55425721-EndodonticMcqs | Pain | Mouth

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?

d. Pulp testing Radiographic appearance Location of swelling Probing patterns 15. The acute apical abscess is best differentiated from the acute apical periodontitis by which of the following? a. b. d. d.a. c. Pulp testing Radiographic appearance Presence of swelling Degree of mobility 16. b. radiographic appearance. The abrupt change (arrow) in radiographic appearance in the following illustration probably indicates which of the following? . 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. c. Chronic apical periodontitis is best differentiated from acute apical periodontitis by which of the following? a. The lateral periodontal abscess is best differentiated from the acute apical abscess by which of the following? a. d. c. and nature of symptoms 17. Pulp testing and radiographic appearance Pulp testing and nature of symptoms Radiographic appearance and nature of symptoms Pulp testing.

d. c.a. The pain is exaggerated by cold. The patient in the following illustration reports severe. b. Which tooth and which tissue is likely the source of pain? . 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.

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

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

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

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

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

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

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

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

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

When this exposed dentin is contacted by cold fluids. Each of the following statements regarding trigeminal neuralgia is correct. b. c. trigeminal ganglion. trigeminal ganglion. trigeminal ganglion. trigeminal nucleus. thalamus. cortex Peripheral nerve. cortex d. c. trigeminal ganglion. Peripheral nerve. trigeminal nucleus. Which is the exception? . sharp pain. cortex 2. Which of the following pulp status is likely? a. mesencephalic nucleus. e. nonrestored premolar so that dentin is exposed. 24. the patient experiences brief. Peripheral nerve. d. cortex c.23. thalamus. A cusp fractures in a noncarious. except for one. d. trigeminal nucleus. Peripheral pain impulses in the dental pulp are transmitted centrally via which of the following pathways? a. 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. thalamus. Peripheral nerve. b. mesencephalic nucleus. a.

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

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

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

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

d. It is equally successful as multiple-appointment root canal treatment. It is best performed in association with trephination or root end surgery. There has been coronal leakage. 7. All of the above statements are accurate. It may predispose the patient to postoperative flare-ups. c. d. 5. They always require root canal treatment. c. b. The general dentist does not have the indicated training and experience. Referral of difficult cases is indicated in which of the following? The general dentist does not have the indicated equipment. b. c. The general dentist is not sure what procedures are indicated.d. b. Single visit is equivalent in outcome to multiple visits (to complete RCT) with what situation? a. d. A cast post and core and a well-fitting crown are present. 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. All of the above . b. a. All of the above 6. Which of the following statements regarding one-appointment root canal treatment is accurate? a. a. 8. d. c.

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

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

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

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

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

e.. the beam is directed more distally) Distally (i. d. Zygoma Floor of the maxillary sinus Coronoid process Eyeglass frame 17.. b. decrease the vertical angle) Superiorly (i. d.e..e.e. b. the beam is directed more mesially) Why does the tooth in the following illustration appear elongated? . Inferiorly (i.. 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. c.a. 18. increase the vertical angle) Mesially (i. c.

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

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

b. 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? .a. Of the following.

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

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. b. 3. The best way to clean dental instruments before sterilization is by which of the following? a. b. . d. b. 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. b. Rapid-steam autoclave will not corrode steel instruments. b. 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. a. c. c. d. Ultrasonic cleaning for 5 minutes in a perforated basket Hand scrubbing. Instruments do not have to be air dried at the end of the cycle. rubber dam The temporary restorative material. c. c. a. 5. Rapid-steam autoclave is safe for all types of materials.2. Cavit. a. An advantage of rapid-steam autoclave over traditional autoclave is which of the following? a. c.

