Challenge

Richard E. Walton, William T. Johnson, Lisa R. Wilcox

CHAPTER 1:
1. a. b. c. d.

DIAGNOSTIC PROCEDURES

Anesthetic testing is most effective in localizing pain to which of the following? Specific tooth Mandible or maxilla Across the midline of the face Posterior tooth

2. Areas of rarefaction are evident on radiographic examination in which of the following? a. b. c. d. 3. a. b. c. d. When the tooth is responsive to cold When the tooth is responsive to percussion When a tooth fracture has been identified When the cortical layer of bone has been eroded Irreversible pulpitis is often defined by which of the following? Moderate response to percussion Painful, lingering response to cold Short, painful response to cold Short, painful response to heat

4. The majority of patients with symptoms of severe odontogenic pain have a diagnosis of which of the following? a. b. Periodontal abscess Irreversible pulpitis

c. d.

Acute apical periodontitis Acute apical abscess

5. Medical history of coronary heart disease is significant for which of the following reasons? a. b. c. d. 6. a. b. c. d. 7. a. b. c. d. It contraindicates endodontic treatment. Many heart medications impact dental treatment. It indicates the need for premedication with antibiotics. It contraindicates local anesthetic with epinephrine. The best approach for diagnosis of odontogenic pain is which of the following? Radiographic examination Percussion Visual examination A step-by-step, sequenced examination and testing approach Of the following, which is the most likely to have referred pain? Irreversible pulpitis Reversible pulpitis Acute apical periodontitis Phoenix abscess

8. A sinus tract that drains out on the face (through skin) is mostly likely from which of the following? a. b. c. d. Nonodontogenic pathosis A periodontal abscess Periradicular (i.e., endodontic) pathosis Pericoronitis of a mandibular, third molar

9. a. b. c. d. 10. a. b. c. d. 11. a. b. c. d. e.

Which of the following statements regarding a test cavity is accurate? It is the first test in diagnostic sequence. It often results in a dull-pain response. It is used when all other test findings are equivocal. It should be performed with local anesthetic. Percussion of a tooth is a test for which of the following? Pulpal inflammation Pulpal necrosis Acute periradicular inflammation Chronic periradicular inflammation Pulp stones are consistent indicators of which of the following? Periodontal inflammation impacting the pulp Pulpal inflammation Older patient Pulp that has been injured in the past but has recovered None of the above

12. Radiographically, which of the following statements regarding acute apical abscess is most accurate? a. b. c. d. 13. It is generally of larger size than other lesions. It has more diffuse margins than other lesions. It often contains radiopacities (i.e., calcification). It may not be evident. In which of the following may a false-negative response to the pulp tester occur?

and nature of symptoms 17. c. Pulp testing and radiographic appearance Pulp testing and nature of symptoms Radiographic appearance and nature of symptoms Pulp testing. radiographic appearance. The abrupt change (arrow) in radiographic appearance in the following illustration probably indicates which of the following? . c. d. The acute apical abscess is best differentiated from the acute apical periodontitis by which of the following? a.a. b. d. Pulp testing Radiographic appearance Location of swelling Probing patterns 15. b. c. Primarily in anterior teeth In a patient with a history of trauma Most often in teenagers In the presence of periodontal disease 14. b. b. Chronic apical periodontitis is best differentiated from acute apical periodontitis by which of the following? a. Pulp testing Radiographic appearance Presence of swelling Degree of mobility 16. d. The lateral periodontal abscess is best differentiated from the acute apical abscess by which of the following? a. c. d.

throbbing pain in the mandibular right molar region. Calcific metamorphosis A dense accumulation of diffuse calcification An increased density of overlying bone A bifurcation into two canals 18. The pain is exaggerated by cold.a. Which tooth and which tissue is likely the source of pain? . The patient in the following illustration reports severe. b. d. c.

First molar and pulp First molar and periapex Second molar and pulp Second molar and periapex 19. Bathing a tooth in ice water Dicholorodifluoromethane (DDM) CO2 snow (i. which is the least effective in producing a response? a. a. b. b. d. dry ice) Ethyl chloride Which of the following statements regarding internal resorption is accurate? The condition is usually accompanied by symptoms.e. 20.a. c. . Of the following cold-testing agents. c. d..

momentary pain. e. Painful stimulus with cold Painful stimulus with heat Painful stimulus on biting Increasing pain Pain affecting patient's lifestyle 3. It is continuous. b. c. It can be determined by the level of pain a patient experiences. intensity) of pain is to determine which of the following? a. It can be correlated best when a diagnosis of irreversible pulpitis is established. d.b. d. C fibers are low-threshold. In describing the sensory innervation of the dental pulp. b. which of the following statements is accurate? a. CHAPTER 2: OROFACIAL DENTAL PAIN EMERGENCIES: ENDODONTIC DIAGNOSES AND MANAGEMENT 1. It is usually visible in its early stages. c. c. A-delta fibers are high-threshold. It does not correlate well with the level of pain a patient perceives. It is treated only if time shows it to be progressive. It is self-limiting. d. A key measure as to the degree (i. Which of the following statements regarding the degree of pulp pathosis is accurate? a. unmyelinated fibers that produce pain in response to inflammatory mediators. .e. b. 2.. It can be related to the level of response of the electrical pulp tester. e. myelinated fibers that transmit sharp.

and is induced by a trigger point. lasts for several hours. such as bending over and when jogging. 7. a. Myocardial infarction Maxillary sinusitis Atypical facial pain Irreversible pulpitis Which of the following most likely indicates pain that is not of pulpal origin? Unilateral pain that radiates over the face to the ear . The pain is characteristically sharp. The pain mimics pain of pulpal origin in that thermal sensitivity and tingling is often encountered just before an attack. The most likely diagnosis is which of the following? a. b. Each of the following statements is correct regarding trigeminal neuralgia. A patient complains of dull and constant pain that lasts 3 days on the left side of the face. c. The patient notes the pain increases on positional changes.c. 4. well-localized pain to cold testing is conducted by both A-delta and Cfiber stimulation. d. d. Which is the exception? a. 6. c. except for one. The sharp. d. a. The pain occurs unilaterally but often involves more than one division of the trigeminal nerve. c. The domination of C-fiber stimulation produces pain that is not well localized. b. Which of the following induces hyperalgesia in local-nerve fibers? Prostaglandin and serotonin Lysosomal enzymes Calcitonin gene-related peptide Substance P 5. The onset occurs in midlife and is unilateral in location. b. d.

Pulp testing indicates all teeth in the quadrant are responsive to electrical-pulp testing. For medical and legal protection and to determine if the medical status will affect the prognosis for root canal treatment 9. 30) when eating ice cream and drinking iced tea. The pulp of more than one tooth will be involved and the pathosis produce a synergistic-hyperalgesia response within the central nervous system (CNS). A complete medical history is essential when treating an emergency dental patient for which of the following reasons? a. . d. c. The cause is most likely nonodontogenic in origin. b. The pain is most likely periradicular in origin and likely to persist even when the necrotic pulp is removed. The patient should be dismissed and asked to return when the symptoms increase and the pain to cold becomes prolonged. Pain that has paresthesia as a component Pain that is described as throbbing and intermittent Pain that is increased during mastication 8. When a patient complains of severe pain that cannot be localized: a. right first molar (tooth no. c. Application of cold fails to reproduce the symptoms. 10. To protect the health care team from potential blood-borne pathogens and other infectious diseases the patient may have d. To identify patients with conditions that would contraindicate root canal treatment b. Treatment procedures should be delayed and the condition managed with analgesic medications. Clinical examination reveals MOD amalgam restorations in all posterior teeth. e. To determine conditions that might require modifications in the approach to treatment c. The margins appear intact and no cracks or caries is detected.b. d. Which of the following actions should be taken? a. A patient's chief complaint is severe pain from the mandibular. Selective administration of local anesthesia can lead to a definitive diagnosis.

Which of the following test or actions is most appropriate based on the chief complaint? a. Remove the restoration in tooth no. There will be a decrease in pulpal blood flow when anesthetic agents with a vasoconstrictor are used. place a sedative restoration. The periodontal-ligament injection is contraindicated when block or infiltration injections are not effective. The clinician should obtain a new preoperative radiograph during which of the following situations? a. d. anti-inflammatory agent. A practitioner refers a patient for root canal treatment. . Periapical radiographs of the posterior teeth Examination with transillumination Electrical pulp testing Percussion and palpation testing 12. 2 and 3 exhibit occlusal amalgams. b. left. posterior quadrant that subsides within seconds of removal of the stimulus. Clinical examination reveals teeth nos. Initiate root canal treatment by performing a pulpotomy or pulpectomy on tooth no. Place a rubber dam on individual teeth and apply ice water. b. A patient complains of pain to biting pressure and sensitivity to cold in the maxillary. When the film from the referring dentist is more than 1 month old In cases when an emergency treatment procedure was performed c. b. c. Immediately before examining the patient 13. and prescribe a nonsteroidal. c. d. Which of the following is true regarding the periodontal ligament injection when treating a tooth with a pulpal diagnosis of reversible pulpitis? a. 11.b. 30. 30. c. Damage to the supporting structures can cause continued symptoms. When the film from the referring dentist reveals a radiolucent area that has a "hanging drop" appearance d.

a bonded amalgam placed. A radiograph will likely reveal a radiolucent area associated with the mesial root. d. first molar (tooth no. A patient describes pain on chewing and sensitivity to cold that goes away immediately with removal of the stimulus. The periodontal ligament injection can be used as primary anesthesia in teeth that exhibit single roots. It is the recommended method of managing the emergency patient. second molar (tooth no. c. left. and no restorations are present. 15. Which of the following statements regarding leaving a tooth open for drainage in cases of an acute. Periodontal probing depths are 3 mm or less. 18) exhibits a mesial. and the tooth should be prepared and restored with a MO-bonded amalgam. It is appropriate. left. The pulpal diagnosis is irreversible pulpitis.d. e. occlusal crack. Pulpotomy Partial pulpectomy Pulpectomy Analgesic agents Analgesic and antibiotic agents 16. apical abscess is accurate? a. . The prognosis for the tooth is unfavorable. The mandibular. b. The pulpal diagnosis is normal pulp. regardless of the number of canals. b. Which of the following statements is correct? a. The tooth is caries free. b. It may adversely affect the outcome of treatment. and the tooth should be restored with a crown. Treatment of severe. and a crown fabricated. e. c. throbbing pain associated with the maxillary. and root canal treatment should be performed. providing the patient is also placed on an antibiotic. c. 14) is best managed by which of the following? a. The pulpal diagnosis is reversible pulpitis. d. 14.

Flare-ups during root canal treatment are more commonly associated with which of the following? a. Primarily only when there is diffuse swelling When there is swelling to any degree (i. The placement of a drain is necessary for 24 to 48 hours. They are not indicated. d. The incision should be placed vertically and go directly to bone. localized or diffuse) 2 to 3 days before beginning treatment of the tooth Only if there is purulence draining from an incision 18. b. Which of the following statements regarding incision and drainage of an indurated swelling is accurate? a. The incision should be horizontal in the attached gingiva at the base of the swelling. antibiotic administration is indicated in which of the following? a. blunt dissection is not necessary.. c. It should be considered in addition to soft tissue incision and drainage. d. c. Which of the following statements is correct regarding performing incision and drainage? a. If drainage occurs with the initial incision.e. fluctuant swelling over the facial alveolar process of the maxillary. 17. A 21-year-old model requires emergency treatment of a soft. They provide a purulent exudate for culture and sensitivity testing. Teeth with vital-pulp tissue when compared to teeth with pulp necrosis . because antibiotic treatment will result in resolution of the lesion. With acute. The swelling is visible because of a high-lip line. They should be delayed until it becomes fluctuant. lateral incisor (tooth no.d. b. left. apical abscess. 20. 10). d. 19. They can reduce pain caused by tissue distention. b. c.

Of the following reasons. e. Teeth with apical radiolucent areas when compared to teeth with normal periapical tissues c. A 22-year-old. Clinical examination reveals swelling located on the alveolar process in the area of the incisor teeth. He notes that his dentist has been treating teeth nos. d. white man requires root canal treatment for pain and swelling in the mandibular. Between multiple-visit endodontic procedures to prevent the occurrence of a flare-up 22. To release exudate b. cortical plate advocated? a. anterior area (see illustration). 25 and 26 are tender to palpation and percussion. With single-visit endodontic procedures Symptomatic teeth exhibiting pulp necrosis Multirooted teeth 21. when is apical trephination through the faciobuccal. The clinician should perform which of the following? . Teeth nos.b. For treatment of severe. As a routine procedure for relief of pain when the offending tooth has been obturated c. 25 and 26 for several months and that swelling has occurred after each visit for cleaning and shaping. recalcitrant pain d.

a. and leave the teeth open for drainage e. 25 and 26. Perform incision and drainage and prescribe an antibiotic for supportive care . Diagnostic tests on the other incisor b. and perform incision and drainage d. 25 and 26. and place calcium hydroxide as an antimicrobial intracanal medicament c. 25 and 26. débride these teeth. Open teeth nos. débride these teeth. Open teeth nos. débride these teeth. Open teeth nos.

a. thalamus. nonrestored premolar so that dentin is exposed. d. except for one. d. b. e. Peripheral pain impulses in the dental pulp are transmitted centrally via which of the following pathways? a. the patient experiences brief. thalamus. trigeminal ganglion. Peripheral nerve. mesencephalic nucleus. Peripheral nerve. b. b. Normal and uninflamed Reversibly inflamed Irreversibly inflamed Innervated only by A-delta fibers Corticosteroids have their major pharmacologic effect as which of the following? Antimicrobial agent Analgesic Antiinflammatory agent Agent to reduce swelling Agent to prevent spread of infection CHAPTER 3: NONODONTOGENIC OROFACIAL PAIN AND ENDODONTICS: PAIN DISORDERS INVOLVING THE JAWS THAT SIMULATE ODONTALGIA 1. Each of the following statements regarding trigeminal neuralgia is correct. 24. When this exposed dentin is contacted by cold fluids. thalamus. cortex c. cortex 2. cortex d. Peripheral nerve. trigeminal ganglion. Which is the exception? . c. c.23. trigeminal nucleus. trigeminal ganglion. trigeminal ganglion. trigeminal nucleus. cortex Peripheral nerve. Which of the following pulp status is likely? a. mesencephalic nucleus. trigeminal nucleus. sharp pain. A cusp fractures in a noncarious.

b. spontaneous pain during his waking hours for the past 1 to 2 weeks. Cluster headache Myalgia . b. c. except for one. The empiric evidence suggests vascular compression of the trigeminal ganglion as a cause of trigeminal neuralgia. e. Which of the following statements regarding cluster headaches is correct? a. The pain involves all three divisions of the trigeminal nerve equally. Each of the following has been shown to benefit patients with cluster headaches. There is an electrical quality of the pain. The pain is usually unilateral and involves the maxilla. 4. The patient relates sporadic. Nifedipine Prednisone in combination with lithium Hyperbaric oxygen Alcohol Sumatriptin 5. The pain is severe. causing pain. e. and retro-orbital area. d.a. sinus. often shooting into the bone and teeth. posterior quadrant. Which is the exception? a. b. c. b. c.e. The standard medical therapy is carbamazepine (i. which is severe and lasts for 30 to 45 minutes. A 57-year-old man complains of pain in the mandibular. Upon examination no dental cause can be identified. 3. can occur at anytime. Vessels that encircle nociceptive fibers compress the fibers during vasoconstriction. d. left. d. Cluster headaches frequently involve females between 40 and 60 years of age. Tegretol). Which of the following would be the most likely cause of the pain? a. The pain..

