percolate into the enamel laminar pores.
B. Biofilm is markedly thicker in some locations than others.
C. Demineralization outweighs remineralization at the ionic level.
D. Multiple biofilm ecosystems in the same mouth.

Answer 34

A. Hydroxyl ions, left unbuffered, percolate into the enamel laminar pores.

Question 35

Enamel is formed by the precipitation of highly-substituted apatite into a matrix of proteins that have been secreted by ameloblasts. Which of the following statements most accurately describes what then happens to the matrix protein?
A. The protein matrix remains between the apatite crystals, adding to the flexibility of the enamel and giving enamel its unique, striated surface appearance.
B. The protein matrix hardens slowly during the years after the tooth erupts into the mouth, resulting in enamel maturation and increased overall tooth strength.
C. Most of the protein matrix dissolves as the apatite crystals grow, resulting in a tissue that is comprised almost entirely of apatite and a small amount of extracellular fluid.
D. The protein matrix remains in place, guiding the replacement over time of hydroxyl ions with fluoride and phosphate with carbonate, decreasing enamel solubility and increasing strength.

Answer 35

C. Most of the protein matrix dissolves as the apatite crystals grow, resulting in a tissue that is comprised almost entirely of apatite and a small amount of extracellular fluid.

Question 36

The mineral of both enamel and dentine is highly-substituted apatite. Which of the following statements most accurately describes the beneficial effects of partial substitution of hydroxyl ion with fluoride at an optimal level?
A. Fluoride, by replacing some hydroxyl ions, results in a crystal structure that is less likely to dissolve in acid conditions, and more likely to re-grow in neutral condition
B. Fluoride, by replacing some hydroxyl ions, results in a crystal structure that has a higher tensile strength at the same time as being more flexible, and is therefore less liable to fracture under load
C. Fluoride, by replacing some hydroxyl ions, results in a crystal structure that is more translucent both under normal daylight conditions and in artificial light, therefore improving tooth esthetics.
D. Fluoride, by replacing some hydroxyl ions, results in a crystal structure with optimal piezo-electric properties, therefore promoting both improved tooth alignment within each arch and optimal intercuspation between arches.

Answer 36

A. Fluoride, by replacing some hydroxyl ions, results in a crystal structure that is less likely to dissolve in acid conditions, and more likely to re-grow in neutral condition

Question 37

Both the enamel surface and the surface of dentine, if the latter is exposed to saliva, become progressively less soluble over time due to what is termed ‘maturation.’ Which of the following statements best describes maturation?
A. Calcium within apatite crystals near the surface is progressively replaced with strontium, and phosphate with carbonate, resulting in lowered solubility of both enamel and dentine.
B. Calcium within saliva increasingly cross-links enamel matrix protein or dentinal collagen near the surface, resulting in decreased solubility and increase fracture resistance.
C. Salivary lysozyme degrades either enamel matrix protein or the collagen of exposed dentine, allowing additional calcification of the exposed surface and therefore decreased solubility and increased strength.
D. Carbonate within apatite is progressively replaced by phosphate, and hydroxyl ion by fluoride, in apatite crystals near the exposed surface resulting a lowered solubility of both enamel and dentine.

Answer 37

D. Carbonate within apatite is progressively replaced by phosphate, and hydroxyl ion by fluoride, in apatite crystals near the exposed surface resulting a lowered solubility of both enamel and dentine.

Question 38

Dental biofilm forms on tooth surfaces, and can be considered to have evolved, as humans have evolved, to be a benign and even beneficial part of the oral ecosystem. In hunter-gatherer populations what is the most probable beneficial effect of biofilm?
A. Biofilm has the capacity to prevent colonization of the tooth surface with acidogenic bacteria that have been transmitted from other individuals
B. Biofilm has the capacity to protect tooth surfaces against dissolution by occasional contact with acid foods
C. Biofilm has the capacity to prevent small fractures in the enamel through mechanical reinforcement
D. Biofilm has the capacity to prevent occlusal wear by abrasive foods through increased lubrication during mastication

