American Student Dental Association

National Board Dental Examinations

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Compiled, released items from approximately 2000-2008

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 TABLE OF CONTENTS

Part II Released Items 5

Case A Questions 23
Case B Questions 24
Case A.. 26
Case B 31
Answer Key 36

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(•<•?] iv-tt VJUI tl-ft

A patient has pain over the left pre-auricular area; 6. A 2-day-old developing plaque consists primarily of
this patient can open approximately 45 mm and
-r : „
has a "pop-and-click" in the joint area. The most A. Treponema species
likely diagnosis is B. Bacteroides species.
C. filamentous organisms.
A. myofascial pain dysfunction syndrome. D. gram-positive cocci and rods.
B. internal derangement with reduction. E. a structureless, non-mineralized pellicle.
C. auriculotemporal syndrome.
D. coronoid hyperplasia.
Each of the following is an electromagnetic
radiation EXCEPT one. Which one is the
Erythromycin is responsible for numerous drug EXCEPTION?
interactions, some of which are fatal. This is
A. Radar
because erythromycin
B. X rays
A. increases the absorption of many drugs. C. Alpha rays
B. decreases the absorption of many drugs. D. Gamma rays
C. decreases cytochrome P-450 metabolism of E. Visible light
other drugs.
D. increases renal reabsorption of many drugs.
E. decreases distribution of many drugs. Which of the following is NOT a complication of
radiation therapy?

The penetrating quality of x-ray beams is A. Mucositis

influenced by which of the following? B. Xerostomia
C. Osteoradionecrosis
A. Kilovoltage D. Granuloma
B. Milliamperage
C. Exposure time
D. Focal-film distance Each of the following is known to contribute to
E. Filament temperature orofacial clefting EXCEPT one. Which one is the
EXCEPTION?

Contraction ofthe lateral pterygoid muscle moves A. Valium®

the articular disk in which of the following B. Poor diet
directions? C. Acetaminophen
D. Vitamin deficiency or excess
A. Anteriorly and medially
B. Posteriorly and medially
C. Anteriorly and laterally 10. Which of the following physical signs indicates
D. Posteriorly and laterally severe CNS oxygen deprivation?
E. Anteriorly, laterally, and interiorly
A. Dilated pupils with increased light reflex
B. Pinpoint pupils with increased light reflex
A decrease in which of the following causes an C. Dilated pupils with an absence of light reflex
increase in radiographic density? D. Pinpoint pupils with an absence of light
reflex
A. Milliamperage (mA)
B. Kilovoltage peak (kVp)
C. Object-film distance 11. Subconjunctival hemorrhage is most commonly
D. Source-film distance found in which of the following fractures?
E. Exposure time
A. Nasal
B. LeFort I
C. Frontal sinus
TM
D. Zygomatic arch
E. Zygomaticomaxillary complex

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 12. Which o f t h e following drug groups increases 17. An analgesic compound #3 contains how many mg
intraocular pressure and is, therefore, of codeine?
contraindicated in patients with glaucoma?
A, 7.5
A. Catecholamines B. 15
B. Belladonna alkaloids C. 30
C. Anticholinesterases D. 60
D. Organophosphates

18. Acute pyogenic bacterial infections produce

13. Which o f t h e following best describes a vestibu-
loplasty? A. leukopenia.
B. lymphopenia.
A. Bone is added to the mandible to augment C. neutropenia.
its height. D. leukocytosis.
B. Osseointegrated dental implants are placed E. lymphocytosis.
to support prosthesis.
C. Soft tissue is repositioned in order to
increase the area on which the denture may 19. A 35-year-old woman has an acute dentoalveolar
be supported. abscess. Which of the following conditions will be
D. The chin is augmented to enhance esthetics. the most likely to complicate the management of
E. Periodontal tissue is removed from around a
this patient?
tooth to establish a biologic width.
A. Asthma
B. Epilepsy
14. On a new patient's initial appointment, the dentist C. Chemotherapy
should do which o f t h e following first? D. Hypertension

A. Establish rapport
B. Inform 20. Which o f t h e following is indicated to correct a
C. Gather information
condition of atropine poisoning evidenced by rapid
D. Evaluate
heart rate, dry mouth and gastrointestinal
inactivity?

15. An elderly patient has worn a maxillary complete A. Nicotine

denture against 6 mandibular anterior teeth for an B. Homatropine
extended period of time. In examining the C. Epinephrine
edentulous mouth of this patient, the dentist would D. Pilocarpine
probably see which of the following? E. Physostigmine

A. Intrusion of the mandibular anterior teeth

B. Flabby ridge tissue in the posterior maxillary 21. If a patient suddenly becomes unconscious during
arch
treatment, the practitioner should immediately
C. Loss of osseous structure in the anterior
assess the patient's
maxillary arch
D. Cystic degeneration of the foramina of the A. airway and pulse,
anterior palatine nerve B. airway and blood pressure,
C. pulse and blood pressure,
D. color and pupils.
16. The use of study casts in orthognathic surgery
does each of the following EXCEPT one. Which
one is the EXCEPTION?

A. Constructs splints
B. Performs model surgery
C. Determines the postoperative occlusion TM
D. Identifies the type of skeletal deformity
E. Aids in explaining the surgical procedure to

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the patient

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\
 22. Gingival overgrowth, hirsutism, coarsening of facial 27. What space management treatment should be
features, lymph gland hypertrophy, cognitive planned for a child age 4. missing both primary
deficits, and fetal abnormalities are side effects mandibular first molars with no primate space
associated with which of the following antiepileptic present?
drugs?
A. Lingual arch
A. Phenobarbital B. Distal shoe(s)
B. Carbamazepine (Tegretol1GX
^) C. Nance holding arch
D. Band-and-loop space maintainer(s)
C. Valproate (Depakene®)
E. Observation; no space maintainer
D. Phenytoin (Dilantin®) necessary.
E. Ethosuximide (Zarontin®)