b. Pain is often referred to all teeth in the maxillary. Each of the following statements regarding maxillary sinusitis is correct. An allergen-induced inflammation of the sinus is an immediate-type hypersensitivity reaction mediated by IgE. b. Trigger points found in the superficial aspect of the masseter may refer pain the maxillary teeth and mandibular teeth. c. Which of the following statements regarding myofascial pain is correct? a. d. e. The Waters view radiograph may be of diagnostic value in demonstrating fluid. except for one. . Which of the following statements regarding sialolithiasis is correct? a. so patient's exhibiting this disorder should be referred to a physician for evaluation. posterior quadrant with percussion sensitivity being a common finding. d. e. Treatment of the sinusitis requires referral to an otolaryngologist and antibiotic therapy.c. posterior teeth because sialolithiasis is most frequently noted in parotid duct. Trigger points have been noted only in the masseter muscles and temporalis muscles. Which is the exception? a. The sialolith develops in patients that often exhibit increased levels of serum calcium. d. 7. An occlusal radiograph provides more diagnostic information than a panoramic film. Sialolithiasis has been associated with kidney stones and gallbladder stones. b. Cardiogenic jaw pain Temporal arteritis Otitis media 6. c. Pain may mimic pulpal pain in the maxillary. posterior area. 8. The maxillary sinusitis may be initiated by a tooth with a necrotic pulp located in the maxillary.

b. 11. d. Although paresthesia is an ominous symptom. . d. d. d. Initial treatment consists of finding occlusal discrepancies and performing an equilibration. e. Meniscus displacement and intraarticular adhesions are the cause. b. It may be a form of deafferentation pain. and there is no identifiable cause. a. The pain has no specific symptoms that lead to a diagnosis. c. Which of the following statements regarding atypical orofacial pain is false? The pain is often chronic. motor deficits are rare. Patient's with atypical orofacial pain complain of pain in other areas of the body. c. except for one. It has been shown to have a psychopathologic component. Metastatic lesions may develop from the lung. and colon. Neuralgia-inducing cavitational osteonecrosis (NICO) is distinct from atypical orofacial-pain disorders. a. 9. b. Which is the exception? a. breast. difficult to localize. Each of the following statements regarding malignant lesions of the head and neck is correct. and corrective surgery provides long-term success.c. Multiple myeloma may produce pain in the affected bone. Radiolucent areas detected on radiographs are frequently poorly marginated. c. Patient's with atypical orofacial pain may give a history of having endodontic treatment that did not alleviate the pain. It has been associated with tooth extraction but does not occur with extirpation of the pulp. 10. Which of the following statements accurately describe phantom tooth pain? It occurs in 10% of the patients having endodontic treatment.

d. All of the above statements are accurate.CHAPTER 4: PLANNING CASE SELECTION AND TREATMENT 1. 3. b. Which of the following accurately describes external resorptions? They are untreatable. . They appear to be superimposed over the root canal. b. b. c. d. Antibiotic prophylaxis is suggested for patients with a history of which of the following? a. d. Patient has an implanted pacemaker. a. c. They can only be distinguished surgically from internal resorptions. c. Which of the following statements regarding the use of electronic-apex locators is accurate? a. Patient has had a heart attack within the last 6 months. Anatomic structures overlay the root apex. 4. a. Patient has had numerous opportunistic infections secondary to HIV infection. c. b. 2. The patient is physically impaired. A pregnant patient wishes to avoid exposure to x-rays. Coronary bypass surgery Atrial fibrillation Artificial heart valve replacement Myocardial infarction Rheumatic fever Elective endodontic treatment is contraindicated in which of the following? Patient is a borderline diabetic. e.

b. b.d. The general dentist is not sure what procedures are indicated. Single visit is equivalent in outcome to multiple visits (to complete RCT) with what situation? a. c. c. The general dentist does not have the indicated training and experience. 8. It is best performed in association with trephination or root end surgery. b. 5. Referral of difficult cases is indicated in which of the following? The general dentist does not have the indicated equipment. d. c. All of the above 6. a. c. It is equally successful as multiple-appointment root canal treatment. All of the above statements are accurate. a. Which of the following statements regarding one-appointment root canal treatment is accurate? a. d. All of the above . There has been coronal leakage. Vital pulp with acute pain Necrotic pulp with acute pain Necrotic pulp without pain Necrotic pulp with a draining sinus tract Root end surgery is indicated for endodontic failure in which of the following? The dentist suspects a missed canal. It may predispose the patient to postoperative flare-ups. A cast post and core and a well-fitting crown are present. They always require root canal treatment. b. d. 7. d.

periradicular. probing defects) Small. lowersuccess rate) is which of the following? a. The pulp is vital. The pulp is necrotic with a periradicular lesion present. c. The pulp is necrotic with no periradicular lesion... c. b.9. radiolucent lesion When is endodontic treatment is contraindicated? The patient has no motivation to maintain the tooth. e. d. The canal appears to be calcified. d. 11. A preoperative finding that predisposes to a decreased prognosis (i. c. d. e. the safest period to provide dental care is during which month? First Second and third Fourth to the sixth Seventh and eighth There is no period that is most safe. a. 10. . b. 12. b. Pain as a symptom Interappointment flare-up Class III mobility and loss of bone support (i. The tooth is in hyperocclusion. a. d. Treatment is in an elderly patient. b. A large periapical lesion is present. c. With pregnancy. The tooth needs periodontal crown lengthening before restoration.e.e. Prognosis for root canal treatment is worse when the patient is experiencing which of the following? a.

c. Which of the following statements describes human immunodeficiency virus (HIV)? a. HIV is more easily transmissible than Hepatitis B. It would be sufficient to cause skin cancer if all exposures were at one site. c. b. They include engineering and work practice controls. dental personnel should do which of the following? . HIV is more fragile than the Hepatitis B virus.CHAPTER 5: PREPARATION FOR TREATMENT 1. It is comparable to a barium study of the intestines. c. They mandate that employees be offered the HIV vaccine. d. b. The standards are established to protect the dentist. It must be freely given. 4. It includes the opportunity to ask questions. Which of the following statements regarding Occupational Safety and Health Administration (OSHA) standards is accurate? a. 2. 3. While exposing films. d. They do not impose financial penalties. 5. Which of the following statements regarding radiation exposure from a single. full-mouth survey is accurate? a. Which of the following statements regarding informed consent information for endodontic therapy is accurate? a. HIV is a good model for infection control practices. It is half that of a single chest film. All the above statements are accurate. c. b. It includes prognosis for the recommended treatment and also the alternatives. b.

Analgesic shortly before the procedure Equal amounts of the analgesic before and during the procedure Analgesic at the conclusion of the procedure Analgesic with instructions to the patient to take if necessary 8. The recommended antibiotics for a patient with a total joint replacement who is allergic to penicillin or cephalosporin is which of the following? a. Amoxicillin Erythromycin Clindamycin Tetracycline 7. Which of the following statements regarding the long-cone paralleling technique is accurate? a. cinderblock. 9. or 1-inch drywall barrier Wear a lead apron 6. b. Radiographic contrast can be directly affected by altering which of the following? Milliamperage Exposure time Kilovoltage . c. c. b. d. c. Stand back at least 6 feet in an area that is 90 to 135 degrees from the beam Stand behind a plaster.a. The most effective method for controlling pain that often occurs after cleaning and shaping is to administer which of the following? a. b. d. c. c. It requires the film be placed directly touching the tooth without bending the film. b. a. It minimizes distortion of tooth dimension. It minimizes superimposition of the infraorbital rim for maxillary molars. b.

c. 11.. In which of the following situations is a rubber dam not placed? When the clamp impinges on the gingiva. With the cone moved to the distal and directed toward the mesial.e.d. It should be pointed (i. 14. cone) in shape. there are no situations in which a rubber dam is not placed. b. b. To enhance crown preparation and retention when an infrabony defect exists. which of the following accurately describes the mesiobuccal root of the first molar? . c. Radiation exposure is reduced. d. 13. reverse bevel Of the following. b. Electrosurgery Gingivectomy Laser surgery Apically positioned flap. d. It should be collimated to reduce exposure level. b. c. 12. causing discomfort When the chamber or canal may be difficult to locate on access When the tooth is rotated. It should have a filtration equivalent of 10 mm of aluminum. which statement accurately describes radiograph units? It should be optimally capable of using 70 kVp. Image quality is better for working length radiographs. a. crown lengthening is completed by which of the following? a. X-ray generating source is not required. preventing placement of a clamp on the indicated tooth None. not to exceed 7 cm at the skin surface. c. d. Angulation 10. An advantage of digitized radiography in endodontic treatment is which of the following? a. a.

c. It does not move. b. d.a. Mesial Distal Parallel Bisecting 16. It is projected lingually on the film. It is projected mesially on the film. 15. The cone angulation in the following illustration is which of the following? a. It is projected distally on the film. d. The radiopaque structure overlying the buccal roots in the following illustration is which of the following? . b. c.

e.. c. increase the vertical angle) Mesially (i.e. c..e. d. d. decrease the vertical angle) Superiorly (i.e. Which of the following is the best way to "move" the structure in the previous illustration away from the buccal apexes of both molars? Reposition the cone a..a. Zygoma Floor of the maxillary sinus Coronoid process Eyeglass frame 17. 18. the beam is directed more mesially) Why does the tooth in the following illustration appear elongated? .. b. Inferiorly (i. b. the beam is directed more distally) Distally (i.

b. The film was bent. The film was not parallel to the tooth. 19. The radiopaque structure (arrow) in the following illustration is which of the following? .a. positive-and-vertical angle to the cone. positive-and-vertical angle to the cone. c. There was insufficient. There was excessive. d.

Condensing osteitis Trabeculation Lamina dura Root surface 20. The view in the following radiograph is a mesially angled (beam is directed distally) film.a. d. The unobturated root is which of the following? . b. c.

Buccal root Lingual root 21. the best way to identify the source of the radiolucency (arrow) in the following illustration is which of the following? . b. Of the following.a.

a. d. c. b. b. Pulp test Incisional biopsy Excisional biopsy Observation over time to evaluate for changes CHAPTER 6: ARMAMENTARIUM AND STERILIZATION 1. c. The patient is exposed to the least amount of radiation when which of the following is used? a. Digital imaging Ektaspeed film Ultraspeed film .

Rapid-steam autoclave is safe for all types of materials. b. a. An advantage of rapid-steam autoclave over traditional autoclave is which of the following? a. c. d. Patients with a latex allergy can be treated how? Safely without a rubber dam With a rubber dam if there is no direct skin contact With a nonlatex. 3. Rapid-steam autoclave will not corrode steel instruments. c. rubber dam The temporary restorative material. d. a. b. b. Cavit. The best way to clean dental instruments before sterilization is by which of the following? a. . 5. b. is which of the following? Type of zinc oxide-eugenol (ZOE) material Superior to other materials in in vitro resistance to bacterial leakage Prepared by mixing a powder and liquid More durable than intermediate restorative material (IRM) or composite 4. Ultrasonic cleaning for 5 minutes in a perforated basket Hand scrubbing. using a brush and heavy rubber gloves Rinsing under a forceful water spray Steam sterilization is achieved when the load has reached which of the following? 250° C for 15 minutes 250° F for 15 minutes 250° C for 30 minutes 250° F for 30 minutes 6. c. Instruments do not have to be air dried at the end of the cycle. c.2. c. a. b.

9. d. c. b. 10. c. 7. Careful sterilization of water lines within hand pieces and syringes between patients e. d. b. a. Installation of sterile water delivery systems Gutta-percha is best sterilized by which of the following? Immersion in full-strength sodium hypochlorite Immersion in rubbing alcohol Dry heat Bead sterilizer The effect of sterilization on endodontic files is which of the following? Negative and proportional to the number of times sterilized Neutral. b. Filters at the water source Flushing the water line before attaching it to the hand piece or syringe Retrograde (i. reverse) flushing of all water lines d. c. It does not destroy heat-sensitive materials. which statement accurately describes a chemical vapor sterilizer? a. An approved method for reducing microorganisms in water output from dental units is which of the following? a. no effect is seen on physical properties Positive. It requires adequate ventilation in the area where it is used. b. Of the following. Rapid-steam autoclave has a shorter sterilization cycle than traditional autoclave. It achieves sterilization when heated to 270° F at 20 psi for 10 minutes. It uses a reusable chemical.e.. 8. it restores to the files flexibility lost over time . a. c.d.

b. two burs in sequence) for access through a porcelain fixed-to-metal crown is which of the following? a. end-cutting fissure 13. c. round fissure SS. b. An advantage that nickel titanium (NiTi) has over SS for intracanal instruments is which of the following? a. c. d. incisor teeth. c.e. e. Which of the following statements describes dens-endente? It occurs primarily in maxillary.. d. Stainless steel (SS). a. end-cutting fissure carbide. d. a. end-cutting fissure SS fissure. round-carbide. The most reliable agent for destroying microorganisms is which of the following? Chemical sterilizing agents Hot water Ultrasonics X-ray irradiation Heat 12. e. e. . round-diamond. round-diamond. round-carbide. Lower cost More resistance to breakage Sharper More uniform in shape More flexibility CHAPTER 7: TOOTH MORPHOLOGY AND CAVITY PREPARATION 1. carbide. lateral. coated fissure Diamond-coated. b. two-stage technique (i. A good. coated.11.

4. The orifice to a second canal in the mesiobuccal root was distal to the main orifice in a line connecting the mesiobuccal canal to the palatal canal. d. periodontal pocket. c. It produces an evagination of dentin and enamel in mandibular premolars. calcification correlated with the radiographic narrowing of the canal space. d. Less than 1% 3% 6% 10% Vertucci noted in maxillary second premolars which of the following? a.b. It results in an untreatable. d. b. 2. b. Although two canals were often present in the mesiobuccal roots. 3. Kulild and Peters noted which of the following? a. approaching 75%. The use of magnification did not increase the number of canals found clinically in this tooth group. b. the canals merged apically. It requires the use of a long-shank bur for access because the pulp chamber is located in the middle portion of the root. the lingual canal is the straightest. d. . The incidence of two canals at the apex was high. When two canals were present and join at the apex. The incidence of accessory canals found in the furcation was 59%. c. c. A high incidence of two canals with separate foramina in the mesiobuccal root (71%). In their study of maxillary molars. c. Histologically. The incidence of three roots and three canals in maxillary first premolars is which of the following? a.

The mandibular. c. second molar should be restored with a crown after endodontic treatment for which of the following reasons? a. b. When there were two canals in the distal root. b. There is a tendency for the buccal cusps to shear off under occlusal loading. . A facial-access opening might be considered. Which of the following teeth is most likely to exhibit C-shaped morphology? Maxillary first premolar Maxillary first molar Mandibular first premolar Mandibular first molar 7.5. The access opening should be rectangular. they remained distinct with separate apical foramina. The canals often remain separate and distinct throughout the root. which of the following statements are true? a. b. d. The pulp chamber is relatively large in comparison to the crown. c. a. The tooth is in close to the insertion of the muscles of mastication. In their study of mandibular molars. The access opening should be triangular with the apex at the cingulum. c. and the percentage of preexisting fractures is high. making the tooth susceptible to fracture. d. Skidmore and Bjorndal noted which of the following? a. d. The incidence of four canals was over 50%. The mesiobuccal canal was located under the mesiobuccal cusp tip and exhibited the straightest morphology. 6. When treating a mandibular incisor with two canals evident on the preoperative radiograph. The internal morphology of the canals will be ribbon shaped. b. 8. c.

Providing a post can be placed in the distal root to strengthen the root. The clinician should consider obturating the coronal segment and performing root end surgery. 10. The mesiolingual canal is often noted to be separate and distinct. The root morphology varies with two separate-and-distinct roots being a common finding. The C-shaped molar exhibits a ribbon-shaped orifice with a 180-degree arc beginning in the mesiobuccal area and forming an arch extending lingually to the distobuccal. 9. CHAPTER 8: CLEANING AND SHAPING THE ROOT CANAL SYSTEM 1. d. Because canals become less calcified as they proceed apically. b. d. After attempting access the canal cannot be located despite drilling into the middle third of the root.d. the canal appears calcified and there is evidence of apical pathosis. Research indicates that the presence of a C-shaped canal is most common in Caucasians. a pathfinder might be used to negotiate the residual canal space. A 30-year-old male patient is being treated for a maxillary central incisor that he traumatized as a teenager. second molar exhibiting a C-shaped morphology is correct? a. . Shaping is performed after cleaning of the apical one third of the canal to ensure patency. c. Which of the following statements regarding further treatment is false? a. exhibiting a separate foramen. Which of the following statements regarding the mandibular. The risk of perforation will be greatest on the lingual surface. c. should the clinician continue. Which of the following statements regarding shaping procedures is false? a. Radiographs may indicate the orientation of the access opening within the root. Radiographically. b.