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

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

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

There is a tendency for the buccal cusps to shear off under occlusal loading. The mandibular. b. The mesiobuccal canal was located under the mesiobuccal cusp tip and exhibited the straightest morphology. b. When there were two canals in the distal root. When treating a mandibular incisor with two canals evident on the preoperative radiograph. The pulp chamber is relatively large in comparison to the crown. they remained distinct with separate apical foramina. 8. c. c. d. In their study of mandibular molars. Skidmore and Bjorndal noted which of the following? a. b. c. 6. The canals often remain separate and distinct throughout the root. . making the tooth susceptible to fracture. The access opening should be rectangular. 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. which of the following statements are true? a. d. and the percentage of preexisting fractures is high. The internal morphology of the canals will be ribbon shaped. c. A facial-access opening might be considered. a. The incidence of four canals was over 50%. b. d. The access opening should be triangular with the apex at the cingulum. The tooth is in close to the insertion of the muscles of mastication. second molar should be restored with a crown after endodontic treatment for which of the following reasons? a.5.

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

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

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

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

Proper placed restoration after root canal treatment Healthy periodontium Three-dimensional (3-D) obturation of the root canal system 2. When using the balanced-force technique for canal preparation. d.to 90degree. Extending a no. Of the following.02 taper 1. It opens the apical foramen to a minimum diameter of 0. It increases postoperative discomfort to occlusal forces. Dentin is engaged with a counterclockwise rotation and cut with a 45.0 mm beyond the apical foramen will result in which of the following? a. 10 file to a no. b. b. 12. b. Eliminate bacteria that remains in the canals Mummify tissue remnants in the canals . Paraformaldehyde-containing obturating materials result in which of the following? a. It requires the use of a crown down technique. the least important determinant of root canal treatment success is which of the following? a. The cutting stroke involves apical pressure and a counterclockwise rotation. which of the following statements is accurate? a.12 mm. d. c. b. c. It eliminates the natural constriction of the foramen and increases the chance for an overfill. CHAPTER 9: OBTURATION OF THE CLEANED AND SHAPED ROOT CANAL SYSTEM 1. It reduces the percentage of change from a no. Clockwise rotation balances the tendency of the file to be drawn into the canal during the cutting stroke. 10 file with a 0. 15 file by 50%. c.11. clockwise rotation.

c. . Vertical condensation results in a better seal. The sealer is a tissue irritant and may delay healing. b. d. b. c. a. Lateral condensation results in a better seal. a. Reduce posttreatment pain Are below the standard of care for root canal treatment 3. The sealer promotes bacterial growth. It is preferable to not extrude sealer beyond the apex for which of the following reasons? a. d. Both consistently fill lateral canals. 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. c. e. Considering lateral versus vertical condensation. d. 4. c. studies have shown which of the following? a. 5. The sealer usually does not resorb. The sealer often stains or tattoos the tissue. c. d. b.

d. b. a. a. b. leading to root fracture They do not penetrate as deeply as stainless steel (SS) spreaders under equal force 8. Sealer and gutta-percha cause a severe. a. d. c. d. The pulp is necrotic and symptomatic. 9. The pulp is vital and symptomatic. 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? . c. 7. 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. b. 10. Sealability with either largely depends on the shape of the prepared canal. inflammatory reaction in periradicular tissue. 11. Moderate extrusion of obturating materials beyond the apex is undesirable because of which of the following? a. All of the above In which of the following is one-visit root canal treatment not recommended? The pulp is necrotic and not symptomatic. The pulp is necrotic and there is a draining sinus tract. c. c. d. b.d. There is more likelihood of postoperative discomfort. The prognosis is poorer.

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

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

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

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

a. A dentist may legally do which of the following? Refuse to treat a new patient. Which of the following statements accurately describe a periodontal examination of a patient referred for endodontic treatment? a. c. Any changes are forbidden. b. d. as defined by the courts. b. c. d. d. c. is which of the following? Requires absolute perfection b. Deletions are permitted if erased completely as soon as they occur. 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. Describes what any careful-and-prudent clinician would do under similar circumstances c. 4. It is necessary only if there is evidence of periodontal disease. 3. a. if dated. a. It should performed on the entire dentition. 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 . It must be performed at least on the tooth to be treated. 5. c. Corrections are permitted. Standard of care. It is necessary only if requested by the referring dentist. b. a. 2. b.