28. Each of the following characterizes an impending

23. Which of the following should be performed first for insulin shock EXCEPT one. Which one is the
a collapsed or unconscious victim of illness or EXCEPTION?
accident?
A. Weakness
A. Open the airway B. Convulsions
B. Establish unresponsiveness C. Mental confusion
C. Establish pulselessness D. Cold perspiration
D. Examine the victim for bleeding and
fractures
29. An unconscious patient is suspected of having an
obstructed airway. How should this patient be
24. A patient presents with facial lacerations that have managed?
irregular or devitalized wound edges. In excising
the wound elliptically, a practitioner takes into A. Protrude the tongue, clear the pharynx,
extend the neck, and protrude the mandible
account each of the following EXCEPT one. Which
B. Extend the neck, clear the pharynx, protrude
is the EXCEPTION?
the tongue, and protrude the mandible
C. Extend the neck, protrude the mandible,
A. Excision is perpendicular to the natural skin
protrude the tongue, and clear the pharynx
tension lines.
D. Clear the pharynx, extend the neck, protrude
B. Length to width ratio of the excision is at
the mandible, and protrude the tongue
least 3 to 1.
C. Excision is done as conservatively as
possible.
D. The wound is undermined prior to closure. 30. A tender swelling in the soft tissue of the
submandibular triangle is most likely caused by

A. lipoma.
25. Which of the following represents the major route
B. lymphadenopathy.
of excretion of penicillin V?
C. an obstruction of Stensen's duct.
D. an infected thyroglossal duct cyst.
A. Secretion in the bile and into the feces
B. Excretion in the urine as inactive metabolites
C. Total metabolism by the liver and excretion
in the feces 31. Which of the following is the least helpful in
D. Secretion not metabolized in the urine determining the anatomical integrity of the
temporomandibular joint?

26. Which of the following systemic conditions lowers A. Arthrography

B. Arthroscopy
resistance, impairs healing, and indicates early use
C. Panoramic films
of antibiotics for infections?
D. Computerized tomography
E. Magnetic resonance imaging
A. Vitamin C deficiency TM
B. Diabetes mellitus
C. Polycythemia vera

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D. Systemic lupus erythematosus

) 2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.
 32. A freshly condensed Class II amalgam restoration 36. Which of the following is a local contraindication for
has a deficient margin at the proximogingival the surgical removal of an impacted tooth?
cavosurface angle. This might have been caused
by which of the following? A. A nonvital tooth
B. Fever of unknown origin
A. Overtightening the matrix band C. A history of bleeding disorder
B. Neglecting to wedge the matrix band D. An undiagnosed ulcer in the oral cavity
C. Neglecting to contour the matrix band E. Pale gingiva with a confirmed history of
D. Using too large an initial increment of anemia
amalgam

37. Which of the following properties increases when

33. Each o f t h e following measures can minimize the intermediate chain of a local anesthetic drug is
fractures of the maxillary alveolar process lengthened?
EXCEPT one. Which one is the EXCEPTION?
A. Potency
A. Use of controlled force when using forceps B. Allergenicity
and elevators C. Solubility in water
B. Removal of buccal bone and/or sectioning of D. Rate of biotransformation
teeth
C. A thorough presurgical analysis and planning
alterations in the surgical approach 38. Which o f t h e following is NOT an advantage of
D. Use of the maxillary pinch grasp to detect chemical vapor sterilization?
expansion of the alveolar bone
E. Use of forceps with beaks that grasp the A. Cycle time is short.
roots more firmly B. It will not char fabrics.
C. It will not cause corrosion.
D. There is no need for special ventilation.
34. Ethyl alcohol is a good antidote for methanol E. Instruments are dry at the end of the cycle.
poisoning because

A. it inhibits methanol metabolism. 39. The most common cause of fracture at the isthmus
B. it competes successfully with methanol for of a Class II restoration is
alcohol dehydrogenase.
C. it prevents formation of formaldehyde. A. delayed amalgam expansion.
D. it prevents damage to the optic nerve. B. a sharp axio-pulpal line angle.
E. All of the above. C. isthmus width too narrow.
D. moisture contamination o f t h e amalgam
during placement.
35. Each of the following nonsedating antihistamines E. lack of interproximal contact.
would be contraindicated in an individual taking
cimetidine for heartburn EXCEPT one. Which one
is the EXCEPTION? 40. Alveoplasty following closed extraction is usually
performed with
A. Astemizole (Hismanal®)
A. a bur.
B. Diphenhydramine (Benadryl®)
B. fingers.
C. Fexofenadine (Allegra®) C. a rongeur.
D. Hydroxyzine (Vistaril®) D. a bone file
E. Terfenadine (Seldane®)

41. The periosteal elevator is used to do each of the

following EXCEPT one. Which one is the
EXCEPTION?

TM A. Luxate the teeth

B. Retract the soft tissue flap
C. Elevate the interdental papillae

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D. Provide protection to the soft tissue flap

i 2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.
 42. The fenestration technique for mandibular vestibu- 48. How does the growth of the cranial base generally
loplasty is based on the premise that the mucosal relate in time to the growth of the jaws?
attachment will
A. Follows
A. not cross the skin graft. B. Precedes
B. not cross the mucosal graft. C. Unrelated
C. not cross a fibrous scar band. D. Accompanies
D. be maintained in its lowered position by the E. Initially follows, then accompanies
new denture.

49. Aplastic anemia is a serious toxic effect associated

43. Which of the following represents a constitutional most frequently with which of the following
symptom? antibiotics?

A. Tinnitus A. Streptomycin
B. Chills B. Tetracycline
C. Xerostomia C. Chloramphenicol
D. Dysphagia D. Chlortetracycline

44. Which of the following is the most commonly used 50. The therapeutic index of a given drug indicates the
surgical procedure to correct maxillary relative
retrognathia?
A. safety.
A. C-osteotomy B. potency.
B. Le Fort I osteotomy C. efficacy.
C. Inverted L-osteotomy D. duration.
D. Anterior maxillary osteotomy E. solubility.