4. d. The instruments exhibit a constant percentage change between successive instruments. Shaping permits the a more accurate assessment of the apical. It removes the bulk of tissue and contaminants before apical preparation. It revents procedural errors. b. It facilitates obturation. except for one. c. Which is the exception? a. Each of the following are direct advantages of pre-enlarging the radicular space. b. 3. It provides a reservoir for the irrigant.b. b. d. The instruments are most useful in the larger sizes because there is a smaller change in diameter between the files. c. The Profile Series 29 files conform to the International Standards Organization (ISO) specifications for instrument design. curved canal. . c. such as canal blockage and transportation. d. 2. The result of root canal treatment in establishing patency is which of the following? a. Which of the following statements best describes the Profile Series 29 files? a. The Profile Series 29 files were designed to facilitate preparation of the coronal portion of the radicular space. cross-sectional canal diameter. Shaping facilitates placement of instruments to the working length by increasing the coronal taper. Shaping is a necessary procedure because calcification occurs from the coronal portion of the canal to the apex. It provides better tactile control of instruments when negotiating a small. It causes irritation of the periodontal attachment apparatus and increased postoperative pain.

6. d. c. Gauging and tuning verify the completed shaping of the apical portion of the canal. Aqueous solutions are most efficient as lubricants and.0 to 2. cylindric diameter to the canal in the apical 2 to 3 mm that enhances obturation and sealing. Viscous suspensions contain the highest concentration of ethylenediaminetetracitic acid (EDTA) and are most effective in removing the smear layer. a. 7. It enlarges the apical terminus and increases the potential for extrusion of obturating materials. The instruments exhibit varied tapers with a constant D0 diameter of 0. b. c. therefore.0 mm beyond the canal terminus. d. Which of the following statements best describes the Quantec files? The instruments have a constant helical angle and three flutes. . preferred to viscous suspensions during canal preparation.c. Viscous suspensions are more effective in preventing accumulation of tissue and dentinal debris. Which of the following statements regarding the use of chelating agents in canal preparation is correct? a.25 mm. Gauging and tuning produces a uniform. Aqueous solutions are preferred to viscous suspensions in canal preparation. 5. b. Gauging is performed in the coronal portion of the canal to confirm the coronal enlargement is complete. d. It requires insertion of a file 1. The instruments exhibit a constant rate of taper along their length. Which of the following statements regarding gauging and tuning is correct? a. cross-sectional diameter of the canal. b. The recommended rotational speed is 1000 to 2000 RPM. d. c. Tuning identifies the most apical.

. During the early phase of root canal preparation. causes a nascent release of oxygen. The initial scouter file should be advanced with a reciprocating action using apical pressure when resistance is encountered. d. 10. d. GG drills used in a step-back technique can relocate the canal away from the furcal wall. 9. c. Nickel-and-titanium (NiTi) rotary instruments are preferred to Gates-Glidden (GG) drills because they remove dentin uniformly from the canal wall. Conventional radiography and digital radiography may both be used in producing an endogram. An endogram would provide information on the extent of internal resorptive lesion. which kills anaerobic organisms. NiTi rotary instruments are best used in a step-back fashion. Both GG drills and NiTi rotary instruments should be used large to small. because this develops a preparation that is centered in the root. which of the following is true? a. The visualization of fractures and leaking restorations is attributed to the incorporation of Hypaque in the irrigating solution. The endogram is used to confirm the correct working length. b.e. in concert with sodium hypochlorite. EDTA. The initial scouter file that moves easily through the canal should be advanced to the estimated working length. b. c. The initial scouter file is used before the introduction of a viscous chelator in cases exhibiting vital tissue. d. The initial scouter file may not advance to the estimated working length because of the rate of instrument paper. Which of the following statements regarding an endogram is false? a. c. 8. Which of the following statements is correct regarding coronal canal preparation in endodontic treatment? a. b.

b. c. It opens the apical foramen to a minimum diameter of 0. It increases postoperative discomfort to occlusal forces. c.0 mm beyond the apical foramen will result in which of the following? a. Eliminate bacteria that remains in the canals Mummify tissue remnants in the canals . d. Paraformaldehyde-containing obturating materials result in which of the following? a. c. It reduces the percentage of change from a no.11. Extending a no. It eliminates the natural constriction of the foramen and increases the chance for an overfill. Dentin is engaged with a counterclockwise rotation and cut with a 45. clockwise rotation. b. b. 12. Of the following. CHAPTER 9: OBTURATION OF THE CLEANED AND SHAPED ROOT CANAL SYSTEM 1. d. 10 file with a 0.to 90degree. Proper placed restoration after root canal treatment Healthy periodontium Three-dimensional (3-D) obturation of the root canal system 2. The cutting stroke involves apical pressure and a counterclockwise rotation.12 mm. 15 file by 50%. Clockwise rotation balances the tendency of the file to be drawn into the canal during the cutting stroke. 10 file to a no. the least important determinant of root canal treatment success is which of the following? a. When using the balanced-force technique for canal preparation. b. It requires the use of a crown down technique.02 taper 1. which of the following statements is accurate? a.

The sealer is a tissue irritant and may delay healing. b.c. c. Lateral condensation results in a better seal. The sealer often stains or tattoos the tissue. e. It is preferable to not extrude sealer beyond the apex for which of the following reasons? a. 5. Vertical condensation results in a better seal. a. Both consistently fill lateral canals. 4. c. b. c. studies have shown which of the following? a. c. a. The sealer promotes bacterial growth. d. Considering lateral versus vertical condensation. b. The sealer usually does not resorb. . d. Gutta-percha in contact with connective tissue is which of the following? Relatively inert Immunogenic unstable Carcinogenic The primary reason to use a sealer and cement is which of the following? Attainment of an impervious seal Canal disinfection Lubrication of the master cone Adhesion to dentin All of the above 6. b. d. d. Reduce posttreatment pain Are below the standard of care for root canal treatment 3.

7. There is more likelihood of postoperative discomfort. All of the above In which of the following is one-visit root canal treatment not recommended? The pulp is necrotic and not symptomatic. d. The pulp is necrotic and there is a draining sinus tract. When is an application of heater-injected gutta-percha potentially beneficial? When there is an open apex When there are aberrations or irregularities of the canal When the clinician cannot master lateral condensation When the canals are curved and small after preparation Which of the following statements accurately describe an adequate apical seal? . inflammatory reaction in periradicular tissue. b. 11. The pulp is vital and symptomatic. d. 10. The pulp is necrotic and symptomatic. Moderate extrusion of obturating materials beyond the apex is undesirable because of which of the following? a. c. a. b.d. c. d. 9. b. leading to root fracture They do not penetrate as deeply as stainless steel (SS) spreaders under equal force 8. A problem with nickel-and-titanium (NiTi) spreaders is which of the following? Tendency to buckle under compaction pressure Tendency to break during condensation Creation of greater wedging forces. Sealability with either largely depends on the shape of the prepared canal. Sealer and gutta-percha cause a severe. The prognosis is poorer. b. a. d. a. c. c.

a. It is superior to other warm-compaction techniques. d. a. b. 14. d. c. b. No special devices are necessary. An advantage of the continuous-wave technique over warm. The continuous-wave technique is not technique sensitive. c. It can be achieved in small. 13. It uses a heat carrier that can both compact and heat gutta-percha. d. The continuous-wave technique is faster. It can only be achieved with lateral condensation. c. b. nontapering canal preparations. Which of the following statements accurately describe the continuous-wave technique? a. The obturation of the incisor shown in the following illustration is inadequate because of which of the following? . 12. b. The continuous-wave technique adapts better to canal irregularities. It has been shown to have no adverse effects on the periodontium. The most likely cause of a gross overfill is which of the following? Lack of an apical seat or stop Use of excessive amounts of sealer Use of excessive apical pressure on the spreader Use of a master cone that is too small 15. c. vertical compaction is which of the following? a. It has been shown to provide a better prognosis than cold-compaction techniques. It depends on placing the compacting instrument close to the apical terminus.

. c. It appears short of the prepared length. . incomplete condensation) throughout its length.e.a. There is variable radiodensity (i. b. There is a space between the temporary restoration and the gutta-percha.

The diagnosis was pulp necrosis and chronic apical periodontitis. Remnants of necrotic tissue A leaking restoration Blood pigments in the dentinal tubules Obturating materials not removed from the chamber 17.d. c. 16. b. what is the most likely cause of failure of root canal treatment on the lateral incisor in the illustration? . It is likely that the discoloration is primarily caused by which of the following? a. The dark tooth in the following illustration has a history of trauma and root canal treatment. Of the following. the canal should be filled to the apical foramen. d.

a. which of the following statements is accurate? . There is coronal leakage. The silver point does not adapt to the prepared space. d. The canal is filled too close to the apex. Concerning making changes in a patient record. The silver point corrodes. c. CHAPTER 10: RECORDS AND LEGAL RESPONSIBILITIES 1. b.

b. b. d. is which of the following? Requires absolute perfection b. d. d. Corrections are permitted. Describes what any careful-and-prudent clinician would do under similar circumstances c. a.a. It is necessary only if requested by the referring dentist. It must be performed at least on the tooth to be treated. as defined by the courts. It is necessary only if there is evidence of periodontal disease. 4. b. c. a. It should performed on the entire dentition. Deletions are permitted if erased completely as soon as they occur. 2. despite severe pain and infection Be bound to see a former patient on recall after treatment is completed Discharge a patient from the practice at any time . a. 5. c. Any changes are forbidden. 3. A dentist may legally do which of the following? Refuse to treat a new patient. b. Which of the following statements accurately describe a periodontal examination of a patient referred for endodontic treatment? a. Patients be advised of the consequences of nontreatment. Does not allow for individual variations of treatment Is equivalent to customary practice The doctrine of informed consent does not require which of the following? Patients to be advised of reasonably foreseeable risks of treatment Patients to be advised of reasonable alternatives Patients forfeit their right to do as they see fit with their body. Standard of care. c. c. if dated.

d.

Refuse to treat a patient who has an outstanding account balance

6. If a patient with human immunodeficiency virus (HIV) requests that the dentist not inform the staff of the condition, the dentist should do which of the following? a. b. c. Refuse to treat the patient Tell the staff in private, and then treat the patient with extra precautions Not tell the staff but treat the patient with great caution

d. Not tell the staff and require the patient to assume liability should anyone contract the virus 7. a. A specialist may be held liable if which of the following occurs? Informs the patient that the general practitioner performed substandard care

b. Fails to disclose to the patient or referring dentist evident pathosis on teeth other than those the specialist is treating c. Fails to locate a small canal that is not evident radiographically

d. Mistakenly initiates treatment on the wrong tooth in a difficult diagnostic situation 8. Of the following, which is the best way for clinicians to avoid legal actions by patients? a. b. c. d. 9. a. b. 10. Tell patients they have no malpractice insurance. Attend continuing education courses to remain informed of current techniques. Refer all major patient complaints to peer review. Demonstrate genuine interest in the welfare of the patient. Computerized treatment records may not be signed electronically. True False Suing to collect fees is a proven route to being counter sued for malpractice.

a. b. 11. a. b. c.

True False Standard of care for routine endodontics is set by which of the following? The state's dental licensing agency Endodontists The community of general dentists

12. A patient continues to have pain after a dentist uses the technique of Paraformaldehyde paste pulpotomy on a tooth with a necrotic pulp and apical pathosis and then places a crown. In this situation, which of the following statements is true? a. The dentist is liable for malpractice because unacceptable treatment procedures were followed. b. The dentist is not liable if the patient is now referred to the appropriate specialist who can treat the case. c. The dentist is not liable if the dentist performs additional treatment for no fee.

CHAPTER 11: STRUCTURE AND FUNCTIONS OF THE DENTIN AND PULP COMPLEX
1. In the process of tooth development, which of the following statements are true? a. The basement membrane separating the inner dental epithelium from the dental mesenchyme is composed of type I and III collagen. b. Blood vessels become established in the dental papilla during the cap stage.

c. Mature ameloblasts appear before odontoblasts mature. However, the formation of enamel takes place following the deposition of dentin. d. e. 2. The II collagen mRNA increase with odontoblastic differentiation. Ameloblasts form enamel spindles near the future dentinoenamel junction (DEJ). von Korff fibers are best described as which of the following?

a. b. c. d. 3. a.

The first-formed collagen fibers formed between preodontoblasts. Unmyelinated sensory fibers in the cell-free zone of Weil Odontoblastic processes interposed between ameloblasts Silver-stained ground substance located between odontoblasts Which of the following statements regarding root development is false? Root development begins after completion of enamel formation.

b. The inner epithelium, the stellate reticulum, and outer enamel epithelium form Hertwig's epithelial root sheath. c. The dental sac disintegrates upon induction of dentin formation and remnants persist as the Epithelial Rests of Malassez. d. Accessory canals in the root are formed when there is discontinuity in the root sheath. 4. Which of the following statements regarding dentin is correct? a. Mantle dentin is the first formed dentin and has collagen fibers that run perpendicular to the DEJ. b. Dentin deposited after eruption is termed secondary dentin.

c. Dentinal tubules make up 50% of the dentin volume and they exhibit extensive terminal ramifications. d. Calcification of dentin results in an organic component composed of noncollagenous matrix components. 5. Which of the following statements regarding the tubular structure of dentin is correct? a. Peritubular dentin and intertubular dentin are the same composition, except for the fact peritubular dentin lines the tubule. b. Peritubular dentin has a lower-collagen content when compared to intertubular dentin and is more susceptible to removal by acids.

They provide a mechanism for intracellular materials to be exchanged. b. packaged by the Golgi complex. 8. They are infrequent but when found are located in the basal portion of the cells. . Remains constant regardless of the depth of a cavity preparation because of a pulpal tissue pressure of 10. d. Intertubular dentin is more highly mineralized when compared to peritubular dentin.3 mm Hg b.g. Which of the following statements regarding production of collagen by the odontoblast is correct? a. Increases as the pulp and dentin border is approached (primarily because the tubular surface area increases) c. Increases near the pulp and dentin border as the hydrostatic pressure in the tubules decreases 7. These then precipitate to form tropocollagen and.. and released by reverse pinocytosis. Is lower in radicular dentin because of tubular sclerosis d. They regulate permeability of extracellular substances between the odontoblastic layer and the predentin. c. b. Vesicles consisting of collagen fibrils migrate into the odontoblastic process and are released. They permit low-resistance pathways for electrical excitation when the odontoblastic process is distorted. d. collagen fibrils. Which of the following statements regarding dentin permeability is true? a. 6. proline) into vesicles that are released into the predentin. Peritubular dentin defines the tubule size and is common to all mammals. Tropocollagen is synthesized in the rough endoplasmic reticulum (RER) and packaged in the Golgi complex. Type I collagen is manufactured in the cellular cytoplasm. c.c. eventually. The Golgi complex packages collagen precursors (e. Which of the following statements regarding tight junctions in the odontoblastic layer is true? a.