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.

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

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

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

16. There is a reduction in the nerves and vasculature of the pulp. a. especially in the radicular pulp. CHAPTER 12: 1. 2. b. There is an increase in peritubular dentin. b. particularly the pulpal floor of multirooted teeth. c. The fact that the pulp may not have a lymphatic system. and macrophages in the lesion . The environment of the dental pulp is low compliant. 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. Odontoblasts decrease in size and may disappear completely in some areas. Which of the following statements regarding age changes in the pulp are false? a. c. plasma cells. e. c. Odontoblasts are end line cells incapable of replication. a. d. d. c. e. There is a decrease in the cellularity and collagenous fibers. 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. b. There is a lack of a collateral circulation. d.

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

11. All of the above statements are accurate. c. d. b. d. c. All of the above statements are accurate. It may heal if induced by a noninfectious agent. Which of the following statements regarding acute apical periodontitis is accurate? a. a. 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. Which of the following statements regarding chronic. It is limited to the periodontal ligament (histologically). b. 8. apical periodontitis is accurate? . b. c. 12. a. 10. They form a ruffled border away from the bone surface. They account for the majority of circulating lymphocytes. 9. d. a. They produce antibodies. Which of the following statements regarding B-lymphocytes are accurate? They were originally discovered in an avian gut-associated organ. It is detectable radiographically. All of the above statements are accurate. b. d. They are mononuclear cells capable of bone demineralization.d. They respond only to mediators released by osteoblasts. c.

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

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

b. 9. a. c. b. b. 6. b. Which of the following statements regarding fascial space infections is accurate? They are associated with radiographically visible periradicular lesions. d. a. c. a. b. They are more concentrated in teeth with spontaneous pain. c. 7. d. . Lipopolysaccharides is found in the liposomes of gram-positive bacteria. All of the above. d. They occur when a tooth apex is located coronal to a muscle attachment. 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. All of the above statements are accurate. Which of the following statements regarding polyamines is accurate? They are produced by bacteria and host cells.a. d. c. c. a. 8. They occur in potential spaces between fascia and underlying tissue. They may be found in infected root canals. Pili break off and form extracellular vesicles filled with enzymes.

It relieves increased tissue pressure. b.d. b. It can progress into the canine and infraorbital space. 11. a. c. Antibiotics are recommended for which of the following? Sinus tracts Acute. 13. 10. 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. d. c. All of the above statements are accurate. d. All of the above statements are accurate. d. a. 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. c. Which of the following statements regarding potassium penicillin V is accurate? . It increases circulation to the area and improves delivery of antibiotics. c. 12. and submental space of the right or left side. b. a. All of the above statements are accurate. sublingual. e. a. It can result in airway obstruction. 14. It provides relief of pain. b. Which of the following statements regarding Ludwig's angina is accurate? It involves the submental. d.

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

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

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

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

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

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

c. It does not require as acute an angle of root resection. b. It is the material of choice when strength is a requirement. It results in apical cracks at low settings. b. 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. but cleaner. cavity walls. 20. a. It results in larger. It is a zinc oxide-reinforced material that can be light cured. a. d. 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. 19. d. The root end is ultrasonically prepared during endodontic surgery for which of the following reasons? a. b. c. Immune response of pulp tissue High tissue pH in the adjacent inflammation Mechanical blockage of sclerotic dentin . c. Relatively few bacteria are found in a pulp abscess because of which of the following? a. It can make a deeper cavity more safely than a bur. d. It has a eugenol component that is antibacterial. c.d. CHAPTER 15: PULPAL REACTION TO CARIES AND DENTAL PROCEDURES 1. b.