45. In the preauricular approach to the TMJ, which of 51. Which of the following flap designs allows the best
the following anatomic structures, if damaged, surgical access to the apical aspect of a tooth root
presents the potential for greatest morbidity? with the least reflection of soft tissue?

A. Facial nerve A. Envelope

B. Parotid gland B. Semilunar
C. Auriculotemporal nerve C. Vertical release
D. Superficial temporal vein D. Rotation pedicle
E. Facial artery

52. Each of the following is a disadvantage of oral

46. Which of the following is most clearly associated sedation EXCEPT one. Which one is the
with the appearance of "moon fades"? EXCEPTION?

A. Hyperthyroidism A. The administrator has little control over the

B. Regular corticosteroid use ultimate clinical actions ofthe drug(s).
C. Diabetes mellitus B. There can be significant differences in the
D. Pancreatic insufficiency bioavailability of oral drugs.
C. With most oral drugs, there is a relatively
slow onset of clinical activity and a
prolonged duration of action.
47. Osteomyelitis of the mandible is most likely to
D. Oral anxiolytic drugs are effective in relieving
develop because of
anxiety in the hours immediately preceding
the dental appointment.
A. failure of pus to localize.
B. a resistant strain of bacteria.
C. low resistance of the patient. TM
D. lack of drainage from the infected area.

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 53. Principles for managing a localized alveolar osteitis
after extraction of a mandibular first molar include
each of the following EXCEPT one. Which one is
the EXCEPTION?
A. Flushing out debris with normal saline
solution
B. Curetting the boney wall to promote bleeding
C. Placing a sedative dressing in the socket to
protect exposed bone
D. Administering mild analgesic drugs as an
adjunct to local treatment
54. When is the most appropriate time to permanently
modify/alter the occlusion of an acute TMD
patient?
A. During the first visit, while the patient has the
acute symptoms
B. Prior to initiating splint therapy, one week
after the first visit
C. Only after the patient is sympton-free and
has shown improvement during splint
therapy
D. Never, until definitive orthodontic treatment
has been started
55. Which of the following best defines the term
"Temporomandibular Disorders"?
A. A clinical condition related to dysfunction of
the temporomandibular joint and disk
B. A collective term for a heterogenous group
of musculoskeletal disorders of varying
etiologies, that present with similar signs and
symptoms
C. A clinical condition caused by disharmony
between the occlusal proprioceptors and
masticatory muscles
D. A group of clinical conditions that arise from
excessive loads being placed on the TM
joints by muscle spasms, resulting in disk
displacement on one or both sides
TM
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56. You are doing some preprosthetic surgery on a
patient in preparation for a new denture. Which of
the following statements about removal of her
moderate-sized mandibular lingual tori is correct?
A. The tori should be removed using a large
pear-shaped acrylic bur.
B. The tori should be removed by grooving the
superior surface then shearing the torus off
with a mono-beveled chisel. The area is
then smoothed with a bone file.
C. The tori should be removed by grooving the
superior surface of the torus with a bur, then
shear the torus off with a bibeveled chisel.
D. The tori should be removed by inserting a
rongeurs vertically under a lingual flap and
"snipping off' the tori.
57. Which of the following statements about the flap
for the removal of a palatal torus is correct?
A. The most optimal flap uses a midline incision
which courses from the papilla between
teeth #8 and 9 posteriorly to the junction of
the hard and soft palates.
B. The most optimal flap is a reflection of the
entire hard palate mucoperiosteum back to a
line between the 2 first molar teeth.
C. The most optimal flap uses a midpalatal
incision that courses from the palatal aspect
of tooth #3 across to the palatal aspect of
tooth #14.
D. The most optimal flap is shaped like a
"double-Y", with a midline incision and
anterior and posterior side arms extending
bilaterally from the ends of the midline
incision.
58. Which of the following statements about
maxillofacial bone grafts is INCORRECT?
A. Xenografts are frequently used in
mandibular reconstruction.
B. The most common source of autologous
bone is the iliac crest.
C. Allogeneic banked bone is often used as a
carrier, supplemented with an autogenous
graft.
D. An example of isogeneic bone grafting is
transplanting bone marrow in the treatment
of such diseases as leukemia.
10
 59. Your patient was referred to an oral and 62. Each of the following statements concerning the
maxillofacial surgeon for an implant, and you were administration technique of inhalation sedation is
advised that she was going to need a sinus lift correct, EXCEPT one. Which one is the
procedure with placement of an autogenous bone EXCEPTION?
graft. What is the definition of that graft?
A. If the patient is wearing contact lenses, they
A. The graft will use an artificial, bone-like should be removed prior to administration of
material. the sedation.
B. The graft uses bone from another human B. The patient should be seated in an upright
being. (85-90 degree) position in the dental chair.
C. The graft uses the patient's own bone, taken C. The initial flow rate of oxygen should be at
from another site. least 6 L/min via the nasal hood.
D. The graft uses bovine bone, or bone from D. As the flow of nitrous oxide through a mixing
another animal species. dial style unit is increased, the flow rate of
oxygen is reduced, so the correct
percentage of each is delivered at a
constant flow rate.
60. A complete denture patient returns for a 24-hour
post-op appointment after insertion of new
dentures. The patient points to a sore area on top
63. Each of the following is a common cause of
of the mandibular ridge crest on the posterior right
postsurgical atelectasis (decreased expansion of
side but no sore spot is visually evident. Which of
the alveoli) EXCEPT one. Which one is the
the following is the first procedure the dentist
EXCEPTION?
should perform?
A. Shallow inspirations
A. Reduce the centric contacts on all posterior
B. Pain-limiting movement
teeth on the right side of the mandibular
C. Inactivity after surgery
denture.
D. Preoperative respiratory infection
B. Using a large acrylic bur, grossly reduce the
E. Narcotic analgesic that depress the
internal surface of the denture.
respiratory drive
C. Reduce all eccentric contacts on the right
side of the maxillary and mandibular
dentures.
D. Apply pressure indicator paste to the internal 64. Cavity liners should have a minimal thickness of
surface of the mandibular denture and check
for pressure spots. A. 1 mm.
E. Tell the patient this is normal for the first day B. 1.5 mm.
of wearing new dentures and to return in one C. 15 mm.
week for another post-op check. D. 125 mm

61. When a patient bites on a hard object on the left 65. Each of the following statements is correct
mandibular molar, the interarticular pressure of the regarding phenytoin EXCEPT one. Which one is
right temporomandibular joint is the EXCEPTION?