11. 12. Dendritic cells are primarily found in lymphoid tissues. b. Electrical stimulation of autonomic fibers decreases blood flow and depresses Adelta fiber activity. The proteoglycans regulate the dispersion of interstitial solutes. d. Teeth with immature root development often are unresponsive to electrical pulp testing because which of the following? a. The state of polymerization of the ground substance regulates osmotic pressures. Although not normally present in the healthy pulp. b. c. Dendritic cells are similar to Langerhans' cells and play a significant role in induction of T-cell immunity. Vesicles are formed and release tropocollagen in the predentin matrix.d. except for one. 10. 9. b. Considered accessory cells. Which of the following statements regarding dendritic cells is false? a. like macrophages. c. Synthesis begins in the RER with procollagen being packaged in the Golgi complex. The water content of the extracellular matrix is relatively low. d. d. giving the tissue a colloidal consistency and limiting movement of components within the tissue. The extracellular matrix changes with eruption of the tooth as the chrondroitin sulfate concentration decreases and the hyaluronic acid and dermatan sulfate fraction increase. Which of the following statements regarding the extracellular matrix of the pulp is false? a. c. Each of the following statements support the hydrodynamic theory for pain. the dendritic cell participates in antigen recognition and presentation. are phagocytic. There is a relative hypoxic condition of the pulp during developmental glycolysis. Predentin and intratubular fibers are not present until root formation is complete. Myelinated fibers are the last structures to appear in the developing pulp. Which is the exception? . dendritic cells appear during inflammation and.

b. are not found in the normal pulp. Odontoblasts have a low-membrane potential and do not respond to electrical stimulation. A-delta and A-beta fibers are being stimulated.a. short sensation to cold that resolves immediately with removal of the stimulus is correct? a. such as polymorphonuclear leukocytes and B-lymphocytes. Inflammatory cells. c. b. The patient's response indicates inflammation and tissue damage. Blood flow within the pulp is homogenous with arteriovenous anastomoses maintaining an even flow. 15. C-fibers are responding to the release of inflammatory mediators. The presence of a smear layer decreases dentinal sensitivity. . Which of the following statements outlines the most significant factor influencing the pulp's response to injury and compromised healing? a. Accessory and lateral canals provide adequate collateral circulation. 14. d. The pulpal blood flow is the highest of oral tissues because of the relatively high metabolic activity of the pulp. d. Which of the following statements regarding pulpal bloof flow is correct? a. A-delta and C fibers are responsible for the painful sensation. There is a positive correlation between fluid movement in the tubules and the discharge of intradental nerves. b. such as bradykinin and substance P. Which of the following statements regarding a patient that has a sharp. d. Placement of local anesthetics on dentin does not alter the pain response. Unmyelinated. Forty percent of the tubules in the area of pulp horns contain intratubular nerve endings. c. c. 13. e. sympathetic fibers innervating the arterioles and venules produce vasoconstriction.

particularly the pulpal floor of multirooted teeth. 16. d. b. The environment of the dental pulp is low compliant. There is a decrease in the cellularity and collagenous fibers. a. There is a reduction in the nerves and vasculature of the pulp. e. Which of the following statements regarding age changes in the pulp are false? a. There is an increase in peritubular dentin. 2. Odontoblasts decrease in size and may disappear completely in some areas. d. c. d. especially in the radicular pulp.b. The fact that the pulp may not have a lymphatic system. and macrophages in the lesion . PATHOBIOLOGY OF THE PERIAPEX Inflammation of the periapical tissue is sustained by which of the following? Stagnant tissue fluid Necrotic tissue Microorganisms All of the above Acute. The pulp demonstrates an increased resistance to the action of proteolytic enzymes. b. plasma cells. b. a. CHAPTER 12: 1. c. c. e. Odontoblasts are end line cells incapable of replication. There is a lack of a collateral circulation. c. apical periodontitis is characterized by which of the following? A focus of neutrophils within the lesion A focus of granulomatous tissue in the lesion A focus of lymphocytes.

Which of the following statements regarding T-lymphocytes are accurate? They are thyroid-derived cells. b. They are responsible for the cell-mediated arm of the immune system. A periapical. b. 6. however. a. All of the above are accurate. The most important route of bacteria into the dental pulp is from which of the following? a. b. 7. true cyst communicates with the root canal. c. b.3. . Microbial interaction Endotoxins released after bacterial death Exotoxins released by living bacteria Enzymes produced by bacteria Which of the following statements regarding neutrophils is accurate? They are nonspecific phagocytes. a periapicalpocket cyst does not. c. a. d. The general circulation via anachoresis Exposure to the oral cavity via caries The gingival sulcus 5. c. b. a. They have a single pathway for intracellular killing. They are mobilized primarily to neutralize bacterial endotoxins. d. True False 4. c. The least important factor influencing the pathogenicity of endodontic flora is which of the following? a. They concentrate in the cortical area of lymph nodes and also circulate in the blood.

Which of the following statements regarding acute apical periodontitis is accurate? a. b. a. c. c. They produce antibodies. c. 11. apical periodontitis is accurate? . a. Which of the following statements regarding chronic. 9. b. 10. d. It is limited to the periodontal ligament (histologically). All of the above statements are accurate. All of the above statements are accurate. They account for the majority of circulating lymphocytes. It may heal if induced by a noninfectious agent. d. It is detectable radiographically. They are mononuclear cells capable of bone demineralization. 8. d. The function(s) of macrophages include(s) which of the following? Phagocytosis of microorganisms Removal of small foreign particles Antigen processing and presentation All of the above Which of the following statements regarding osteocytes is accurate? They originate as monocytes in the blood. b. They form a ruffled border away from the bone surface. They respond only to mediators released by osteoblasts. 12. Which of the following statements regarding B-lymphocytes are accurate? They were originally discovered in an avian gut-associated organ. c.d. a. b. All of the above statements are accurate. d.

b. It is a fungal disease characterized by filamentous colonies called sulphur granules. Which of the following statements regarding periapical actinomycosis is accurate? a. b. d. a. c. All of the above statements are accurate. b. c. apical granulomas Periapical-pocket cysts with cavities open to the root canal Periapical actinomycosis Acute.a. It is caused by gram-negative organisms exhibiting branching filaments that end in clubs or hyphae. c. d. All of the above statements are accurate. Extraradicular infections are not found in which of the following? Solid. It represents a continuous. It may contain epithelial arcardes or rings. c. It is most commonly an endodontic infection resulting from dental caries. 15. They are difficult for macrophages and multinucleated giant cells to remove. 13. 14. Which of the following statements regarding cholesterol crystals is accurate? They may induce granulomatous lesions. It is a predominance of B-cells over T-cells. d. b. d. They are potentially associated with nonresolving apical periodontitis. apical periodontitis CHAPTER 13: ENDODONTIC MICROBIOLOGY AND TREATMENT OF INFECTIONS . slow process that is asymptomatic. It is a neutrophil-dominated lesion encapsulated in a collagenous connective tissue. a.

They function best at high oxidation-reduction potentials. 3. 5. All of the above statements are accurate. The attraction of bloodborne microorganisms to inflamed tissue during a bacteremia b. b. Which of the following statements regarding the organism producing pulpal pathosis is correct? a. b. d. a.1. d.. and the pulp that are seeded to the systemic circulation. The process of carious invasion. The most common black-pigmented bacteria cultivated from endodontic infections is which of the following? . c.e. catalase. Pulpal and periradicular pathosis results primarily from which of the following? Traumatic injury caused by heat during cavity preparation Bacterial invasion Toxicity of dental materials Immunologic reactions 2. c. b. The organisms are primarily facultative streptococci. monoinfection) produce the most severe reactions Isolates tend to be polymicrobial and anaerobic. c. Which of the following best describes anachoresis? a. cavitation. and exposure of the pulp from bacteria c. a. inducing disease in other areas of the body 4. and superoxide dismutase. Organisms infecting the pulp tend to be aerobic. Single isolates (i. Bacteria located in dentinal tubules. They can grow in the presence of oxygen. compared to organisms infecting the periapex. d. Which of the following statements regarding strict anaerobes is accurate? They are missing enzymes.

Lipopolysaccharides is found in the liposomes of gram-positive bacteria. All of the above. Which of the following statements regarding polyamines is accurate? They are produced by bacteria and host cells. b. Pili break off and form extracellular vesicles filled with enzymes. c. b. b.a. 6. 9. They are more concentrated in teeth with spontaneous pain. a. c. c. All of the above statements are accurate. c. c. 7. a. d. They may be found in infected root canals. 8. They occur when a tooth apex is located coronal to a muscle attachment. b. d. b. Which of the following statements regarding fascial space infections is accurate? They are associated with radiographically visible periradicular lesions. d. . a. d. a. Bacteroides melaninogaster Fusobacterium nucleatum Prevotella nigrescens Porphyromonas intermedia Treatment of actinomycosis israelii may include which of the following? Root canal treatment Root end surgery Antibiotics All of the above Which is true regarding microbial virulence factors? Fimbriae assist in bacterial aggregation. They occur in potential spaces between fascia and underlying tissue.

Antibiotics are recommended for which of the following? Sinus tracts Acute. 12. 13. c. It relieves increased tissue pressure. d. c. b. apical periodontitis All of the above Incision and drainage of cellulitis is effective because of which of the following? It provides a pathway of drainage to prevent spread of infection. b. a. c. It provides relief of pain. All of the above statements are accurate. All of the above statements are accurate. All of the above statements are accurate. b. d. It increases circulation to the area and improves delivery of antibiotics.d. and submental space of the right or left side. d. It can result in airway obstruction. It can progress into the canine and infraorbital space. 11. 10. d. 14. Which of the following statements regarding Ludwig's angina is accurate? It involves the submental. b. a. sublingual. e. apical periodontitis After root end surgery None of the above Incision and drainage is indicated which of the following? For sinus tracts When the swelling is diffuse and indurated For acute. a. Which of the following statements regarding potassium penicillin V is accurate? . a. c.

c. It cannot be taken with lithium or alcohol. d. They are the standard of care for clinicians. It has up to a 25% allergy rate. It has a broader spectrum than amoxicillin. 16. It is effective against facultative and anaerobic bacteria. a. They are based on controlled clinical studies.a. It will select for resistant organisms. The AHA recommends antibiotic prophylaxis for which of the following? Surgery Instrumentation beyond the apex Periodontal-ligament injection . 17. All of the above statements are accurate. They are not a substitute for clinical judgment. d. c. b. b. 15. All of the above statements are accurate. c. Which of the following statements regarding metronidazole is accurate? It is effective against facultative and anaerobic bacteria. a. It may be dosed at 4-hour intervals for severe infection. Which of the following statements regarding clindamycin is accurate? It is an alternative to potassium penicillin V in allergic individuals. especially in the GI tract. Which of the following statements regarding the American Heart Association (AHA) guidelines for prophylactic antibiotic coverage is accurate? a. b. 18. b. b. c. c. d. It is rarely associated with pseudomembranous colitis in doses recommended for endodontic infections. It cannot be given with penicillin because of disulfuram reaction. a.

d. It results in needles tooth extraction. c. It was propounded by Dr. With regard to electrical pulp testing. CHAPTER 14: INSTRUMENTS. MATERIALS. It was used to explain diseases for which there was no cure. 20. It is an accurate assessment of pulp vitality. T-helper cells predominate over T-suppressor cells. William Hunter in 1910. 2. b. b.. . d. Which of the following is correct in relation to the periradicular lesion formed in response to dental caries and subsequent pulp necrosis? a. Formation of the granuloma is mediated through a specific immunologic response. b.d. All of the above statements are accurate. AND DEVICES 1. Bacteria are commonly found in the granuloma.e. c. It was referred to infections found around poorly made restorations. All of the above 19. Which of the following statements regarding pulp stimulation with cold is accurate? a. It is best determined with a blast of air. a. Which of the following statements regarding he theory of focal infection is accurate? a. It is best accomplished with carbon dioxide snow (i. c. It directly stimulates the pain fibers in the pulp. d. e. The release of interleukins can mediate bone resorption. which of the following is true? Positive responses can be used for differential diagnosis of pulp pathosis. dry ice).

Gingival and periodontal tissues are more sensitive to testing than the pulp. They exhibit a high elastic modulus. b. square blank. A barbed broach is most useful for which of the following? Removal of cotton. c. d. which increase flexibility. alternating current with a duration of 1 to 15 ms. 4. They have greater resolution than traditional film. They have the advantage of being manipulatable. a. a. d. The device uses a pulsating. 3. b. They are captured by a sensor that has a greater surface area than traditional film. They are easier to prebend before placement in the canal than SS. Which of the following statements regarding nickel and titanium (NiTi) instruments is accurate? a. c. They cannot be strained to the same level as stainless steel (SS) without permanent deformation.b. They differ. Which of the following statements regarding digital radiographs is accurate? They are produced by a charged coupled device and do not require x-rays. which of the following statements regarding K-type files is accurate? a. The device uses a low current with a high-potential difference in voltage. d. b. c. which facilitates interpretation. which provides flexibility. In comparing K-type files with reamers. d. c. and other objects from the canal Removal of vital tissue from fine canals Initial planing of the canal walls Coronal-orifice enlargement before establishing the correct working length 6. paper points. they exhibit transformation from the austenitic crystalline phase to a martensitic structure. because the file is manufactured by twisting a tapered. When stressed. b. 5. . They have more flutes per millimeter.

c. They incorporate radial lands in the flute design. because external signs of stress are more visible as changes in flute design. . They are NiTi instruments manufactured in half sizes. They are more effective in removing debris. 9. d. a. d. Based on instrument design and method of manufacturing. They are sensitive to canal contents. d. b. c. They are used at a range of 1500 to 2000 rpm. 8. They are safer than K-type files. K-type file fabricated from tapered. 7. Which of the following statements regarding the best apex locators is accurate? They require training with the instrument to become proficient. They are the least flexible when comparing instruments of the same size.c. square SS blank K-flex file fabricated from rhomboidal SS blank Hedström file fabricated from round SS blank Reamer fabricated from triangular SS blank Which of the following statements regarding Hedström files are accurate? They are manufactured by machining a round cross-sectional wire. which of the following is most susceptible to fracture? a. a. They exhibit sizes that are ISO and ANSI standardized. They measure the impedance between the file and the mucosa. c. They are effective when used in a reaming action. c. They are aggressive because of a negative-rake angle that is parallel to the shaft. d. b. 10. Which of the following statements regarding the Profile rotary instruments is accurate? a. b. b.

d. and TrioSonic file system. d. e. which of the following statements is accurate? a. It is a rapid-and-efficient method of removing the smear layer. which increases toxicity. 13. d. Which of the following statements regarding ultrasonic root canal instrumentation is accurate? a. The piezoelectric unit uses a RispiSonic. c. b. c. When ethylenediaminetetraacetic acid (EDTA) is used as an endodontic irrigant. b.5 mm of the apex. It must be completely removed after use to prevent continued action and destruction of dentin. 12. Piezoelectric. . It is a good wetting agent that permits the solution to flow into canal irregularities. It should be used in higher concentrations because of the increased free chlorine available. b. It should be performed in a dry environment. It is most useful in small canals where file contact with the wall is maximized. The piezoelectric unit vibrates at 2 to 3 kHz. d. On average. It exhibits a chelating action on dentin. Which of the following statements regarding sodium hypochlorite used as a root canal irrigating solution is accurate? a. they are accurate to within 0. b. The piezoelectric unit transfers more energy to the files. It poses little risk of file breakage. c. ShaperSonic. 14. The piezoelectric unit produces heat that requires a coolant. It is not very useful for dentin removal. ultrasonic devices differ from magneto-strictive devices in which of the following? a. 11. All of the above statements are accurate. It is buffered to a pH of 12 to 13.

They adhere to dentin when compacted. 1 to 2 hours) at body temperature It can be distinguished from gutta-percha radiographically 18. d. It acts on organic-and-inorganic components of the smear layer. They contain 40% to 50% pure gutta-percha. Endomethasone. c. Produce liquefaction necrosis in the periradicular tissues Induce healing in the apical pulp wound after vital pulp extirpation Can cause periapical inflammation . 15. N2. Its ability to dissolve necrotic tissue Its antimicrobial activity Its ability to stimulate hard-tissue formation Its ability to temporarily seal the canal 16. An advantage to AH26 as an endodontic sealer is which of the following? The release of formaldehyde on setting Low toxicity Long working time.c. d. b. c. 17. b. c. They are not compressible. Which of the following statements is accurate regarding gutta-percha points is accurate? a. d. but quick setting (i. c. a. Calcium hydroxide is advocated as an interappointment medication primarily because of which of the following a.. b. They can be heat sterilized. It penetrates deep into dentin and enhances root canal preparation. and Reibler's paste are sealers that do which of the following? a. d. b.e.