Acid penetrates to the pulp and damages the vessels. b. b. b. d. c. 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. c. d. d.000 epinephrine causes which of the following? a. Dentinal tubules are opened. Acid penetrates to the pulp and kills large numbers of cells. thereby increasing permeability.d. A periodontal ligament injection of 2% lidocaine with 1:100. The pulp circulation decreases slightly. 4. b. The pulp circulation remains the same. The response of the pulp to a recently placed amalgam without a cavity lining is usually which of the following? a. c. A disadvantage of acid etching dentin (regarding effects on the pulp) is which of the following? a. Antibacterial products of neutrophils 3. Slight-to-moderate inflammation Moderate-to-severe inflammation Slight but increasingly severe with time None . c. Acid softens the dentin and increases microleakage at the restoration dentin interface. The pulp circulation ceases for about 30 minutes. 6. a. The pulp circulation increases markedly.

It resists the effects of acid etching of the dentin. a. It eliminates the need for a cavity liner or base. c. d. Its bactericidal activity acts against oral microorganisms. Deeper cavity preparations have more potential for pulpal damage because of which of the following? 1.. 2.e.7. 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. 8. d. A reaction that tends to protect the pulp from injury from dentinal caries is which of the following? a. d. b. e. Odontoblastic processes are more likely to be severed. 1 only . The smear layer on dentin walls acts to prevent pulpal injury for which of the following? a. There is more vibration to pulp cells. c. 3. c. therefore there is increasing permeability. It reduces diffusion of toxic substance through the tubules. a. 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. b. b. Tubule diameter and density increases. 9.

b. Calcium hydroxide .b. b. A pulp has been damaged and is inflamed because of deep caries and cavity preparation. Retain the smear layer Use sharp burs with a brush stroke Use adequate air coolant Use adequate water coolant 13. Of the following. Polymerization shrinkage distorts cusps and opens gaps. 3 only c. Toxic chemicals are released from the composite and diffuse into the pulp. What material placed on the floor of the cavity aids the pulp in resolving the inflammation? a. 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. c. Which is the major reason why Class II restorations with composite are damaging to the pulp? a. a. which is the best way to prevent pulp damage during cavity preparation? a. c. 1 and 2 11. Microleakage occurs at the gingival margin. d. Agents that clean. c. 1 and 3 d. 2 and 3 e. d. 14. dry. d. Microleakage occurs at the occlusal surface. b.

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

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

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

It determines whether root canal treatment is indicated. 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. the most reasonable explanation is which of the following? a.d. b. It establishes a baseline for comparison with future testing. It determines if the blood supply to the pulp is compromised. b. c. d. e. d. It predicts the prognosis. Initial vitality testing of traumatized teeth is most useful to which of the following? a. e. Macrophages and lymphocytes Lymphocytes. 3. If several teeth are out of alignment after trauma. b. plasma cells. and macrophages 19. A normal periapical radiograph of a traumatized tooth is useful for which of the following? . c. d. Hypersensitivity of the pulp after restoration placement indicates which of the following? a. c. Luxation Subluxation Alveolar fracture Root fracture 2.

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.

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

Pulp necrosis frequently occurs in teeth with palatogingival grooves because of the lack of cementum covering the dentin. c. creating a periodontal pocket. b. except for one. 4. and the toxic irritants cause inflammation that migrates to the gingival margin. Although periodontitis can cause pulp inflammation and necrosis. radiolucent lesion characterized by the loss of the apical lamina dura. d. d. e. treatment procedures have little effect on the pulp. 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. Pulp necrosis occurs. 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. causing pulp inflammation and eventually pulp necrosis b. Pulp necrosis results in the formation of an apical. c. . Which is the exception? a. complete pulp necrosis will result. producing tissue destruction that mimics periodontitis. c. Which of the following statements best describes the effect periodontal disease has on the dental pulp? a. The prognosis for a tooth with a perforation is affected by all of the following factors. There is a direct correlation between the severity of the periodontal disease and the percentage of pulps that become necrotic. 5. d. Inflammation from the periodontal sulcus migrates apically. 3.d. Irritants gain access to the periodontal tissues at the site of a vertical-root fracture. b.