A. increased. A. Causes gingival hyperplasia

B. decreased. B. Corrects certain cardiac dysrhythmias
C. remains unchanged. C. Is ineffective when administered orally
D varied but it is unpredictable. D. Causes toxic effects related to the
cerebellum and vestibular system
E. Exerts antiseizure activity at doses which do
not cause general CNS depression

TM

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© 2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.
 66. A properly executed posterior superior alveolar 71. Which of the following is the most serious result of
nerve block will anesthetize each of the following digoxin intoxication?
structures EXCEPT one. Which one is the
EXCEPTION? A. Bradycardia
B. Renal failure
A. Maxillary sinus membrane in the molar C. Atrial tachycardia
region D. Atrial fibrillation
B. Second and third molar teeth and a portion E. Ventricular fibrillation
of the first molar tooth
C. Buccal alveolar bone, soft tissue and
periodontium in the posterior maxilla 72. Each of the following represents an advantage of
D. Soft palate mucosa on the side of the oral sedation EXCEPT one. Which one is the
injection EXCEPTION?

A. Need for specialized training and equipment

67. Which areas should be avoided for an IM injection B. High incidence and severity of adverse
before a child can walk? reactions
C. Erratic and incomplete absorption of drugs
A. Gluteal muscles from the Gl tract
B. Ventrogluteal D. Short duration of action
C. Vastus lateralis
D. Deltoid area
73. The depth of light penetration into the tooth or
restoration before it is reflected outward is the
68. Adrenal insufficiency during major stress results in
A. metamerism.
A. gingival hyperplasia. B. degree of translucency.
B. cardiovascular collapse. C. color perception.
C. hypotension. D. value.
D. ketoacidosis.

74. In young patients, stains are usually more

69. A patient that is having general anesthesia using prominent in which areas of the teeth?
an IV barbiturate rapidly passes through
A. Incisal
A. Stage I. B. Occlusal
B. Stage II. C. Cervical
C. Stage III. D. Facial
D. Stage IV

75. The character and individuality of teeth are largely

70. Which of the following antibiotics has been determined by
implicated in the vast majority of cases of oral
contraceptive failure during antibiotic use? A. translucency.
B. surface texture,
A. Penicillin C. color,
B. Rifampin D. shape.
C. Keflex
D. Erythromycin
E. Tetracycline

TM

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© 2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.
 76. When the dentist enters the operatory, the patient, 81. The outstanding advantage of phenytoin over
who is new to the office, stands close to the wall, phenobarbital in the treatment of epilepsy is that
has his arms folded, and is looking at the floor. The phenytoin
dentist should initiate communication by saying
which of the following? A. does not bring about dependence.
B. has a longer duration of action.
A. Let's get going, I've got a lot to do. C. is effective against both grand and petit mal.
B. What are you angry about? D. produces less sedation for a given degree of
C. Didn't my assistant get you seated? motor cortex depression.
D. You seem uncomfortable; did you have a
bad dental experience?
E. Hi, I'm Doctor Wilson, what brings you here 82. The main function o f t h e liner used in a casting
today? ring is to

A. provide venting of the mold.

77. Which o f t h e following antibiotics is the substitute B. help prevent shrinkage porosity.
of choice for penicillin in the penicillin-sensitive C. provide easy divesting of the casting.
D. provide additional water to the investment
patient?
mix.
A. Cephalexin E. allow uniform and uninhibited setting
B. Erythromycin expansion o f t h e investment.
C. Tetracycline
D. Clindamycin
83. The use of a rubber dam is considered an
essential component of endodontic
78. The phenomenon whereby various light sources armamentarium.
produce different perceptions of color is called
Exception to its use in a given situation is
A. fluorescence. acceptable if the patient is informed and consents.
B. incandescence.
C. opalescence. A. Both statements are true.
D. translucency. B. Both statements are false.
E. metamerism. C. The first statement is true, the second is
false.
D. The first statement is false, the second is
79 A 4-year-old child has a history of frequent true.
spontaneous pain in a primary mandibular second
molar. This molar has a necrotic pulp. Which of the
following represents the treatment of choice? 84. The Occupational Safety and Health
Administration's (OSHA) "Bloodborne Pathogens
A. Pulpectomy Standard" deals with each of the following
B. Pulpotomy EXCEPT one. Which one is the EXCEPTION?
C. Extraction
D. Pulp cap A. Disposal of medical waste
B. Exposure Control Plan
C. Hepatitis B vaccination
80. Which o f t h e following is an outstanding advantage D. Instrument sterilization and storage
E. Material Safety Data Sheets (MSDS)
of phenytoin over phenobarbital in the treatment of
grand mal epilepsy?

A. Exerts less sedation for a given degree of

motor cortex depression
B. Is effective in a greater percentage of cases
C. Needs to be given much less frequently
D. Does not cause gastric distress
E. Has a longer duration of action TM

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I 2009. American Dental Association. Joint Commission on National Dental Examinations. All rights reserved.
 85. A 20-year-old patient presents with an upper 90. Back pressure porosity is
maxillary centra) incisor previously treated for
endodontic fractures at the level of the alveolar A. the same as occluded gas porosity.
B. the result of using an oxidizing flame.
crest. Which of the following represents the first
C. most likely when the wax pattern is
necessary step to restore and maintain the tooth's
positioned very close to the open end of the
esthetics? ring.
D. often evidenced by rounded margins on the
A. Orthodontically extrude remaining tooth
casting,
structure
the same as suck-back porosity.
B. Extract remaining tooth structure
C. Fabricate FPD over the remaining root
D. Fabricate RPD over the remaining root
91. Which of the following explains why a properly
designed rest on the lingual surface of a canine is
86. Shrinkage porosity in a gold casting is associated preferred to a properly designed rest on the incisal
with surface?