It does not require as acute an angle of root resection.d. 20. c. Do not produce a seal when used in combination with a core material Which of the following statements is accurate regarding TERM is accurate? It seals as well as Cavit. c. It is the material of choice when strength is a requirement. It results in apical cracks at low settings. It is a zinc oxide-reinforced material that can be light cured. It results in larger. 19. a. b. The most common response in the dentin deep to caries is which of the following? Increased permeability Alteration of collagen Dissolution of peritubular dentin Dentinal sclerosis 2. The root end is ultrasonically prepared during endodontic surgery for which of the following reasons? a. d. Relatively few bacteria are found in a pulp abscess because of which of the following? a. CHAPTER 15: PULPAL REACTION TO CARIES AND DENTAL PROCEDURES 1. b. b. but cleaner. c. It has a eugenol component that is antibacterial. d. cavity walls. c. a. It can make a deeper cavity more safely than a bur. Immune response of pulp tissue High tissue pH in the adjacent inflammation Mechanical blockage of sclerotic dentin . b. d.

6. c. The pulp circulation decreases slightly. b. d. The highest incidence of pulp necrosis is associated with which of the following? Class V preparations on root surface Inlay preparations Partial veneer restorations Full-crown preparations 5. d. 4. The response of the pulp to a recently placed amalgam without a cavity lining is usually which of the following? a. c. The pulp circulation increases markedly. Acid penetrates to the pulp and kills large numbers of cells. b. c. The pulp circulation remains the same. A periodontal ligament injection of 2% lidocaine with 1:100. Dentinal tubules are opened. b.d. d. Acid penetrates to the pulp and damages the vessels. Acid softens the dentin and increases microleakage at the restoration dentin interface. d. thereby increasing permeability. The pulp circulation ceases for about 30 minutes. A disadvantage of acid etching dentin (regarding effects on the pulp) is which of the following? a. c. a. Antibacterial products of neutrophils 3.000 epinephrine causes which of the following? a. Slight-to-moderate inflammation Moderate-to-severe inflammation Slight but increasingly severe with time None . b.

b. It reduces diffusion of toxic substance through the tubules. Deeper cavity preparations have more potential for pulpal damage because of which of the following? 1. therefore there is increasing permeability. c. It eliminates the need for a cavity liner or base. Its bactericidal activity acts against oral microorganisms. d. e. d. c. b. 8. b. 2. 3. It resists the effects of acid etching of the dentin. neutralization) by ground substance of bacterial toxins A decrease in pulpal metabolism Hypersensitivity is best relieved or controlled by which of the following? Opening the tubules to permit release of intrapulpal pressure Root planing to remove surface layers that are hypersensitive Applying antiinflammatory agents to exposed dentin Blocking exposed tubules on the dentin surface 10. Odontoblastic processes are more likely to be severed.7. 9.. a.e. A predictable stimulation of sensory nerves resulting in pain A decrease in permeability of dentin An increase in numbers of odontoblasts under the tubules affected by the caries A buffering (i. c. a. d. A reaction that tends to protect the pulp from injury from dentinal caries is which of the following? a. 1 only . The smear layer on dentin walls acts to prevent pulpal injury for which of the following? a. Tubule diameter and density increases. There is more vibration to pulp cells.

or sterilize the cavity are which of the following? Best used in deep cavities Indicated when a patient reports symptoms Generally very damaging to the pulp Generally not useful 12. 3 only c. Agents that clean. d. b. d. Of the following. a. A pulp has been damaged and is inflamed because of deep caries and cavity preparation. 14. d. What material placed on the floor of the cavity aids the pulp in resolving the inflammation? a. Retain the smear layer Use sharp burs with a brush stroke Use adequate air coolant Use adequate water coolant 13.b. Microleakage occurs at the gingival margin. Toxic chemicals are released from the composite and diffuse into the pulp. c. b. 1 and 2 11. c. b. Which is the major reason why Class II restorations with composite are damaging to the pulp? a. Calcium hydroxide . Microleakage occurs at the occlusal surface. dry. which is the best way to prevent pulp damage during cavity preparation? a. Polymerization shrinkage distorts cusps and opens gaps. c. 1 and 3 d. 2 and 3 e.

d. The best description of the pulp reaction is which of the following? . What is the probable response in the pulp? a.b. b. d. c. Zinc oxide-eugenol Steroid formulations None. Severe damage with irreversible inflammation Mild-to-moderate inflammation Pain but no inflammation No pulp response 16. which was done 1 day previous. there is no material that promotes healing. The following illustration shows a section of pulp and dentin underlying an area of cavity preparation. c. A cusp fractures and exposes dentin but not the pulp. 15.

There is no reaction. The inflammatory response is primarily which of the following? . b. the pulp appears normal. c. Odontoblasts are aspirated into tubules. d. This is an area of pulp close to a carious exposure (see the following illustration). 17. and there is mild inflammation. Odontoblasts are absent. The odontoblast layer is disrupted. and there is mild inflammation. and there is extravasation of erythrocytes.a.

and lymphocytes .a. b. d. plasma cells. c. Acute Chronic Giant cell Vascular 18. The early inflammatory cell infiltrate response of the pulp to caries involves primarily which of the following? a. c. Neutrophils Macrophages Neutrophils. b.

e. It predicts the prognosis. the most reasonable explanation is which of the following? a. and macrophages 19. Initial vitality testing of traumatized teeth is most useful to which of the following? a. plasma cells. Acute inflammation in the pulp Chronic inflammation in the pulp Microleakage at the restoration and tooth interface Stimulation of sensory nerves by hydrodynamics Tubules are blocked by restorative material or smear layer or both CHAPTER 16: TRAUMATIC INJURIES 1.d. b. c. Hypersensitivity of the pulp after restoration placement indicates which of the following? a. It determines if the blood supply to the pulp is compromised. b. If several teeth are out of alignment after trauma. e. d. c. Macrophages and lymphocytes Lymphocytes. Luxation Subluxation Alveolar fracture Root fracture 2. d. c. It determines whether root canal treatment is indicated. b. d. 3. It establishes a baseline for comparison with future testing. A normal periapical radiograph of a traumatized tooth is useful for which of the following? .

a. b. c. d. 4. a. b. c. d.

It visualizes most root fractures. It visualizes concussion injuries. It gathers baseline information. It locates foreign objects. Which of the following statements regarding crown infraction is accurate? It may indicate luxation injuries. It is rarely seen on transillumination. It seldom requires a follow-up examination. It describes the process of coronal pulp necrosis.

5. Which of the following statements regarding uncomplicated crown fracture is accurate? a. b. c. d. e. It is an indication for a dentin-bonded restoration. It requires baseline pulp testing. It involves root canal treatment if the exposed dentin is sensitive to cold stimulus. It has a questionable long-term prognosis. It is managed differently in young versus older patients.

6. Which of the following statements regarding complicated crown fractures is accurate? a. Exposure to the oral cavity permits rapid bacterial penetration through the pulp.

b. Inflammation is limited to the coronal 2 mm of the exposed pulp for the first 24 hours. c. 7. a. The tooth is normally managed by root canal treatment and restoration. Which of the following statements regarding replacement resorption is accurate? It results from direct contact between root, dentin, and bone.

b. c. d. 8. a. b. c. d. 9. a. b. c. d. 10. a. b.

It is managed by surgical exposure and repair with a biocompatible material. It results when at least 75% of the root surface is damaged. It can be avoided by timely endodontic intervention. Pulp necrosis is most likely to occur after which of the following? Midroot fracture Intrusive luxation Concussion Complicated crown fracture Which of the following statements regarding cervical root resorption is accurate? It is a common, self-limiting result of luxation injury. It causes significant pulpal symptoms. It can be arrested by root canal treatment. It may extend coronally to present as a pink spot on the crown. Which of the following statements regarding internal root resorption is accurate? It is more common in permanent than deciduous teeth. It is simple to differentiate from other types of resorption.

c. It is characterized histologically by inflammatory tissue with multinucleated giant cells. d. 11. a. b. c. It is ruled out when there is no response to pulp testing. A luxated tooth should be splinted in which of the following situations? If the tooth is mobile after splinting Until the root canal treatment is completed With the composite as close to the gingiva as possible

d.

All of the above

12. Which medium of storage for an avulsed tooth is best for prolonged extraoral periods? a. b. c. d. 13. a. b. c. d. 14. a. b. c. d. e. 15. a. b. c. d. Hanks balanced salt solution Milk Distilled water Saliva The most important factor for managing avulsion is which of the following? Extraoral time Decontamination of the root surface Prompt initiation of root canal treatment Proper preparation of the socket Tooth mobility after trauma may be because of which of the following? Displacement Alveolar fracture Root fracture Crown fracture All of the above Which of the following is true about thermal and electrical tests after trauma? Sensitivity tests evaluate the nerve and circulatory condition of the tooth. False-positive tests are more likely than false-negative tests. It may take up to 9 months for normal blood flow to return. None of the above statements are accurate.

Which of the following statements regarding internal root resorption is accurate? It is rate in deciduous teeth. b. c. a. d. Which of the following statements regarding avulsed teeth is accurate? They can be treated endodontically outside the mouth in limited circumstances. Branching from the main canal to form an apical delta In the apical one third of the root On the lateral surface of the root In the furcation Which of the following statements regarding palatogingival grooves is false? a. The grooves extend apically in varying distances. a. It is usually asymptomatic. molar teeth are most likely to have accessory and lateral canals: a. It is initiated by odontoblasts. They should have apexification attempted when the apex is not closed. b. b. The maxillary lateral incisor is affected more that the central incisor. According to Gutmann. c.16. They should be rigidly splinted for 3 to 4 weeks to allow periodontal support to mature. They generally do not require antibiotic treatment at the time of replantation. c. d. The incidence of palatogingival grooves ranges from 10% to 20% of the population. b. . 2. c. 17. CHAPTER 17: ENDODONTIC AND PERIODONTIC INTERRELATIONSHIPS 1. with less than 1% reaching the apex. d. It is seldom confused with external resorption.

treatment procedures have little effect on the pulp. Which of the following statements best describes the effect periodontal disease has on the dental pulp? a. causing pulp inflammation and eventually pulp necrosis b. d. producing tissue destruction that mimics periodontitis. b. Inflammation from the periodontal sulcus migrates apically. 3. creating a periodontal pocket. Which is the exception? a. 4. d. and the toxic irritants cause inflammation that migrates to the gingival margin. b. complete pulp necrosis will result. c. Irritants gain access to the periodontal tissues at the site of a vertical-root fracture. The prognosis for a tooth with a perforation is affected by all of the following factors. e. except for one.d. Location of the perforation The time of repair The ability to seal the defect The ability to perform root canal treatment on the remaining canals The placement of a post to retain the core after perforation repair Which of the following statements best describes retrograde periodontitis? a. radiolucent lesion characterized by the loss of the apical lamina dura. Pulp necrosis results in the formation of an apical. Periodontal disease that does not expose the apical foramen is unlikely to produce significant damage to the pulp. When periodontal disease or the treatment of the disease exposes a lateral or accessory canal. Although periodontitis can cause pulp inflammation and necrosis. c. . There is a direct correlation between the severity of the periodontal disease and the percentage of pulps that become necrotic. c. Pulp necrosis occurs. d. Pulp necrosis frequently occurs in teeth with palatogingival grooves because of the lack of cementum covering the dentin. 5.

The long-term prognosis for the pulp in teeth with vital-root resection is poor. 8. Pulp necrosis occurs initially and an apical lesion forms. c. Bioresorbable membranes exhibit results similar to nonresorbable membranes. right. d. Treatment consists of performing endodontic treatment. periodontal therapy is initiated. 6 to 8) was placed because of a congenitally missing. 9. Which of the following statements regarding root resection is false? Success depends primarily on treatment planning and case selection.6. Three years ago she relates a porcelain fused-to-metal bridge (nos. A 24-year-old female patient has drainage from the gingival sulcus of her maxillary. Failures occur primarily because of continued periodontal breakdown. central incisor (tooth no. b. Evidence suggest that GTR enhances bone formation by preventing contact of connective tissue with the bone. permits the accumulation of plaque and calculus on the root. Which of the following statements regarding guided tissue regeneration (GTR) is false? a. c. d. If the periodontal component is still present. The primary endodontic lesion with secondary periodontic involvement exhibits a poorer prognosis when compared with the primary periodontal lesion with secondary endodontic involvement. Apical migration of periodontal disease results in communication between the two lesions. 8). GTR is an effective adjunct to treatment of periodontal disease but has limited value in treating endodontic pathosis. Endodontic treatment should precede resection of a root. c. a. The combined endodontic periodontic lesion has the least favorable prognosis for GTR because of the relationship of the lesion to the gingival margin. lateral . 7. b. over time. b. Which of the following statements regarding the primary endodontic lesion with secondary periodontic involvement is correct? a. d. Pulp necrosis occurs and forms a sinus tract through the periodontal ligament that. which is followed by a 6month recall examination.

A 51-year-old woman seeks evaluation of swelling of the buccal tissue opposite her mandibular. Based on this information what diagnostic classification is most appropriate? a. 29. no. ENDODONTIC PHARMACOLOGY Odontogenic pain is usually caused by which of the following? Noxious physical stimuli . e. 8. 30). right. 10 are responsive to CO2 snow. Tooth no. 30. Vertical-root fracture Palatogingival groove Pulp necrosis Periodontitis Osteogenic sarcoma 10. Pulp testing reveals that no. She states that she has had pain for the past week and that the swelling began yesterday. 30. first molar (tooth no. there is a radiolucent area in the furcation of tooth no. Clinical examination reveals a 12 mm probing defect on the lingual aspect of tooth no. except for a 6-mm defect in the furcal area of tooth no. however. 30. 30 is not responsive. no. She relates a history of having a full-gold crown placed 2 months ago. b. no.incisor. 6. 28. Probing depths are 3 to 4 mm. a. Which of the following is the most likely cause of this lesion? a. Radiographic examination reveals normal apical structures. d. Radiographic examination reveals a diffuse radiolucent area along the mesial lateral root surface extending from the crestal tissue to the apex. e. Pulp testing with CO2 snow reveals teeth nos. Additional probing depths are 3 mm or less. Primary endodontic lesion Primary periodontic lesion Primary endodontic lesion with secondary periodontic involvement Primary periodontic lesion with secondary endodontic involvement Concomitant endodontic and periodontic lesion CHAPTER 18: 1. 9. d. b. This area was not evident on the film taken before placement of the crown. Clinical examination reveals swelling in the buccal furcation area of tooth no. 8. and 31 respond. c. c.

b. c. Sympathetic fibers are not blocked with application of local anesthetic agents.b. a. C fibers transmit pain to the superior cervical ganglion. c. a. b. 2. The release of inflammatory mediators Stimulation of sympathetic fibers in the pulp Edema produced in a ridged. d. Convergence Sublimation Nociception Information transfer Projection Which of the following statements is true regarding descending fibers? They inhibit transmission of nociceptive information. A-delta fibers play the predominant role in encoding inflammatory pain. b. . Nociceptive signals are transmitted primarily to which of the following? Nucleus caudalis Limbic system Reticular system Superior cervical ganglion 4. b. a. c. noncompliant root canal system Which of the following best describes the neural innervation of the dental pulp? A-delta fibers transmit pain to the trigeminal nucleus. e. 3. They are not affected by endogenous opioid peptides. c. Pain that refers from an inflamed maxillary sinus to maxillary molars is likely to the phenomenon of which of the following? a. d. d. d. 5.