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

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

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

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

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

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

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

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

The horizontal incision for the mucogingival flap is made perpendicular to the cortical bone. 1.000 epinephrine 2% lidocaine 1:50. Ferric sulfate .000 epinephrine 0. The anesthetic of choice when performing endodontic root end surgery on a patient with mild cardiovascular disease is which of the following? a.000 epinephrine 4% prilocaine plain 5. The semilunar flap has the advantage of providing an esthetic result without scar formation.000 epinephrine 2% lidocaine 1:100. d.5% etidocaine 1:200. Which of the following statements regarding flap reflection is correct? a. e. It decreased systemic uptake of the anesthetic solution. Which of the following hemostatic agents activates the intrinsic coagulation pathway? a. The primary beneficial action of epinephrine when performing root end surgery is which of the following? a. c. The mucogingival flap with an anterior-releasing incision is preferred in posterior areas. b. 7. d. 6. e. It effects the drug on beta-1 receptors of skeletal muscle. c.4. d. It effects the drug on alpha-1 receptors in the alveolar mucosa. The rectangular flap design is most appropriate in the posterior areas. It prolonged the duration of anesthesia.5% marcaine 1:200. b. The type of vertical-releasing incisions distinguish the mucogingival flap from the Luebke-Oschsenbein flap. c. b.

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

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. d. a. b. It cecreases the protein-binding of the local anesthetic.b. c. c. c. When comparing amide and ester local anesthetic agents. 3. d. d. It results in fewer anesthetic molecules entering the nerve sheath. 4. b. 5. It changes the pKa value for a given local anesthetic. Amides are more allergenic when compared to esters. Failure to obtain adequate anesthesia after an appropriately administered nerve block is most likely the result in which of the following? a. which of the following is true? a. c. Esters are more likely to produce systemic toxicity when compared to amides. . b. 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. a. c. d. b. Amides are more effective than esters.

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

12. d. Injection at the neck of the mandibular condyle is the objective. 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. b. a. Administration instructions for patients in pain the day before initiating root canal treatment to ensure adequate blood levels d. As a true intraosseous injection As a modified periodontal ligament injection c. All of the above statements are accurate.c. 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. 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. c. The Stabident local anesthesia system is used for which one of the following reasons? a. Immediate preoperative administration of opiates when pulpal pain is present 13. d. To limit the adverse reactions to vasopressor components of local anesthetic cartridges d. . It produces significant analgesic effect when used in conjunction with local anesthetics. For emergency treatment of patients with pulp pathosis. 11. b. b.

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

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

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

It decreases as they progress from the periphery to the pulpal dentin junction. patients apply a bleaching gel every 2 hours during their waking hours. c. the process occurs rapidly. Should pulp necrosis occur in teeth restored with crowns. fracture. It remains constant as they progress from the periphery to the pulpal dentin junction with a decreasing diameter. Vitamin E can be used to neutralize the oxidizing effects of hydrogen peroxide that comes in contact with soft tissues. Which of the following statements regarding teeth restored with crowns is correct? a. those serving as abutments exhibit a higher rate of necrosis. Which of the following statements regarding the density of dentinal tubules (per square millimeter) is accurate? a. e. usually within the first 3 years after cementation. 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.b. d. maintaining a constant diameter. or other causative factors are restored with crowns. c. After fabrication of custom trays with appropriate reservoirs. 2. It increases as they progress from the periphery to the pulpal dentin junction with an increase in diameter. It remains constant as they progress from the periphery to the pulpal dentin junction with an increasing diameter. maintaining a constant diameter. d. b. Power bleaching can often be performed by trained dental auxiliary personnel. c. . CHAPTER 22: RESTORATION OF THE ENDODONTICALLY TREATED TOOTH 1. When teeth exhibiting no caries. b.