A. the use of excessive flux. A. The enamel is thicker on the lingual surface.
B. the use of no flux. B. Less leverage is exerted against the tooth by
C. sprue diameter. the lingual rest.
D. alloy oxidation. C. The visibility of, as well as access to, the
E. excessive burnout time. lingual surface is better.
D. The cingulum of the canine provides a
natural surface for the recess.
87. Which of the following is an acronym for a
marketing strategy to use for reluctant patients?
92. The most potent antitubercular drug is
A. SUCCESS
B. RECRUIT A. isoniazid.
C. OPTIMEM B. vancomycin.
D. C. trimethoprim.
EIEIO
D. sulfamethoxazole.

88. Spontaneous gingival hemorrhage or acute

93. The main metabolite of ingested isopropyl alcohol
stomatitis, observed in a pediatric patient under
treatment for absence seizures, indicates
withdrawal of which ofthe following anticonvulsant A. urea.
drugs? B. acetone.
C. methanol.
A. Phenytoin D. acetaldehyde.
B. Ethosuximide E. formaldehyde
C. Carbamazepine
D. Phenobarbital
E. Valproic acid
94. At the try-in appointment for a 3-unit posterior gold
FPD, the proximal contacts, fit, occlusion, contour,
and surface finish have been determined to b8
89. Which of the following drugs is most likely to cause
acceptable. Which ofthe following represents what
convulsions when a physically dependent person is
step is accomplished next with this FPD?
withdrawn?
A. Soldering index
A. Pentobarbital (Nembutal®) B. Copalite preparations
B. Diazepam (Valium®) C. Temporary cementation
C. Hydroxyzine (Vistaril®) D. Mix zinc phosphate cement
D. Chloral hydrate (Noctec®)
TM
E. Chlorzoxazone (Parafon Forte®)

PDF Editor 14
) 2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.
 95. Larger condensers and laterally applied 100. With respect to temperature, the processing cycle
condensation forces are recommended to ensure of a denture is designed to
complete condensation of which of the following
amalgam types? A. attain development of color.
B. prevent boiling of the monomer.
A. Admixed C. prevent breakdown of the initiator.
B. Spherical D. volatilize the hydroquinone inhibitor.
C. Lathe-cut
D. High-copper
E. Conventional 101. Alcoholic euphoria results from

A. increased activity of the cerebrum.

B. increased activity of thalamic areas.
96. Proposed modes of action for the oral antidiabetic
C. increased activity of limbic synapses.
agents include each of the following EXCEPT one.
D. decreased activity of medullary centers.
Which one is the EXCEPTION? E. removal of the inhibitory effect of the cortex.
A. Blockade of glucagon release from pancreas
B. Blockade of catecholamine release from 102. The portion of an artificial tooth that is found only
adrenal medulla in porcelain anterior teeth is
C. Stimulation of insulin release from pancreatic
beta cells A. the pin.
D. Action as direct receptor agonists for the B. the collar.
insulin receptor C. the finish line.
E. Increase affinity of tissues for utilization of D. the diatoric.
available plasma glucose E. None of the above.

103. The casting shrinkage of cobalt-chromium alloys is

97. Compressing the acrylic resin in a rubbery stage approximately
will probably result in
A. 1.25%
A. an open bite or open pin. B. 1.75%
B. porosity of the finished acrylic. C. 2.2%.
C. incomplete filling of the mold details. D. 3.2%.
D. large amounts of excess that is difficult to
trim.
104. Which of the following is a disadvantage of glass
ionomer cement?
98. Which of the following statements concerning ethyl A. Difficulty in mixing
alcohol is true? B. Irritation of the pulp
C. Low bond strength to dentin
A. It produces a true stimulation of the central D. Moisture sensitivity during initial set
nervous system.
B. It protects individuals against exposure to
cold by preventing heat loss. 105. Which of the following will result when using a
C. It is metabolized primarily by the lungs. thinner mix of a gypsum-bonded casting
D. It is partially absorbed in the stomach. investment?
E. It possesses anticholinergic properties.
A. Produce a smoother casting
B. Increase setting expansion
C. Decrease setting expansion
99. The most likely cause of failure in the pre-ceramic
D. Increase thermal expansion
soldering technique is
E. Decrease required burn-out temperature
A. underheating the parts to be joined.
B. overheating the parts to be joined.
C. using an incompatible solder.
D. using phosphate as the soldering TM
investment.
E. preheating the soldering assembly.

PDF Editor 15
©2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.
 1 0 6 . Which of the following oral bacteria have been 112. Allowing the ultrasonic-sealer tip to remain on the
implicated as periodontal pathogens? tooth surface too long will

A. Porphyromonas gingivalis, Eubacterium sp., A. damage the tooth surface.

and Campylobacter recta B. dull the tip of the instrument.
B. Streptococcus gordonii, Streptococcus C. burnish the calculus onto the tooth surface.
mutans, and Gemella sp. D. cause irreversible pulpal damage.
C. Lactobacillus casei and Veillonella sp.
D. Streptococcus mitior, Streptococcus gordonii
and Bacteroides gracilis 113. The most important anticoagulant effect of heparin
is to interfere with the conversion of

107. The base of the incision in the gingivectomy A. PTA to PTC.

technique is located B. PTC to Factor VIII.
C. fibrinogen to fibrin.
A. in the alveolar mucosa. D. prothrombin to thrombin.
B. at the mucogingival junction. E. proaccelerin to accelerin.
C. above the mucogingival junction.
D. coronal to the periodontal pocket.
E. at the level of the cementoenamel junction. 114. Dental phobias are very hard to eliminate because
they