They transmit information from the cerebral cortex to the thalamus. Hyperalgesia is characterized by the following. Which of the following statements regarding activation of the opiate receptor is accurate? a.. a. Opioids are frequently used in combination with other drugs because which of the following? a. Lodine). c. d. When compared with ibuprofen. Regarding etodolac (i. 8. 7. It induces the release of endorphins. d. b. d. except for one. This drug can be prescribed for adult patients with aspirin hypersensitivity. It blocks transmission of signals from the thalamus to the cerebral cortex. c. antiinflammatory drugs in combination with the opioid act synergistically on the opiate receptor.e. b. Studies indicate etodolac is unique. They are sympathetic fibers that modulate blood flow in the pulp after sensory stimulation. 9. Which is the exception? a.c. It blocks nociceptive signals from the trigeminal nucleus to higher brain centers. . c. Hyperalgesia is primarily a central mechanism. 6. Spontaneous pain is present. b. because the drug does not have a peripheral analgesic mechanism of action. etodolac has a more profound analgesic action. It blocks the release of dynorphins. Hyperalgesia produces an increased pain perception to a noxious stimuli. The nonsteroidal. The pain threshold is reduced. d. which of the following statements is correct? The drug exhibits minimal gastrointestinal irritation when compared to ibuprofen.

d. the opioid is supplemented with a non-steroidal. c. c. Codeine prescribed in 30-mg doses is more effective than a placebo. Codeine prescribed in 30-mg doses is more effective than 600 mg of acetaminophen. 11.b. a. If pain persists. antiinflammatory agent a day before the appointment and then as necessary for postoperative pain. Doses are then alternated. Removing the peripheral mechanism of hyperalgesia Providing an adequate level of nonsteroidal. c. b. d. local anesthetic agents to break the pain cycle 12. Opioids are not antipyretic. b. antiinflammatory agent or acetaminophen is administered. Patients are advised to take the maximal dose of a nonsteroidal. Which of the following best describes a "flexible plan" for prescribing analgesic agents? a. which can reduce side effects. anti-inflammatory analgesic agent Prescribing an appropriate antibiotic in cases where pain is the result of infection Using long-acting. A maximal dose of an opioid is administered. Which of the following is true for the use of codeine as an analgesic agent? Codeine prescribed in 60-mg doses is more effective than 650 mg of aspirin. Opioids do not act peripherally. Doses are then alternated. the drug is supplemented with an opioid. The combination permits a lower dose of the opioid. If pain persists. 10. A maximal dose of a nonsteroidal. Codeine prescribed in 60-mg doses is more effective than a placebo. Management of pain of endodontic origin should focus on which of the following? a. . c. d. b. antiinflammatory agent or acetaminophen.

c. 13. b. d. c. They increase the risk of nephrotoxicity. They result in increased concentrations of the nonsteroidal agent in the blood plasma. They induce bone marrow suppression. Reducing the concentration of those mediators Decreasing responsiveness to nociceptive stimuli Decreasing the number of anesthetic molecule receptors . antiinflammatory agents administered in combination with cyclosporine may result in which of the following? a. Indomethacin administered in combination with sympathomimetic agents results in which of the following? a. Patients are advised to take an opioid agent a day before the appointment and then as necessary for postoperative pain. Increase the prothrombin time Result in a decreased bleeding time Increase the bioavailability of the anticoagulant Produce no adverse effect 15. Increased blood pressure. Peripheral afferent nerve fibers in an inflamed pulp may respond to mediators by which of the following? a. b. Nonsteroidal. c. They decrease the activity of the cyclosporine.d. Nonsteroidal. d. Decreased water retention Decreased absorption of indomethacin. Decreased blood pressure. antiinflammatory agents administered in combination with anticoagulants may result in which of the following? a. c. d. b. requiring a higher dose 16. b. 14.

Prophylactic administration of antibiotics to control adverse posttreatment symptoms in prospective. e. e. when are analgesics most effective when administered? a. To minimize posttreatment pain. b. e. Ineffective Effective if given in high doses Effective only if given pretreatment Effective if given in conjunction with intracanal antibiotics CHAPTER 19: ENDODONTIC MICROSURGERY . Two nonsteroidal antiinflammatory drugs (NSAIDs) that have minimal adverse gastrointestinal side effects are which of the following? a. c. c.d. b. clinical trials on asymptomatic patients has been shown to be which of the following? a. Etodolac and ibuprofen Etodolac and rofecoxib Ibuprofen and ketoprofen Ketoprofen and etodolac Ibuprofen and rofecoxib 18. d. c. d. controlled. Decreasing numbers of ion channels Sprouting of terminal fibers 17. d. As a pretreatment Immediately after treatment When the anesthetic begins to wear off When the patient first perceives pain When the pain is the most intense 19. b.

8) and facial swelling. He relates traumatic injury as a child with root canal treatment during his teenage years. c. d. central incisor (tooth no. prescribe an antibiotic. Root canal retreatment was necessary and the tooth was restored with a cast post. 8 playing basketball in his early thirties. Each of the following statements on the reasons two radiographs are recommended for evaluation of a tooth to be treated surgically is correct. right. a. When a vessel is severed. Management of the infection and performance of root end surgery when the swelling subsides d. 3. The depth of the overlying bone can be determined. Root curvatures can be viewed. core and crown. Root end surgery and a postsurgical antibiotic c. The root length can be assessed. b. Incise and drain the swelling. Subsequent to this treatment he fractured tooth no. c. Incision and drainage followed by nonsurgical retreatment and fabrication of a new restoration b. except for one. initial hemostasis results from which of the following? Contraction of the vessel wall Formation of a platelet plug The conversion of prothrombin to thrombin The conversion of fibrinogen to fibrin . d. A 45-year-old man has a radiolucent area associated with his maxillary. Two films permit the evaluation and location of normal anatomic structures. Tooth extraction and implant placement 2. and follow the patient on recall examinations e.1. b. The size of the lesion can be determined. e. Which of the following is the most appropriate treatment sequence? a. Which is the exception? a.

d.000 epinephrine 4% prilocaine plain 5. Which of the following statements regarding flap reflection is correct? a. The mucogingival flap with an anterior-releasing incision is preferred in posterior areas. It prolonged the duration of anesthesia. The rectangular flap design is most appropriate in the posterior areas. The semilunar flap has the advantage of providing an esthetic result without scar formation. The type of vertical-releasing incisions distinguish the mucogingival flap from the Luebke-Oschsenbein flap.000 epinephrine 0. The horizontal incision for the mucogingival flap is made perpendicular to the cortical bone.5% etidocaine 1:200. The primary beneficial action of epinephrine when performing root end surgery is which of the following? a. b. Which of the following hemostatic agents activates the intrinsic coagulation pathway? a. The anesthetic of choice when performing endodontic root end surgery on a patient with mild cardiovascular disease is which of the following? a. e.000 epinephrine 2% lidocaine 1:50. It effects the drug on alpha-1 receptors in the alveolar mucosa. Ferric sulfate . 6. c. c.5% marcaine 1:200.4. d. c. 1. It decreased systemic uptake of the anesthetic solution. b.000 epinephrine 2% lidocaine 1:100. It effects the drug on beta-1 receptors of skeletal muscle. d. b. e. 7.

b. c. d. e.

Calcium sulfate paste Microfibrillar collagen Bone wax Epinephrine pellets

8. Which of the following is the recommended hemostatic technique to control bleeding during root end surgery? a. Local anesthesia with 2% lidocaine 1:50,000 epinephrine, epinephrine saturated pellets, ferric sulfate, calcium sulfate paste b. Local anesthesia with 2% lidocaine 1:50,000 epinephrine, ferric sulfate, microfibrillar collagen, bone wax c. Local anesthesia with 2% lidocaine 1:100,000 epinephrine, ferric sulfate, microfibrillar collagen, Telfa pad d. Local anesthesia with 0.5% marcaine 1:200,000 epinephrine, ferric sulfate, calcium sulfate paste 9. Each of the following statements is correct regarding the use of the H 161 Lindemann bone cutter for root end surgery is correct, except for one. Which is the exception? a. b. c. d. 10. It reduces frictional heat when resecting bone. It has more flutes that conventional burs, so cutting is faster and more efficient. When used with the Impact Air 45 hand piece splatter is decreased. It has fewer flutes and is less likely to clog. Which of the following statements regarding root end resection is correct?

a. The root should be resected at a 45-degree angle to ensure adequate access and visibility. b. The apical 2 mm should be removed to ensure that apical ramifications are not present. c. Root end resection should precede apical curettage.

d. Resection of the root should be as perpendicular to the long access of the root as possible. 11. Which of the following statements regarding the isthmus between canals is correct? a. Although often noted between canals, failure to include this area in the preparation does not affect the prognosis of a tooth. b. The incomplete isthmus should be prepared with a tracking groove before ultrasonic preparation. c. Isthmus incidence is not affected by the amount of the root resection but increases as the bevel approaches 45 degrees. d. When using a surgical operating microscope, the absence of an isthmus at 16 × to 25 × is evidence that no connection between canals exist. 12. Which of the following statements regarding ferric sulfate is correct?

a. Ferric sulfate acts by producing a tamponade effect and is absorbed by the body over 2 to 3 weeks. b. Ferric sulfate exhibits an alkaline pH.

c. Applied to the osseous surface, ferric sulfate causes agglutination of blood proteins. d. 13. Ferric sulfate induces osseous tissue formation. Which of the following statements regarding root end preparation is false?

a. The ideal preparation should extend 3 mm into the root and follow the long axis of the tooth. b. c. The lingual wall of the preparation is the most difficult area to evaluate. Ultrasonic preparation has the potential to induce micofractures in the dentin.

d. KiS tips have enhanced cutting efficiency for root end preparations because of a zirconium nitride coating. e. Ultrasonic root end preparation may thermoplasticize the remaining gutta-percha.

14.

Which of the following statements regarding root end filling materials is false?

a. Super EBA is preferred as a root end filling material over IRM because it lacks eugenol. b. IRM is preferred over amalgam.

c. Mineral trioxide aggregate (MTA) is not adversely affected by contamination with blood. d. Periapical healing with MTA results in cementum formation over the material.

e. Composite resins appear to be acceptable, providing a dry-opening field can be maintained. 15. Which of the following statements is correct regarding treatment for a 73-year-old woman who develops ecchymosis after root end surgery? a. Instruct the patient to place warm compresses over the area three to four times daily. b. c. d. Place the patient on an antibiotic to prevent infection of the area. Prescribe an antiinflammatory analgesic to enhance the healing process. Explain the cause of the problem to the patient and provide reassurance.

CHAPTER 20:

MANAGEMENT OF PAIN AND ANXIETY

1. The majority of life-threatening systemic complications arise in which of the following? a. b. c. d. 2. a. During or immediately after injection of local anesthetics In conjunction with surgical procedures, such as tooth extraction During the pulp extirpation phase of root canal treatment As a result of bleeding from patients with known bleeding disorders Which of the following tooth groups is the most difficult to anesthetize? Mandibular premolars

. c. d. Failure to obtain adequate anesthesia after an appropriately administered nerve block is most likely the result in which of the following? a. pH changes in the pulp tissue caused by inflammations Morphologic neurodegenerative changes and inflammatory mediators Insufficient volume of local anesthetic injected Tolerance to the anesthetic agent 6. b. d. c. Amides are more allergenic when compared to esters. It results in fewer anesthetic molecules entering the nerve sheath. c. b. It changes the pKa value for a given local anesthetic. c. 5. which of the following is true? a. c. When comparing amide and ester local anesthetic agents. Esters are more likely to produce systemic toxicity when compared to amides. Amides are more effective than esters. a. d. 4. d. It cecreases the protein-binding of the local anesthetic. b. a. 3.b. Maxillary premolars Maxillary molars Mandibular molars Which of the following is not a factor affecting the onset of local anesthesia? Diffusion of the local anesthetic through the lipid-rich nerve sheath The pKa for the anesthetic agent The pH of the tissue The protein-binding ability of the local anesthetic A decrease in the tissue pH causes which of the following? It increases the free base of the local anesthetic agents. b.

The needle is inserted at the height of the mucogingival junction of the most posterior. second premolar. d. superior nerve Performing a palatal infiltration Repeating the PSA 8. Esters and amides are equally effective. b. The needle is passed lingual to the mandibular ramous until is bone is contacted. c. 7. . b. 10.d. An infiltration injection is given for a maxillary. In this situation the clinician should consider which of the following? a. Anterior superior alveolar (ASA) block PSA block Palatal infiltration Maxillary (division II) block Greater palatine nerve block 9. b. Adequate anesthesia is not obtained. which of the following are accurate? a. first molar. c. b. A patient is anesthetized using a posterior superior alveolar (PSA) nerve block to perform endodontic treatment on the maxillary. d. Which injection should be considered? a. Infiltration in the mandible may be an effective technique in treating the which of the following? a. d. Central incisor Canine First premolar Second molar In performing the Akinosi technique. maxillary tooth. Anesthetizing the anterior. e. c. Adequate anesthesia is not obtained. superior nerve Anesthetizing the middle.

11. For emergency treatment of patients with pulp pathosis. It produces significant analgesic effect when used in conjunction with local anesthetics. To limit the adverse reactions to vasopressor components of local anesthetic cartridges d. Administration instructions for patients in pain the day before initiating root canal treatment to ensure adequate blood levels d. 12. All of the above statements are accurate. Immediate preoperative administration of opiates when pulpal pain is present 13. . d.c. As a true intraosseous injection As a modified periodontal ligament injection c. b. As a method to administer intrapulpal injections painlessly Prescriptions for analgesic agents should provide which of the following? Instructions for administration at regular intervals Instructions for taking the medication when patients experience pain c. d. c. b. Injection at the neck of the mandibular condyle is the objective. a. b. When deep sedation of the fearful patient is desired When barbiturates with oral sedation should be considered When oral sedation with midazolam may provide an amnesia effect When a short-acting agent permits the patient to leave without an escort 14. Which of the following statements regarding the use of nitrous oxide inhalation sedation is accurate? a. oral sedation should be considered during which of the following? a. The Stabident local anesthesia system is used for which one of the following reasons? a.

It may be more effective because it is deposited in normal. It anesthetizes all branches of the maxillary nerve. It is difficult in managing endodontic patients because of the application of the rubber dam. d.b. It occasionally anesthetizes the orbicularis oris. It can be delivered by a computer-controlled system or by traditional needle and syringe. If the dentist thinks there may be considerable posttreatment pain. 15. the clinician may do which of the following? . c. It anesthetizes buccal and palatal bone. Which of the following statements regarding regional nerve block is accurate? It achieves anesthesia by blocking efferent nerve impulses. b. It should be considered if oral sedation cannot be used. It should be used only when an auxiliary of the same sex as the patient is present to assist. Which of the following statements regarding the anterior middle superior alveolar (AMSA) nerve block is accurate? a. 16. It is effective for most maxillary teeth. d. tissue. It is exemplified by the long buccal nerve block. d. c. It is targeted mesial and distal to the apex of the involved tooth. It is more effective in the presence of infection It is ineffective for both adults and children in anesthetizing mandibular teeth. but not soft tissue. b. d. c. a. c. 18. Which of the following statements regarding supra-periosteal injection (infiltration) is accurate? a. b. 17. It requires use of an agent without vasoconstrictors. rather than inflamed.

The whitening mechanism for bleaching teeth is thought to be which of the following? a. Cervical resorption can be as high 25% when Superoxyl and heat are used. Prescribe antibiotics Reanesthetize with a long-acting anesthetic Prescribe antianxiety medications All of the above Which of the following statements regarding oral sedation is accurate? It has a quick onset of action. c. 19. Lesions develop rapidly and can be detected 1 to 2 months after bleaching. d. b. c.a. CHAPTER 21: TOOTH-WHITENING MODALITIES FOR PULPLESS AND DISCOLORED TEETH 1. It is difficult to titrate to ideal levels. b. It has a significant number of adverse reactions. b. Which of the following statements is correct regarding the incidence of cervical resorption after internal bleaching? a. c. such as iron and copper 2. d. A result of the degradation organic molecules of high molecular weight that reflect a specific wavelength of light b. c. Related to changes in the inorganic hydroxyapitite crystals Related to the dissolution of the stain A result of removal of free-metal ions. . It has a reasonably short duration. d. a. The incidence of cervical resorption increases in patients who are 25 years old and older.