Answer 38

B. Biofilm has the capacity to protect tooth surfaces against dissolution by occasional contact with acid foods

Question 39

Dental caries was, and is, rare in hunter-gatherer societies, but became increasingly common in industrialized and other urban and rural human societies during recent centuries. Which of the following is the most likely reason for this increase?
A. The depletion of natural sources of fluoride in drinking water, as industrialization developed, lead to a weakening of tooth structure through effects on apatite chemistry
B. The increased prevalence of dairy foods in the human diet lead to increases in Lactobacilli in biofilm, leading to increased acid production and decreased acid buffering
C. The increase in the availability of sucrose and other simple sugars in the human diet lead to a change in both the oral microflora and the acidity of biofilm
D. The increased use of prescription and non-prescription drugs lead to a change in salivary flow and constituents, leading to increased tooth solubility

Answer 39

C. The increase in the availability of sucrose and other simple sugars in the human diet lead to a change in both the oral microflora and the acidity of biofilm

Question 40

40. Dental corrosion differs from dental caries in several key respects. Which of the following statements best describes these differences?
    A. Corrosion can be reversed by treatment of the tooth surface with matrix proteins and fluoride; caries cannot be reversed and must be restored with filling materials.
    B. Caries softens the tooth surface, making it more liable to wear away during tooth-brushing or chewing hard foods; corrosion occurs most commonly in pits, fissures and other surface defects.
    C. Caries can be treated by substituting drugs that increase salivary flow with those that decrease salivary flow; corrosion can be treated by substituting drugs that decrease salivary flow with those that increase salivary flow.
    D. Corrosion is caused by acids in foods and drinks, or by gastric acid; caries is caused by acids produced by bacterial metabolism of simple sugars within

Answer 40

D. Corrosion is caused by acids in foods and drinks, or by gastric acid; caries is caused by acids produced by bacterial metabolism of simple sugars within

Question 41

“Toothbrush abrasion’ is most probably due to a combination of factors. Which of the following statements describes these factors best?
A. Hard toothbrush bristles, aided by detergents in tooth-paste, can dislodge surface crystallites of enamel if they have been weakened by exposure to soft foods.
B. Abrasive particles in toothpaste are usually softer than the surface of normal enamel, but are harder than the surface of acid-softened enamel.
C. Excessive brushing due to fear of periodontal disease is most commonly associated with excessive wear of tooth surfaces.
D. Brushing using small, circular motions of the brush head is more likely to wear away tooth enamel than is brushing that moves the brush head backwards and forwards in the mouth.

Answer 41

B. Abrasive particles in toothpaste are usually softer than the surface of normal enamel, but are harder than the surface of acid-softened enamel.

Question 42

42. Where, in relation to the contact area between two teeth, is a proximal carious lesion most likely to first develop?
    A. At the contact area
    B. At and immediately below the contact area
    C. At and immediately above the contact area
    D. 1.0 to 1.5 mm below the contact area

Answer 42

D. 1.0 to 1.5 mm below the contact area

Question 43

43. You suspect that there is an early carious lesion developing on the root surface of an upper bicuspid. How can you best check this over time?
    A.Look carefully for colour change on the surface
    B.Check the surface hardness with a sharp probe
    C. Check the surface hardness with a blunt instrument
    D. Take a radiograph and check for a radiolucency

Answer 43

C. Check the surface hardness with a blunt instrument

Question 44

Acid-accelerated wear is now quite common in human populations. Why is this likely to be so?
A. Modern lifestyles and drug use lead to increased gastric acid regurgitation in most individuals, which has changed the demineralization-remineralization balance, favoring demineralization
B. The decreased concentration of fluoride in community water supplies since the widespread introduction of fluoride-containing toothpaste has resulted in softer dental enamel, favoring demineralization
C. Increased consumption of carbonated beverages, fruit juices and other acidic drinks has changed the remineralization-demineralization balance in many individuals, favoring demineralization
D. Modern lifestyles and increased drug use has lead to increased salivary flow rates in many individuals, which has changed the demineralization/remineralization balance, favoring demineralization

Answer 44

C. Increased consumption of carbonated beverages, fruit juices and other acidic drinks has changed the remineralization-demineralization balance in many individuals, favoring demineralization

Question 45

In assessing the risk for ongoing corrosion-related tooth structure loss several factors need to be considered. Which of the following is least likely to be relevant?
A. Salivary flow rate.
B. Salivary pH. 
C. Salivary buffering capacity. 
D. Dietary protein intake.
E. Frequency of eating and drinking.