c. Dowel length Dowel width The surface configuration of the dowel The core material An adequate ferrule . The amount of occlusal reduction is a more significant factor in inducing pulpal pathosis when compared to axial reduction. d. e. 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. A tooth requires a post. Which of the following would best fit the definition of the "stressed pulp syndrome"? a. c. b. Pulpal pathosis becomes significant when the remaining thickness of dentin is less than 1. e. Each of the following is a concern when restoring an endodontically treated molar with minimal remaining tooth structure. core. 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. A tooth that is asymptomatic but has had numerous restorations placed over a period of years because of recurrent caries c.d. Which of the following is the most important factor in the restorative equation? a.5 mm. d. d. Which is the exception? a. b. 3. 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. except for one. e. and crown for adequate restorative treatment.

c.6. 7. a. It is readily seen on radiographs. 9. A patient requires a post and core for restoration of a narrow. mandibular. The most appropriate time to determine the precise method for restoring the endodontically treated tooth is which of the following? a. 8. b. b. d. c. c. Which of the following statements regarding the zirconia dowel is accurate? It is easily removed from the canal by ultrasonics and special burs. They provide esthetic qualities similar to metal dowels. d. a. central incisor tooth with 1 mm of structure above the gingival level. b. The carbon fiber dowels are more resistant to fracture. 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. They have a modulus of elasticity similar to dentin. 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? . Which of the following would be the most appropriate dowel for this situation? a. d. It is similar to dentin in elasticity. 10. d. c. It requires a composite core.

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

4. 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. b. It includes placing calcium hydroxide or zinc oxide-eugenol (ZOE) over the remaining caries and permanently restoring the tooth with amalgam. 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. b. Which of the following statements regarding indirect pulp therapy is accurate? a. b. d. 5. It involves all of the above. a. b. 6. Direct pulp capping is recommended for primary teeth with which of the following? a. Electrical pulp tests Percussion None are reliable in children. It removes much of the bacteria present in dentin. d. permanent tooth is judged to be successful during which of the following? a. d. When the patient is asymptomatic When the tooth responds to pulp testing .b. c. A calcium hydroxide pulpotomy performed on a young. c. c. c. d.

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

b. As related to dental visits by the older patient. They are different for maxillary teeth and mandibular teeth. which of the following statements are accurate? a. 14. d. They are from the lingual surface. c.d. c. c. They are from the incisal edge. b. 12. CHAPTER 24: GERIATRIC ENDODONTICS 1. They are from the facial surface. 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. The number of visits by older patients should decrease in the future. b. 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. Which of the following statements regarding access opening on primary incisors is accurate? a. d. Older patients have fewer visits per year than younger patients. . a. The paste should be mixed to a thick consistency. a. d. Most visits are for comprehensive procedures. All are true. b. It is less readily metabolized. c.

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

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

11. which of the following statements are accurate? Lateral canals enlarge and become more clinically significant. which is less resistant to caries. All of the above occur. d. A postsurgical condition that tends to occur more frequently in older patients is which of the following? a. There is a reduced volume and increased neural component of the pulp. 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. d. which of the following statements are accurate? a. c. Gingival recession exposes cementum and dentin. d.. c.b. 12. b. c. a. b. a. e.e. In geriatric patients. Ecchymosis (i. b. The cementodentinal junction locates progressively more coronally. 13. . b. c. d. There is a direct correlation between the nature of response to electrical-pulp testing and the degree of inflammation. Usually more tissue traumatic Often less expensive in the long run More likely to result in postappointment complication 10.

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

b. 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.

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

b. 3. requiring retreatment. c. a.c. They should be opened up with rotary rather than ultrasonic instruments. 7. a. c. b. 6. Presence of excess gutta-percha beyond the apex is usually caused by which of the following? a. d. c. 5. d. b. b. Use of too small a master cone Excessive heating and compaction during warm. The major reason for failure. 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. c. ultrasonics are used for which of the following reasons? . a. e. is which of the following? Persistent pain Draining sinus tract Restorative indications Microleakage 4. d.