108 Which of the following is the most important factor A. are ego-syntonic.
B. cannot be seen.
affecting pulpal response?
C. become habitual.
A. Heat D. are self-reinforcing.
B. Depth to which dentinal tubules are cut
C. Desiccation
115. Which of the following describes a material with
D. Invasion of bacteria
high compressive strength but low tensile
strength?
109 Primary herpetic gingivostomatitis is most likely to
A. Resilient
occur in which o f t h e following age groups?
B. Brittle
A. 1 -5 years C. Ductile
B. 6-10 years D. Malleable
C. 11-15 years
D. 16-20 years
116. The Occupational Safety and Health Administration
E. 21-25 years
(OSHA) is concerned with regulated waste within
the office.
110. Which of the following filling materials is least
OSHA regulates the transportation of waste from
desirable for use as Preventive Resin Restoration?
the office.
A. Microfilled resin
A. Both statements are true.
B. Amalgam
B. Both statements are false.
C. Hybrid resin
C. T h e first s t a t e m e n t i s l i u e , the s e c o n d i s
D. Glass ionomer
false.
D. The first statement is false, the second is
111. Each o f t h e following osseous defects would be true.
classified as infrabony EXCEPT one. Which one is
the EXCEPTION? 117. One can accelerate the setting time of zinc oxide-
eugenol impression pastes by adding a small
A. A trough amount of
B. A dehiscence
C. A hemiseptum A. water,
D. An interdental crater B. glycerin,
C. petrolatum,
TM D. plaster of paris.

PDF Editor 16
) 2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.
 118. What percentage ofthe U.S. population does not 122. The drug of choice to treat overdosage with
have dental insurance? tricyclic antidepressants is

A. 35-40% A. atropine.
B. 45-50% B. phenytoin.
C. 55-60% C. physostigmine.
D. 65-70% D. pentobarbital.
E. an amphetamine.

119. A patient works at a nuclear power plant. He is

frequently exposed to a small amount of radiation, 123. Chlortetracycline acts by interfering with
although the dose he receives is below the
occupational limits. Which of the following best A. cell wall synthesis.
explains why this patient need not wear his B. nucleic acid synthesis.
employee film badge while he is having dental C. protein synthesis on bacterial but not
radiographs made? mammalian ribosomes.
D. protein synthesis on mammalian but not
A. His badge records only gamma-radiation, bacterial ribosomes.
not x rays.
B. His film badge must be used only to
measure occupational doses. 124. The toxic impurity that can theoretically be found in
C. It is unlikely that the current dose will rise nitrous oxide gas is
above his occupational limit.
A. ozone.
D. The dose from the dental radiographs is too
B. helium.
low to be measured accurately by the
C. methane.
badge.
D. nitric oxide.
E. cyclopropane
120. A 5-year-old child has a posterior unilateral
crossbite that is accompanied by a functional shift
of the mandible. When should this crossbite be
125. How many hours per day should a cervical pull
headgear be worn to achieve the most effective
corrected?
results?
A. Immediately, without waiting for the eruption
A. 6
of permanent first molars
B. 8
B. When all the primary teeth have exfoliated
C. 10
C. After the permanent first molars have fully
D. 12
erupted
E. 14
D. When the child is approximately 9 years of
age
126. Drug interaction resulting in serious adverse
cardiovascular events, including death, might occur
1 2 1 . When determining the appropriate dose of
between erythromycin and which of the following
systemic fluoride supplement for a child, it is. most
antihistamine drugs?
important for the dentist to consider which of the
following? A. Terfenadine (Seldane®)
B. Promethazine (Phenergan®)
A. The fluoride content of the drinking water
B. The child's diet and caries activity C. Hydroxyzine (Atarax®)
C. The child's age and the fluoride content of D. Diphenhydramine (Benadryl®)
the drinking water
E. Chlorpheniramine (Chlor-Trimeton®)
D. The child's weight and the fluoride content of
the drinking water

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PDF Editor 17
© 2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.
 127. A mercury spill in the laboratory or office is 132. Which of the following cannot be used to calculate
appropriately cleaned up by the dosage of a drug for a child?

A. removing the mercury, then spraying the A. Clark's rule

area with BAL. B. Vital signs
B. scrubbing the spill area with hot water and C. Body surface area
detergent. D. Body weight (mg/kg)
C. sweeping up the mercury and disposing of it
in a plastic bag.
D. aspirating the mercury into a wash bottle 133. Which of the following symptoms is the most
trap, then dusting the spill area with sulfur distinct characteristic of morphine poisoning?
powder.
A. Comatose sleep
B. Pin-point pupils
128. The concentration of which of the following ions C. Depressed respiration
determines the binding affinity of agonists and D. Deep, rapid respiration
antagonists to the opioid receptor? E. Widely dilated, non-responsive pupils

A. Sodium
B. Calcium 134. In addition to the treatment of epilepsy, phenytoin
C. Chloride may be indicated for the treatment of
D. Potassium
A. arrhythmia,
E. Phosphate
B. narcolepsy,
C. hypertension,
129. In communicating with children, which o f t h e D. schizophrenia,
following should the dental team do? E. panic attacks.

A. Allow the parent to answer questions asked

by the child at chairside 135. Which o f t h e following drugs is commonly used in
B. Allow both the parent and the dentist to the treatment of congestive heart failure?
communicate simultaneously with the child
A. Phenytoin
C. Transmit word substitutes for dental
B. Digitalis
procedures and equipment during the
C. Quinidine
appointment
D. Procainamide
D. Attain voice control to build the groundwork
E. Nitroglycerin
for future instructions

1 3 6 . The mechanism of action of the muscle relaxation

1 3 0 . A prescription includes each o f t h e following parts
induced by diazepam most clearly resembles that
EXCEPT one. Which one is the EXCEPTION?
produced by
A. Superscription
A. d-tubocurarine.
B. Inscription
B. meprobamate.
C. Subscription
C. succinylcholine.
D. Transcription
D. decamethonium.
E. Conscription
E. gallamine.