Answer 45

D. Dietary protein intake.

Question 46

Sensitivity of teeth to cold is a good indicator both of active corrosion by acids and of the presence of exposed dentine. Why is this so?
A. Because acids diffuse through exposed dentine to induce pulpal inflammation, which increases sensitivity of pulpal nerve endings.
B. Because acids coagulate the proteins inside dentinal tubules, thereby increasing the sensitivity of pulpal nerve endings.
C. Because acids prevent the precipitation of pellicle and smear layer which would otherwise close open dentinal tubules.
D. Because acids prevent the mineralization of pellicle and smear layer, which would otherwise close open dentinal tubules.

Answer 46

A. Because acids diffuse through exposed dentine to induce pulpal inflammation, which increases sensitivity of pulpal nerve endings.

Question 47

There are characteristic differences in patterns of tooth structure loss through corrosion between intrinsic gastric acids and extrinsic food- or drink-derived acids. Which of the following statements best describes these differences?
A.Intrinsic acids tend to result in the loss of the lingual surfaces of upper teeth, while extrinsic acids tend to result in the loss of the occlusal surfaces of lower teeth.
B. Intrinsic acids tend to result in the loss of the lingual surfaces of lower teeth, while extrinsic acids tend to result in the loss of the occlusal surfaces of upper teeth.
C. Intrinsic acids tend to result in the loss of the occlusal surfaces of upper teeth, while extrinsic acids tend to result in the loss of the facial surfaces of lower teeth.
D. Intrinsic acids tend to result in the loss of the occlusal surfaces of upper teeth, while extrinsic acids tend to result in the loss of the lingual surfaces of lower teeth

Answer 47

A.Intrinsic acids tend to result in the loss of the lingual surfaces of upper teeth, while extrinsic acids tend to result in the loss of the occlusal surfaces of lower teeth.

Question 48

Wedge-shaped defects in cervical areas, commonly termed ‘toothbrush abrasion’ defects, are probably due to a combination of factors. Which of the following is least likely to be implicated in the development of such defects?
A. Brushing teeth thoroughly before the first meal of the day.
B. Brushing teeth thoroughly after each main meal.
C. Frequent consumption of acid-containing foods or drinks.
D. Heavy occlusal load on an adjacent cusp.

Answer 48

A. Brushing teeth thoroughly before the first meal of the day.

Question 49

In diagnosing the problem of ongoing, rapid occlusal wear in an individual showing significant tooth structure loss, which of the following factors is most likely to be implicated?
A. Frequent use of tobacco products, including chewing tobacco
B. Frequent consumption of hard-to-chew dried meat snacks
C. Frequent consumption of acid-containing energy or soft drinks
D. Frequent musical performance with wood-wind musical instruments

Answer 49

C. Frequent consumption of acid-containing energy or soft drinks

Question 50

The dentine and pulp are closely associated with each other physically. Which of the following statements best describes their relationship in biological terms?
A. The dentine is hard tissue, the pulp is soft tissue; they are separate and distinct biologically because of protective responses provided by the odontoblast layer.
B. The relationship between dentine and pulp is intimate biologically; physical, chemical and bacterial insults to dentine also affect the pulp.
C. Dentine provides an impermeable, hard and thermally insulating barrier that protects the pulp from external trauma and insult.
D. All insults to dentine are immediately transmitted to the pulp via nerve fibers, veins and lymph vessels within the odontoblastic tubule.