6.d. Which of the following statements regarding power bleaching is false? a. such as Prema. b. c. The definitive bonded restoration should be placed at the visit in which the sodium perborate paste is removed. . d. Although cervical resorption is often attributed to bleaching. The agent used in the technique is 30% hydrogen peroxide. Microabrasion should not be used before placement of bonded restorations. except for one. 5. which of the following statements is accurate? a. 3. which can be obtained in proprietary products. b. Which is the exception? a. d. Endemic fluorosis Hereditary opalescent dentin Tetracycline staining Peridex staining Which of the following statements regarding microabrasion is correct? a. it is more likely caused by a previous traumatic injury to the involved tooth. 4. Requires a local anesthetic and frequently produces postoperative thermal sensitivity. The sodium perborate paste should be covered by a minimum of 2 mm of Cavit or IRM. b. d. The technique is useful in treating white-and-brown-spot surface lesions. When performing a walking bleach procedure. c. Each of the following is an intrinsic form of tooth discoloration. Power bleaching often uses a liquid rubber dam composed of a light cured resin gel. A barrier over the obturating material is not required. c. The dentin should be etched before placement of the bleaching agent to increase permeability of the tubules and enhance the bleaching action.

c. 2. Should pulp necrosis occur in teeth restored with crowns. It increases as they progress from the periphery to the pulpal dentin junction. d. b. The periodontal status of teeth restored with crowns is not a significant factor in the pulpal prognosis. It increases as they progress from the periphery to the pulpal dentin junction with an increase in diameter. maintaining a constant diameter. Which of the following statements regarding the density of dentinal tubules (per square millimeter) is accurate? a. It remains constant as they progress from the periphery to the pulpal dentin junction with an increasing diameter. c. d. those serving as abutments exhibit a higher rate of necrosis. usually within the first 3 years after cementation. fracture. Power bleaching can often be performed by trained dental auxiliary personnel. maintaining a constant diameter. Which of the following statements regarding teeth restored with crowns is correct? a. e. CHAPTER 22: RESTORATION OF THE ENDODONTICALLY TREATED TOOTH 1. c. the process occurs rapidly. . After fabrication of custom trays with appropriate reservoirs. or other causative factors are restored with crowns. It decreases as they progress from the periphery to the pulpal dentin junction. When teeth exhibiting no caries. b. patients apply a bleaching gel every 2 hours during their waking hours. Vitamin E can be used to neutralize the oxidizing effects of hydrogen peroxide that comes in contact with soft tissues.b. It remains constant as they progress from the periphery to the pulpal dentin junction with a decreasing diameter.

d. Increased chance for root fracture Greater potential for recurrent caries Infringement on the biologic width The altered light refraction Changes in collagen cross linking 5. Dowel length Dowel width The surface configuration of the dowel The core material An adequate ferrule .d. core. d. A tooth recently prepared for a porcelain fused-to-metal crown that (with placement of a provisional crown) exhibits severe pain to thermal stimulation b. 3.5 mm. except for one. e. A nonrestored tooth that exhibits probing depths of 4 to 5 mm A tooth that is not responsive to pulp testing with CO2 and EPT 4. The amount of occlusal reduction is a more significant factor in inducing pulpal pathosis when compared to axial reduction. Pulpal pathosis becomes significant when the remaining thickness of dentin is less than 1. d. e. A tooth requires a post. A tooth that is asymptomatic but has had numerous restorations placed over a period of years because of recurrent caries c. b. Which is the exception? a. Which of the following is the most important factor in the restorative equation? a. b. Which of the following would best fit the definition of the "stressed pulp syndrome"? a. e. c. c. Each of the following is a concern when restoring an endodontically treated molar with minimal remaining tooth structure. and crown for adequate restorative treatment.

c. central incisor tooth with 1 mm of structure above the gingival level. The carbon fiber dowels are more resistant to fracture. 8. mandibular. 10. 7. b. Which of the following statements regarding the zirconia dowel is accurate? It is easily removed from the canal by ultrasonics and special burs. d. c. c. a. It is similar to dentin in elasticity. They have a modulus of elasticity similar to dentin. b. d. a. d. Cast post and core Carbon fiber post with a composite core Parallel stainless steel (SS) post with an amalgam core Threaded dowel with a composite core Which of the following statements regarding the carbon fiber dowels is false? They are radiolucent. b. The most appropriate time to determine the precise method for restoring the endodontically treated tooth is which of the following? a. b. A patient requires a post and core for restoration of a narrow. When the initial diagnosis and treatment plan is established During the endodontic treatment procedures After completion of the root canal treatment After the initial-crown preparation Which of the following statements regarding post space is correct? . d. It requires a composite core. c. 9. They provide esthetic qualities similar to metal dowels.6. Which of the following would be the most appropriate dowel for this situation? a. It is readily seen on radiographs.

Pathologic changes in the periradicular tissues are most often apparent at the apexes than the furcation of molars. d. Thickness of dentin between pulp and enamel is greater in primary teeth Enamel is thicker in primary teeth The pulp chamber is comparatively smaller in primary teeth The pulp horns are higher in primary molars 2. which of the following statements regarding primary teeth is accurate? a. c. The post space for passive dowels must provide intimate contact between the dowel and the dentin wall. c. 3. Thermal pulp tests . Which of the following diagnostic tests is usually reliable for determining pulpal status of primary teeth? a. d. Direct composite-reinforced systems require the least amount of preparation. c. Radiographically. The basic morphologic difference between primary and permanent teeth is which of the following? a. CHAPTER 23: PEDIATRIC ENDODONTICS: ENDODONTIC TREATMENT FOR THE PRIMARY AND YOUNG. The presence of calcified masses within the pulp is indicative of acute pulpal disease. PERMANENT DENTITION 1. b. Post space should extend into the root to a depth 3 to 5 mm from the apex. b. By the time internal resorption is visible the only treatment is extraction. The post space required for fabrication of a dowel and core using a direct technique requires removal of more tooth structure than the proprietary dowel systems because of the need to remove undercuts.a. d. Pathologic bone-and-root resorption is always indicative of nonvital pulp. b.

A calcium hydroxide pulpotomy performed on a young. When the patient is asymptomatic When the tooth responds to pulp testing .b. It removes much of the bacteria present in dentin. Electrical pulp tests Percussion None are reliable in children. c. It includes placing calcium hydroxide or zinc oxide-eugenol (ZOE) over the remaining caries and permanently restoring the tooth with amalgam. Which of the following statements regarding indirect pulp therapy is accurate? a. c. b. a. b. b. d. d. Carious exposures Mechanical exposures Calcification in the pulp chamber All of the above Symptoms of pulp abnormalities in primary teeth include which of the following? Pain to percussion History of spontaneous pain Variations in mobility All of the above 7. 4. 5. c. 6. Direct pulp capping is recommended for primary teeth with which of the following? a. d. permanent tooth is judged to be successful during which of the following? a. It is indicated only in the treatment of teeth with deep carious lesions in which there is no clinical evidence of pulpal degeneration or periapical pathosis. It involves all of the above. b. c. d.

c. c. c. It has less systemic distribution beyond the pulp. Glutaraldehyde may be preferred to formocresol for primary pulpotomy because of which of the following reasons? a. b. It has a better prognosis. . When normal root development continues All of the above statements are accurate. It is not antigenic. b. d. The effect of formocresol on the pulp tissue is controlled by which of the following? a. Formocresol Calcium hydroxide Electrosurgery Laser surgery 11. Concentration used Method of application Length of time applied All of the above 10. Formocresol pulpotomy on a primary tooth is indicated during which of the following? a. c. 8. c. b. d. d. b. When there is a history of spontaneous toothache When the inflammation or infection is confined to the coronal pulp When the pulp does not bleed When there is only apical pathosis 9. d. An increasingly popular technique for pulpotomy in primary teeth is which of the following? a.

They are from the facial surface. Which of the following statements regarding access opening on primary incisors is accurate? a. b. which of the following statements are accurate? a. b. They are different for maxillary teeth and mandibular teeth. Most visits are for comprehensive procedures. Which of the following is true in placing zinc oxide-eugenol in a primary tooth? Techique is not important The overfill has a poorer prognosis than a flush fill. . 14. d. CHAPTER 24: GERIATRIC ENDODONTICS 1. They are from the incisal edge. c. Which of the following is an indication for root canal treatment of primary teeth? Radiographic evidence of internal root resorption Periapical lesion Dentigerous cyst Mechanical or carious perforation of the chamber floor 13. Older patients have fewer visits per year than younger patients. b. As related to dental visits by the older patient. The paste should be mixed to a thick consistency. All are true. c. a. a. d. c. d. c. They are from the lingual surface. It is less readily metabolized.d. 12. The number of visits by older patients should decrease in the future. b.

patients become less alert and. d. It usually progresses more slowly. c. d. It does not require an irritant. In the older patient (as compared with a younger patient). b. c. therefore. It is less likely to be as painful as in a younger patient. repeated injuries. Sensory nerves in dentin degenerate with time. It may result in complete pulp obliteration. c. 5. Pulpal calcifications block external stimuli from reaching receptors. b. 4. Dental visits of older patients are for less-complicated procedures when compared to younger patients. Pulps in older patients tend to be less responsive to thermal stimuli because of which of the following reasons? a. Pulps tend to have less sensory innervation in older teeth. It may compromise the blood supply and cause pulp necrosis. It is more likely to be acute than chronic. An abrupt midroot radiographic disappearance of a canal usually indicates which of the following? a. It is less likely to occur. Which of the following statements regarding secondary dentin formation in the radicular pulp in an older patient is accurate? a.d. Sensory nerves in pulp lose their myelin sheath as a result of long-term. It is less likely to occur in response to abrasion than in younger patients. less responsive to external stimuli. 2. 3. Bifurcation in the canal . b. e. d. regarding pulpal inflammation from caries. which of the following statements is accurate? a. With age.

It should be avoided because it decreases successful prognosis. b. b. 8. c. Usually more emotionally traumatic . c. Which of the following statements regarding single-visit root canal treatment in an older patient is accurate? a. It is acceptable if it is more convenient for the patient. d. d. It should be avoided because there is more likely to be an increase in postappointment pain. Secondary dentin formation apically Concentrations of dystrophic calcifications apically Diminished (often unnegotiable) sized canal 6. In the older patient (as compared with the younger patient) the exit of the canal (i. c. Success of root canal treatment in older patients (as compared with younger patients) is which of the following? a. apical foramen) is which of the following? a. In the older patient root canal treatment (as compared to extraction) is which of the following? a. Better Poorer Equivalent Unknown (has not been investigated) 9. d. c. b. It should be avoided to place an intracanal medicament.b.e.. Closer to the radiographic apex Closer to the true apex Easier to detect tactilely More variable because of cementum formation 7. d.

a. b. c. 13. In geriatric patients. d. All of the above occur. A postsurgical condition that tends to occur more frequently in older patients is which of the following? a. which is less resistant to caries. b. Gingival recession exposes cementum and dentin. c. e. The cementodentinal junction locates progressively more coronally.b. b. which of the following statements are accurate? a. which of the following statements are accurate? Lateral canals enlarge and become more clinically significant.e. There is a direct correlation between the nature of response to electrical-pulp testing and the degree of inflammation. discoloration) of soft tissues Infection of the surgical site Loss of sutures because of more friable tissues Continued hemorrhage of the incision site Loss of consciousness When should periapical radiographs be prescribed? Before discussion of the chief complaint After discussing the chief complaint with the patient Just before the clinical examination After completing the clinical examination With aging. Ecchymosis (i. d. Usually more tissue traumatic Often less expensive in the long run More likely to result in postappointment complication 10. a. 11. d. d. b. There is a reduced volume and increased neural component of the pulp.. 12. . c. c.

14. Cold sensitivity is the usual symptom that indicates a missed canal. It may be somewhat easier because the vestibule is deeper. d. c. It requires more anesthetic and vasoconstrictor than in younger patients. Which of the following statements regarding endodontic surgery in older patients is accurate? a. There may be failure even though the patient has no symptoms. It has been demonstrated to be much less successful than in younger patients. Diffuse pain of vague origin is unlikely to be odontogenic. The bone of the aged patient is more mineralized than that of a younger patient. a consideration is which of the following? a. The radiolucent structure at the periapex of the premolar in the following illustration is likely which of the following? . Overlooked canals are seldom a problem because they are usually calcified. 16. b. 15.c. b. d. It is risky because inadequate blood supply may result in postsurgical osteomyelitis. Tooth discoloration usually is not indicative of pulpal death. In evaluating success and failure of endodontic treatment in aged patients. d. c.

d. A maxillary sinus An endodontic apical pathosis A fibroosseous lesion A bony trabecular pattern 17. c. The elevated structure facial to the crowned first molar in the following illustration is likely which of the following? .a. b.

d. c. They have a different appearance than the surrounding dentin. a. b. . d. Radiographically. Acute apical abscess Periodontal abscess Fibroma Exostoses CHAPTER 25: NONSURGICAL ENDODONTIC RETREATMENT 1.a. c. which of the following statements regarding canals that appear calcified are accurate? a. b. They are seldom able to be instrumented. Canals may be missed during treatment because of which of the following? Calcification Anomalous location Inadequate access All of the above 2. b.

b. b. requiring retreatment. Use of too small a master cone Excessive heating and compaction during warm. c. c. a.c. e. c. d. 7. d. b. vertical condensation Destruction of the natural apical constriction Lateral or furcal canals are which of the following? Commonplace Not able to be mechanically cleaned Not routinely obturated Seldom the sole cause of endodontic failure All of the above Retreatment has the most favorable prognosis during which of the following? When the cause of failure is identified and is correctable When the patient is asymptomatic When gutta-percha was used instead of paste When a surgical microscrope is used For silver point removal. b. a. The major reason for failure. is which of the following? Persistent pain Draining sinus tract Restorative indications Microleakage 4. d. Presence of excess gutta-percha beyond the apex is usually caused by which of the following? a. 6. c. 3. a. 5. ultrasonics are used for which of the following reasons? . They should be opened up with rotary rather than ultrasonic instruments.

a. To break up cement surrounding the point To reduce the level of dentin on the floor of the chamber to expose the point To break up the silver point into small pieces. c. 11. c. b. the generally preferred time for repairing the defect is which of the following? a. a. d. How should rotary instruments be used for the removal of gutta-precha? To remove all the gutta-percha the length of the canal At the highest speeds In reverse of the canal preparation direction In portions of the canal where the instruments fit passively In portions of the canal where the instruments fit snugly 9. a. If a cervical root perforation occurs during the treatment and the canal preparation is incomplete. which can then be flushed out d. d. c. d. before proceeding with further preparation After cleaning and shaping is complete but before obturation Immediately after obturation After an appropriate recall period. c. e. to assess the status of the tissues Removal of objects can be facilitated by: Straight-line access A good light source Magnification All of the above Carrier-based gutta-percha removal and retreatment is: . that is. Immediately. b. b. To loosen the silver point by applying the vibrating instrument directly to the silver cone 8. 10. b.

Generally produces an image of superior quality Is easier to duplicate (reproduce) Requires less radiation exposure Accurately depicts the extent of caries . c. b. e. An advantage of conventional radiographic film relative to digital radiographic imaging is that film: a. d. b. Are very expensive to purchase Are more expensive to operate Have inferior image resolution Have a greater delay in obtaining images Are very complicated to operate 2. d. a. c. b. b. c. then surgery CHAPTER 26: PRACTICE DIGITAL TECHNOLOGIES IN ENDODONTIC 1. Generally easy. A disadvantage of digital cameras relative to film-based cameras is that the digital cameras: a.a. such as MTA Obturation. d. because the gutta-percha is insoluble Usually by using a combination of techniques Impossible Type III transportation is best managed by: Extraction Apexification with calcium hydroxide Forming an artificial barrier with a material. as best as possible. because all components are soluble Very difficult. d. c. 12.

e. b. c. b. Record pertinent data on a referred patient prior to any appointment Any of the above are possibilities TEST YOUR KNOWLEDGE Questions 1 to 3 relate to the following radiograph. c. 3. . a. d. a. Automatically contact insurance companies to determine coverage limits of a patient d. d. e. Produces an image more quickly The Internet is usable in dentistry for all of the following except: Inter-doctor consultations Online scheduling of patients Patient access to his/her dental records Online ordering of supplies Transmission of insurance claims The Clinical Chairside Workstation is used for: Storing and displaying clinical information Electronically determining shades for porcelain crowns Selecting and mixing cements Communicating by voice with the front desk The pre-registration specialized system is designed to: Obtain early registration for professional meetings Remind patients of recall appointments c. e. b. 5. a. 4.