11. which can then be flushed out d. c. d. To loosen the silver point by applying the vibrating instrument directly to the silver cone 8. If a cervical root perforation occurs during the treatment and the canal preparation is incomplete. d. the generally preferred time for repairing the defect is which of the following? a. c. that is. a. 10. 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. 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. Immediately. b.a. b. b. before proceeding with further preparation After cleaning and shaping is complete but before obturation Immediately after obturation After an appropriate recall period. a. e. c. b. d. c. 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: .

e. d. b. b. An advantage of conventional radiographic film relative to digital radiographic imaging is that film: a. as best as possible.a. 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. 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. 12. A disadvantage of digital cameras relative to film-based cameras is that the digital cameras: a. Generally produces an image of superior quality Is easier to duplicate (reproduce) Requires less radiation exposure Accurately depicts the extent of caries . c. c. d. b. d. c. a. because all components are soluble Very difficult. c. then surgery CHAPTER 26: PRACTICE DIGITAL TECHNOLOGIES IN ENDODONTIC 1. such as MTA Obturation. d. b. Generally easy.

e. b. a. 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. b. 3. 5. c. 4.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. Automatically contact insurance companies to determine coverage limits of a patient d. d. d. a. . a.

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

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

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

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

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

b. 12. a. . 13. d. d. c. d. a. c. 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. c. d. 11. c. b. b. a. b.

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.

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

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

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

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

.

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

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

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

9. d. 12. 4.3. e. c. d. 2. c. b. a. 7. 11. d. d. 16. 13. c. 17. d. c. c. . a. 8. b. b. Chapter 2 1. 10. 3. 4. 14. a. d. 19. 15. c. 6. 5. 18. b. b. 20. e.

b. c. 22. 14. b. b. 17. b. Chapter 3 1. b. 24. 21. 8. c. a. b. a. d. 20. 6. b. 12. b. c. 19. b. 16. c. 10. b. 2. a. 11. a. 9. 13. 18.5. d. 15. b. 23. 7. . b.

b. 4. 10. d. 10. d. c. 8. d. e. 11. a. 5. b. 6. a. d. 2. 9. 12. c. c. . c. a. 8. 11. 5. Chapter 4 1. c. 7. 7. c. 3. c. d. 9. c. c. 6.3. 4. b.

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

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

c. 9. 11. c. 10. d. 2. e. d. b. a. 2. 3. 8.8. 6. d. 4. d. b. b. 7. b. d. 12. 3. c. c. a. a. 5. 9. 10. 4. a. b. Chapter 8 1. Chapter 9 1. a. 5. .

6. 5. b. b. a. 7. 11. 14. 10.6. 17. a. 4. a. d. a. b. b. a. 2. 8. 12. 10. 3. 9. d. 15. . 13. a. a. 7. c. 16. d. c. 8. b. Chapter 10 1. a. d. c. 9. b. d.

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

6. 9. 10. 6. c. b. d c a a c d b. 9. c. 3. 4. d b. 2. 15.3. a. 14. b. d. 7. b. a. 11. 8. 7. 8. 13. . c. 5. a. c. b. 4. Chapter 13 1. a. 12. 5.

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

c. c. d. d. 18. d. 16. d. d. c. 8. b. 9.12. 4. b. b. 15. d. 13. d. 19. 11. 20. a. 13. b. a. a. . Chapter 15 1. a. 5. a. a. 10. 14. 7. 12. b. d. 17. 6. 3. 2.

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

10. a. a. 7. 9. a. Chapter 18 1. 3. b. a. 6. 3. 8. a. a. 2. 2.17. d. 6. 4. d. e. . 9. b. b. a. a. 8. 4. 5. b. b. a. Chapter 17 1. 5. 7. a. b. a.

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

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

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

9. 7. 10. 2. a. b. d. b. c. 9. a. 14. c. 7. c. a. 10. 6. 12. 11.4. 5. d. 11. b. Chapter 24 1. 6. c. . e. a. c. c. 13. 8. b. a. d. 4. d. d. d. 3. 8. 5.

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

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

c. d. d. 29. c. 22. a. b. 30.20. 25. d. a. 32. e. d. d. 21. 23. a. a. 33. 34. a. 28. 31. . d. 24. a. 35. 26. 27.

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