Answer 50

B. The relationship between dentine and pulp is intimate biologically; physical, chemical and bacterial insults to dentine also affect the pulp.

Question 51

The dental pulp may be damaged by an advancing carious lesion. Which of the following is the most probable combination of symptoms as the lesion advances?
A. Increased sensitivity to hot, cold and osmotic change when pioneer bacteria have advanced into dentine.
B. Increased sensitivity to hot, cold and osmotic change when pioneer bacteria first reach the dentino-enamel junction.
C. Increased sensitivity to biting pressure because of changes in the periodontal ligament in response to bacterial toxins.
D. Increased sensitivity to hot, cold and osmotic change when pioneer bacteria invade the pulp space.

Answer 51

A. Increased sensitivity to hot, cold and osmotic change when pioneer bacteria have advanced into dentine.

Question 52

The pulp may be damaged by chemicals released from some restorative materials that are placed into contact with dentine. Dentine provides some level of protection against this. Which of the following is most likely to reduce this protective effect?

a. Exothermic reactions during the setting of restorative materials, which liquefy the content of odontoblastic tubules.
b. Excessive exposure to intense light during curing of restorative materials, which displaces tubule contents through thermal change.
c. Heat generation during tooth cutting, which liquefies the tubule contents and displaces them, preventing chemical buffering.
d. When there is only a thin layer of dentine remaining, because both tubule diameter and the number of tubules in a given area increases close to the pulp.

Answer 52

d. When there is only a thin layer of dentine remaining, because both tubule diameter and the number of tubules in a given area increases close to the pulp.

Question 53

The pulp may be damaged by bacterial microleakage around and beneath restorative materials. Which of the following is most likely to provide the best, long-term protection against bacterial microleakage?
A. The use of fluoride-based remineralization solution prior to restoration placement, followed by acid treatment and a resin-based restorative material.
B. The use of an ion exchange adhesive material as the restoration itself or as a base, followed by an appropriate restorative material.
C. The use of a light-activated resin-based restorative material following acid treatment of dentine, in combination with daily use ofan antibacterial mouth rinse.
D. The use of a copal varnish, followed by direct placement of dental amalgam into the defect to be restored.

Answer 53

B. The use of an ion exchange adhesive material as the restoration itself or as a base, followed by an appropriate restorative material.

Question 54

The pulp may be damaged by mechanical and thermal trauma during tooth cutting. In a tooth that has not previously suffered major trauma, which of the following is most likely to be the tissue response to tooth cutting?
A. Transient acute inflammation in the days immediately following tooth cutting, then recovery and healing over several further days.
B. Persistent acute inflammation for several weeks following tooth cutting,followed by chronic inflammation leading to pulp death up to a year later.
C. Chronic inflammation during the months following tooth cutting, followed by progressive decline and death at any time up to five years later.
D. Transient acute inflammation immediately after tooth cutting, followed by chronic inflammation and progressive decline and death at any time up to ten years later

Answer 54

A. Transient acute inflammation in the days immediately following tooth cutting, then recovery and healing over several further days.

Question 55

Damage to the pulp can result in inflammation and pain that may or may not resolve. Patients experiencing pulpal symptoms will want to be advised about what is likely to happen next. Reversible inflammation of the pulp, that is, inflammation that is likely to resolve in the absence of further trauma, is best confirmed in which of the following ways?
A. Reversible inflammation of the pulp is best confirmed radiographically because it causes increased radiolucency at the root apex.
b. Reversible inflammation of the pulp is best confirmed by percussion testing because it causes sympathetic inflammation of the periodontal ligament
c. Reversible inflammation of the pulp is best confirmed from the patient’s symptoms because it causes increased sensitivity to temperature change.
d. Reversible inflammation of the pulp is best confirmed by thermal and percussion testing because it causes increased sensitivity of both pulpal and periodontal nerve endings.

Answer 55

d. Reversible inflammation of the pulp is best confirmed by thermal and percussion testing because it causes increased sensitivity of both pulpal and periodontal nerve endings.