The patient does not have symptoms. 2. All teeth shown in the radiograph respond to pulp testing. d. The radiolucent structure (arrow) at the apex of the canine is likely which of the following? a. except the canine. b. a. 1. Maxillary fracture Apical pathosis Nasopalatine duct Nutrient canal The radiographic appearance internally indicates which of the following? Two likely superimposed canals . c.

Extraction is prescribed. there is pulp pathosis. c. . c. d. The tooth responds to probing with an explorer into the carious lesion. Tooth no. Questions 4 to 8 relate to the following illustration. but the pulp space is too small to attempt root canal treatment. Root end resection and root end filling. there is pathosis. Root canal treatment. there is no pathosis. No treatment. b. 30 (first molar) causes the patient prolonged pain to cold and episodes of spontaneous pain. d. Dentinogenesis imperfecta Dense accumulations of linear calcifications Calcific metamorphosis 3.b. The recommended treatment and reason for the treatment is which of the following? a.

b. b. c. 5. d. Periodontal probing is within normal limits. 6. a. c. The entire pulp is inflamed. Coronal pulp is inflamed. 4. d. bone resorption Chronic inflammation. c. b. no bone resorption Acute inflammation. What is the likely appearance of the periapex histologically? Normal structures Acute inflammation. a. c. radicular pulp is normal. 7. b. pending further information What is the periapical diagnosis? Normal Acute apical periodontitis Chronic apical periodontitis Acute apical abscess What is the likely appearance of the pulp histologically? Coronal pulp is necrotic. radicular pulp is inflamed. d. The entire pulp is necrotic. a. 8. d. a. What is the pulpal diagnosis? Reversible pulpitis Irreversible pulpitis Necrosis Unknown. bone resorption What minimal immediate treatment is indicated? .There is no pain to percussion or palpation and no swelling.

Schedule the patient for future evaluation. . Complete canal preparation at this visit. Questions 9 to 13 relate to the following photograph and radiograph.a. Remove the caries and place a sedative temporarily. Perform pulpotomy or partial pulpectomy. c. d. b. None.

a. What is the pulpal diagnosis for tooth no. b. the second molar does not respond. 10. d. c.) 9. The third and first molars respond to pulp testing. (Photograph: The shallow occlusal alloy has been removed. but the tooth is tender to percussion on the cusps and tender to biting on a bite stick. She reports a period of cold sensitivity 6 months prior but has not had any cold tenderness for several months.A 50-year-old woman comes to the clinic complaining of sharp sensitivity with chewing on the lower left second molar. a. There is no pain to palpation. 18? Normal Hypersensitive Irreversible pulpitis Necrosis What type of bacteria would likely be found in the pulp? Gram-positive aerobes . There is an isolated 6mm probing defect on distal.

d. c. c. c. c. d. . d.b. a. b. a. 13. b. a. Gram-negative anaerobes Mixed flora None What is the likely cause of the patient's pain? Inflamed pulp Apical abscess Cracked tooth Periodontal abscess What additional tests are indicated? Cold test Heat test Test cavity Transillumination What type of permanent restoration is indicated? Occlusal amalgam Occlusal bonded complete Pin-retained amalgam Full-cast crown Questions 14 to 20 relate to the following photograph and radiograph. 12. d. b. 11.

The patient reports "a bad toothache for 2 days. I can't bite on these lower, right, front teeth." There is pain on pressure and palpation in the region of the lateral incisor and canine. The premolar (small amalgam) is asymptomatic. The lateral and premolar respond to pulp testing; the canine does not respond. There is no swelling. There is an aphthous ulcer on the facial attached gingiva of the lateral. All probings are normal. The lateral and canine have moderate mobility. 14. a. b. c. d. 15. a. b. c. d. 16. a. b. c. d. 17. a. b. c. Which tooth and tissue are the probable source of pain? Lateral incisor and pulp Canine and pulp Canine and periapical tissue Lateral incisor, canine, and periapical tissue What is the likely pulpal and periapical diagnosis for the lateral incisor? Irreversible; phoenix abscess Normal; chronic apical periodontitis Necrosis; phoenix abscess Reversible; normal What is the likely pulpal and periapical diagnosis for the canine? Irreversible pulpitis; phoenix abscess Normal; chronic apical periodontitis Necrosis; phoenix abscess Necrosis; suppurative apical periodontitis Which teeth (tooth) require(s) endodontic treatment? Lateral incisor only Canine only Both the lateral incisor and canine

d. 18. a. b. c. d.

Neither at present Which bacteria have been related to this pathosis? Gram-negative rods; anaerobic Gram-positive rods, anaerobic Gram-negative cocci; aerobic Gram-positive cocci; aerobic

19. Of the following inflammatory cells, which would likely predominate periapically? a. b. c. d. Lymphocytes Polymorphonuclear neutrophilic leukocytes Plasma cells Macrophages

20. Looking at the radiograph and clinical photograph, what is the likely cause of the pulpal and periapical pathosis? a. b. c. d. Incisal attrition Cervical erosion Caries Impact trauma

Questions 21 to 25 relate to the following radiograph.

22. Amalgams were place a few months earlier after removal of deep caries on both molars. right quadrant. She has increased pain on lying down.The patient reports severe. Cold-water application causes intense. She slept poorly last night. d. a. Medical history is noncontributory. She states that the pain began when she was drinking iced tea last evening and the pain has not subsided. diffuse pain in the region. She cannot localize the pain to an individual tooth. c. Probings are normal. continuous pain in the mandibular. Pulp testing shows response on the premolar and second molar. The pain is not relieved with analgesics. Which tooth (teeth) is (are) the most likely cause of her pain? Premolar First molar Second molar First and second molars What is the pulpal and periapical diagnosis for the first molar? . Percussion and palpation are not painful. 21. b. The first molar does not respond.

b. Necrosis. chronic apical periodontitis irreversible pulpitis. Because of inflammation. d. what is the likely reason? a. c. Reduce the occlusion and prescribe antibiotics. There is a decreased pH in the region favoring formation of cations. Place a cotton pellet of formocresol. d. . Prescribe analgesics and antibiotics. acute apical abscess Normal. this carries away the anesthetic very rapidly. phoenix abscess Irreversible pulpitis. If the offending tooth (teeth) is (are) not anesthetized. c. Questions 26 to 28 relate to the following radiograph. There may be morphologic changes in the nerves that originate in the inflamed areas. Inferior alveolar injection is indicated. c. b. chronic apical periodontitis Necrosis. a. b. normal What would be the minimal emergency treatment on the offending tooth (teeth)? a. d. Perform a pulpotomy and place a dry-cotton pellet. c. b. acute apical periodontitis What is the pulpal and periapical diagnosis for the second molar? Irreversible pulpitis. The anesthetic solution is diluted by the inflammatory fluids. there is increased circulation in the area. d. Remove the amalgam and place a sedative dressing. 25.a. these nerves becomes more excitable. acute apical periodontitis Irreversible pulpitis. Do a complete canal preparation. normal Irreversible pulpitis. 23. 24.

What diagnosis is likely? Chronic apical periodontitis . Surgery was several years ago. The canine responds to pulp testing. There are no probing defects.The patient has no adverse signs or symptoms. 26. a.

Questions 29 to 35 relate to the following clinical photograph and radiograph. c. d. a. b. What should the treatment plan be? Replace the crown. c. Foreign-body reaction Apical radicular cyst Scar tissue What is the likely cause? Continued irritation from an undébrided. 28. c.b. b. Place the patient on antibiotics to resolve the lesion. retreat the canal. No treatment is needed. a. Perform another surgery and place another root end material. 27. d. unsealed canal Adverse reaction to corrosion of the amalgam Coronal leakage Perforation of both cortical plates. . d.

.

. The swelling is between teeth nos. Normal Reversible pulpitis . b. 9? a. and the radiograph. 10. and 11 are responsive to electrical-pulp testing and to thermal stimulation with carbon dioxide snow (i. She denies thermal sensitivity and tenderness to biting pressure.A 58-year-old woman has swelling in the maxillary anterior area that has steadily increased for 2 days. dry ice). 9. 29. the clinical photograph. 9 probing 8 mm. 8. There is no tenderness to percussion. There is normal mobility. 9 (central incisor) and 10 (lateral incisor). but there is tenderness to palpation. what is the pulpal diagnosis for tooth no.e. Based on this information. Pulp tests reveal that teeth nos. and probing depths are 4 to 5 mm with the distofacial surface of tooth no.

10? a. Percussion . Based on this information. c. apical periodontitis Acute apical periodontitis Acute periodontal abscess 32. d. the clinical photograph. 31. c. a. e. d. b. what is the pulpal diagnosis for tooth no. d. b. d. e. b. Which of the following is most important in determining if this lesion is of periodontal origin or of pulpal origin? a. Which of the following is the most likely the cause of swelling associated with teeth nos. and the radiograph. c. 9? Normal Chronic apical periodontitis Chronic suppurative. 9 and 10? a. Normal Reversible pulpitis Irreversible pulpitis Necrotic What is the periradicular diagnosis for tooth no. Irreversible pulpitis Necrotic 30. Pulp necrosis Periodontal disease A developmental groove defect Vertical-root fracture Peripheral giant-cell granuloma 33.c.

. c.b. d. Citric acid application appears to produce pulpal inflammation when used in conjunction with reattachment procedures. followed by incision and drainage c. d. Which of the following statements is true regarding the effects of periodontal treatment procedures on the dental pulp? a. a. 2. b. b. Hypersensitivity may result from scaling but is a sign of pulpal pathosis or inflammation or both. Flap reflection to inspect the root for a vertical root fracture or lateral canal Surgical excision and biopsy 35. Analgesic treatment and antibiotic treatment until the involved tooth can be localized d. Scaling and root-planing procedures remove cementum. Scaling and root-planing procedures may produce deposition of tertiary dentin. ANSWER KEY Chapter 1 1. b. e. c. expose dentinal tubules. root planing of the area. which are invaded and result in pulp inflammation. e. and drainage Root canal débridement of tooth no. 9. 34. A periapical radiograph Periodontal mobility and mobility assessment Pulp testing Periodontal probing Treatment of this case requires which of the following? Periodontal scaling. d.

c. d. d. c. 10. a. d. 16. 12. 2. e. a. 14. 15. b. 17. b. 6. b. b. 8. 13. Chapter 2 1. a. 11. 3. 19.3. c. c. 5. . d. e. d. 9. 4. b. c. 20. 18. 4. d. c. 7.

10. 13. a. c. 12. b. 18. d. 11. a. 20. b. 16. c. 17. b. . 8. b. d. 24. 22. 23. b. b. 7. a. c. b. b. 19. b. a. b. 15. b. b. 6. c.5. 21. Chapter 3 1. 9. 14. 2.

d. 6. 11. 8. b. c. 12. 8. 5. 10. c. 6. 4. 7. c. c. 2. c. b. d. Chapter 4 1. 11. 9. e. c. a. b. a. 9. d.3. 10. c. 4. c. d. 5. a. 3. d. 7. . c.

5. d. d. a.Chapter 5 1. a. c. a. 15. 17. 9. b. c. 13. 6. 3. 19. a. 20. . d. c. c. 8. 18. 2. c. 10. 11. 7. b. c. 21. b. c. a. 4. 12. 16. c. d. 14. a.

8. b. a. 3. 6. 2. 6. a. a. 12. Chapter 7 1. b.Chapter 6 1. a. e. d. c. c. 9. 2. e. b. c. 7. 13. a. 11. b. 5. 7. 3. . c. d. a. 10. 4. 4. b. 5. b.

a.8. c. d. 12. 6. 9. 11. 5. 10. 10. b. d. d. e. d. b. a. a. 4. Chapter 8 1. 3. 2. a. a. 8. b. c. 3. Chapter 9 1. 4. 5. 2. 7. c. b. b. . d. c. 9.

16. 6. b. a. c. 17. b. 9. a. . b. d. a. a. d. 11. b. 15. a. a. 13.6. 5. 2. 9. 10. c. d. d. 14. 8. a. b. 12. d. Chapter 10 1. a. 3. 7. 10. b. 8. c. 7. 4.

15. b. 2. a. Chapter 12 1.11. 2. a. 11. 10. 7. b. d. Chapter 11 1. d. 5. 8. a. b. 6. b. b. 16. a. 12. 12. 14. 3. b. c. d. c. a. c. a. . 9. a. b. 4. 13.

3.3. 10. 8. 4. d b. c. 12. c. a. c. 11. a. 13. 15. 14. 6. 2. 9. 4. 7. 9. 6. 8. d c a a c d b. b. d. . b. a. 5. b. 5. b. a. c. 7. Chapter 13 1.

4. 20. 5. 15. a. a. 7. 8. 9. e. 13. a. 10. b. e b. a. d. 6. a. c. 11. 18. 3. b. Chapter 14 1. a. 17. c. c.10. 19. c. 14. 12. . 2. c. e. 16. c. 11. c d b.

c. c. c. d. 8. b. d. 18. 16. . 2. 3. a. 10. d. b. d. b. 12. 13. 5. 7. a. Chapter 15 1. d. 17. b. a. 4. b. 20. a. 15. d.12. 19. 14. a. a. 6. d. 13. d. 11. 9.

12. e. 7. c. c. b. d. d. 19. a. d. 16. c. 3. 5. . 14. 17. 4. 15. 15. a. b. 16. a. Chapter 16 1. 6. d. b. 11. e. 13. a. 9. 8. 2. a. 10. c. a. a. b. b. 18.14.

a. a. 8. 9. 10. a. 2. b. Chapter 17 1. 7. 7. 3. 5.17. a. 6. 5. b. a. b. 4. a. d. d. 3. 8. a. a. a. e. Chapter 18 1. 2. 9. 6. a. b. b. . a. 4. b.

b. b. 7. d. 3. 17. 6. 19. 12. 11. . a. d. e. a. Chapter 19 1. 12. c. 11. b. 13. a. e. b. 18. b.10. 8. 10. a. 4. 16. 5. d. 14. 15. 2. a. 9. c. a. d. a. c. a.

a. 9. a. d. a. . a. a. b. d. c. 7. 6. b. d. 14. 4. 15. d. 19. 11. b. 12. 3. a. d. 2.13. 18. 16. 8. b. 17. a. 13. b. d. 15. c. 14. c. Chapter 20 1. 5. 10. c.

c. 6. d. 5. 3. d. a. Chapter 22 1. b. 10. b. a. d. d. 4. 3. 7. a. 4. d. 3. e. Chapter 23 1. a. 8. 5. d. b. 2. d. 9. d. b. 2.Chapter 21 1. 6. . d. 2.

12. Chapter 24 1. 10. b. 7. 6. b.4. 10. d. 2. a. c. . 3. a. 11. 9. c. c. 8. 5. 13. a. 7. e. d. 4. a. 5. b. 9. c. c. 11. 8. d. d. 14. c. 6. b. d. d. a.

Chapter 26 1. a. a. d. 2. b. 16. a. Chapter 25 1. 8. c. d. 3. 7. 5. .12. a. 10. 4. 6. 15. 12. b. 14. c. 2. d. 9. d. e. c. c. c. b. 13. a. 17. d. 11. d.

b. a. 18. d. b. 2. d. 13. 7. 5. d Test Your Knowledge 1. a. b. d. 19. 4. 3. c. 10. 5. 15. a. c. 17. 14. d. c. 6. c. b. 9. d. . c. a. d. 4. 8. c. 16. 12. d. 11.3.

c.20. d. 24. . a. d. 22. 34. 23. d. 26. e. d. 30. d. a. b. a. 29. 35. 32. a. 25. a. 31. 21. a. 28. 33. 27. d. c.