1 3 1 . Inhalation of amyl nitrite can result in each of the

137. What percent of the blood alcohol level is the most
following EXCEPT one. Which is the EXCEPTION?
likely to produce a lethal effect in 50 per cent of the
A. Tachycardia population?
B. Coronary artery dilation
A. 0.05%
C. Peripheral arteriolar dilation
B. 0.10%
D. A decrease in arterial blood pressure
C. 0.20%
E. Increased motility o f t h e small bowel
D. 0.30%
E. 0.50%

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18

© 2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.
 138. Prolonged use of amyl nitrite may result in 142. Which of the following best describes adjunctive
orthodontic treatment?
A. aplastic anemia.
B. thrombocytopenia. A. Orthodontic therapy performed only with
C. granulocytopenia. removable appliances
D. methemoglobinemia. B. Limited orthodontic treatment to align the
E. hypoprothrombinemia. front teeth for maximum esthetics
C. Orthodontic treatment to enhance restorative
and periodontal rehabilitation
139. The thinnest portion of the wax pattern should be D. Early treatment of orthodontic problems to
placed prevent more serious malocclusion
A. against the ring for support.
B. in the deepest part of the ring. 143. Which of the following drug groups is currently the
C. opposite the direction of rotation of the mainstay of treatment in depressive
casting arm. psychoneurotic disease?
D. in the same direction as the rotation of the
casting arm. A. Amphetamines
B. Phenothiazines
C. Benzodiazepines
140. Which of the following statements is true D. Monoamine oxidase inhibitors
concerning anticholinesterase? E. Tricyclic (imipramine-like) antidepressants
A. Agents such as DEP inhibit only plasma
cholinesterase. 144. Each of the following is a symptom of poisoning by
B. Organophosphates are readily absorbed an organophosphate insecticide EXCEPT one.
through the skin. Which one is the EXCEPTION?
C. Agents may cause paroxysmal supraven-
tricular tachycardia. A. Diarrhea
D. Reactivators such as 2-PAM reactivate B. Hot, dry skin
ACHE which has undergone "aging". C. Excessive salivation
E. Alkaloid physostigmine has the greatest D. Increased lacrimation
number of side effects unrelated to ACHE E. Skeletal muscle fasciculation
inhibition.

145. Digitalis should be given to patients with atrial

141. In developing a canine-protected articulation where fibrillation who require quinidine to avoid
the anterior vertical overlap is determined to be
less than 2 mm, the posterior cusp height should A. hypokalemia.
be kept shallow because the buccal cusps of the B. thromboembolism.
posterior teeth will have to assist in protrusive C. sino-atrial bradycardia.
disclusion. D. ventricular tachyarrhythmias.
E. prolongation of P-R interval of the ECG.
A. Both the statement and the reason are
correct and related.
B. Both the statement and the reason are 146. The presence of Ag in metal-ceramic alloys
correct but NOT related. contributes to which of the following?
C. The statement is correct but the reason is
NOT A. Increases melting temperature
B. Increases alloy strength
D. The statement is NOT correct, but the
C. Increases alloy corrosion resistance
reason is correct.
D. May cause green discoloration of the
E. NEITHER the statement NOR the reason is
porcelain
correct.

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PDF Editor 19
© 2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.
 147. Having had a complete radiographic survey made 151. The "S" in DMFS signifies which of the following?
12 months ago, an asymptomatic adult patient
presents for a recall appointment. There is no A. Score
clinical evidence of caries or periodontal disease. B. Standard
The United States Food and Drug Administration C. Surfaces
would recommend which of the following for this D. Simplified
adult? E. Significant

A. No radiographs
B. Bite-wing radiographs only 152. Each of the following pharmacologic effects is
C. Panoramic radiograph only produced by ethanol EXCEPT one. Which one is
D. Panoramic and bite-wing radiographs the EXCEPTION?
E. Full-mouth survey including bite-wing
A. Diuresis
radiographs
B. CNS depression
C. Enzyme induction
148. When high gold content alloys are compared to D. Cutaneous vasoconstriction
base metal alloys, the base metal alloys exhibit E. Increased gastric acid secretion

A. a higher melting point, increased specific

gravity, and generally higher yield strength 153. The cardiac glycosides will reduce the
and hardness. concentration of which ion in an active heart
B. a higher melting point, decreased specific muscle cell?
gravity, and generally higher yield strength
and hardness. A. Sodium
B. Calcium
C. a higher melting point, generally higher yield
C. Chloride
strength and hardness, and more consistent
D. Potassium
bonding to porcelain.
E. Magnesium
D. increased specific gravity, generally lower
yield strength, and more consistent bonding
to porcelain. 154. Which of the following antihypertensive agents acts
E. decreased specific gravity, generally higher directly on arterial smooth muscle to cause
yield strength and hardness, and more vasodilation?
consistent bonding to porcelain.
A. Methyldopa (Aldomet®)
149. The central skeletal muscle relaxation produced by B. Clonidine (Catapres®)
depressing the polysynaptic reflex arcs is brought C. Guanethidine (Ismelin®)
about by all of the following drugs EXCEPT D. Metoprolol (Lopressor®)
A. diazepam (Valium®). E. Hydralazine (Apresoline®)
B. lorazepam (Ativan®).
C. meprobamate (Equanil®). 155. The combination of a Schedule II narcotic with an
D. d-tubocurarine (Tubarine®). antipsychotic drug produces which ofthe
following?

150. Which of the following statements best describes A. Neuroleptic analgesia

why L dopa eventually becomes ineffective in the B. Conscious sedation
treatment of Parkinson's disease? C. Dissociative anesthesia
D. Psychotomimetic analgesia
A. L-dopa absorption slows with aging.
B. Dopa decarboxylase activity increases with
156. Which ofthe following drugs is excreted primarily
age.
C. Dietary intake of pyridoxine speeds L-dopa by renal tubular secretion?
metabolism. A. Benzylpenicillin
D. Patients gradually develop tolerance B. Streptomycin
because L-dopa induces liver enzyme Tetracycline
activity. c.
D. Bacitracin
E. Neuronal cell loss in the substantia nigra is E. Polymyxin
progressive and continuous over the course
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o f t h e disease.

PDF Editor 20
© 2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.
 157. Excessive vertical dimension of occlusion may 162. In pursuit of what the dentist believes is best for
result in which of the following? the patient, the dentist attempts to control patient
behavior. This is known as
A. Poor denture retention
B. Increased interocclusal distance A. autonomy,
C Drooping of the corners of the mouth B. competence,
D. Creases and wrinkles around the lips C. maleficence,
E. Trauma to underlying supporting tissues D. paternalism.

158. Which of the following represents the cause of 163. When 50 mg. of chlorpromazine (Thorazine®) is
death in poisoning from an irreversible administered to a patient, on standing the patient
anticholinesterase, such as diisopropylfluo- might experience a fall in blood pressure due to
rophosphate? which of the following?

A. Cardiac failure, resulting from excessive A. Anticholinergic action

vagal stimulation B. Decrease in heart rate
B. Dehydration, resulting from hypermotility of C. Alpha-adrenergic blockade
the gastrointestinal tract D. Negative inotropic action
C. Asphyxia, resulting from increased airway E. Stimulation of autonomic ganglia
resistance
D. Respiratory failure, resulting from paralysis
ofthe intercostals and the diaphragm 164. Which ofthe following represents an
E. Central nervous system depression, amphetamine-like drug that is widely used in the
following prolonged excitation treatment of hyperkinetic children?

A. Doxapram (Dopram®)
159. Treatment with sulfonamides is less likely to be B. Hydroxyzine (Atarax®)
accompanied by crystalluria if
C. Theophylline (Theobid®)
A. a mixture of sulfonamides is used. D. Methylphenidate (Ritalin®)
B. cortisone is administered concurrently.
C. probenecid is administered concurrently.
D. the urine is acidified with ammonium 165. Metabolism of a drug will usually result in
chloride. conversion to each of the following EXCEPT one.
E. para-aminosalicylic acid is administered Which one is the EXCEPTION?
concurrently.
A. Inactive form
B. More active compound
160. Which of the following is the most common reason C. Less active compound
for a cast crown not to seat on a patient's tooth? D. More water-soluble compound
E. Less ionized compound
A. Overextended margins
B. Excessive proximal contact
C. Undercut areas on the preparation 166. The disk sensitivity assay for antibiotic activity is
D. Casting too wide bucco-lingually used because
E. Porosity within the inner surface of the
crown A. the results are obtainable in a few minutes.
B. it distinguishes between bacteriostatic and
bactericidal drugs.
161. Loss of a primary right molar in a 3-year-old child C. it indicates whether or not an antibiotic has
requires placement of a good oral absorption.
D. it allows for routine testing of sensitivity to a
A. band and loop. range of antibiotics.
B. distal shoe.
C. removable acrylic appliance.
D. None of the above.

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PDF Editor 21
© 2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.
 167. Which of the following agents is the least effective 173. Nystatin (Mycostatin®) is used in the treatment of
in producing topical anesthesia? infections caused by

A. Tetracaine (Pontocaine®) A. Peptostreptococci spp.

B. Butacaine (Butyn®) B. Bacteroides spp.
C. Candida albicans.
C. Procaine (Novocaine®) D. Streptococcus mutans.
D. Lidocaine (Xylocaine®) E. Pseudomonas aeruginosa.
E. Benzocaine

174. Which ofthe following analgesics can be given

168. Which of the following routes of administration either orally or by intramuscular injection?
exhibits the slowest rate of absorption?
A. Aspirin
A. Oral B. Acetaminophen (Tylenol®)
B. Sublingual
C. Subcutaneous C. Ibuprofen (Motrin®, Advil®)
D. Intramuscular D. Ketorolac (Toradol®)
E. Naproxen (Naprosyn®, Aleve®)
169. Which ofthe following sedatives is most likely to
cause a dry mouth? 175. A cast gold restoration might be indicated for the
replacement of a faulty amalgam to obtain
A. Buspirone (BuSpar®)
B. Hydroxyzine (Vistaril®) A. better margins.
B. more ideal contours.
C. Chloral hydrate (Noctec®) C. less trauma to the pulp.
D. Phenobarbital (Luminal®) D. less removal of tooth structure.

170. Barbiturates taken in combination with very high 176. During a soldering procedure, flux serves to
doses of ethanol exhibit an interaction best
described as which of the following? A. provide an oxidizing environment in the area
to be soldered.
A. Potentiation B. displace gases and dissolve corrosion
B. Protein bumping products.
C. Negative synergism C. remove any debris that may remain in the
D. Competitive inhibition area to be soldered.
E. Enterohepatic circulation D. hold the solder in place during heating.

171. Which of the following erythromycins is both 177. Excessive heating of the acrylic resin during
enteric coated and long acting? processing should be avoided to prevent

A. ERYC A. exothermic heat buildup.

B. E.E.S. B. acrylic resin shrinkage.
C. Erythrocin C. evaporation of the monomer.
D. llosone D. excessive acrylic resin expansion.
E. discoloration ofthe acrylic resin.
172. Each of the following is a characteristic of tramadol
(Ultram®) EXCEPT one. Which one is the 178. Following compression of acrylic into the denture
EXCEPTION? flasks, placing the flasks into the processing tanks
at curing temperature is delayed to
A. Centrally acting analgesic
B. Structurally similar to morphine A. assure complete flow of acrylic into the mold.
C. Binds to the mu-opioid receptor B. allow the monomer to permeate all polymer
D. Biotransformed into a more active metabolite crystals.
E. Inhibits uptake of norepinephrine and C. establish an equalized and uniform pressure
serotonin in the molds.
D. allow the flasks and the acrylic to reach a
TM
stable temperature.

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22
) 2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.
 184. Which of the following represents the best initial
Case A #'s 179-187 restorative treatment for tooth #4?
(see page 26) A. Place porcelain fused to metal crown
179. The plaques on this patient's lower labial mucosa B. Restore with conservative MO amalgam
most likely represent which of the following? C. Treat mesial caries with composite resin
D. Place mesial glass ionomer restoration to
A. Leukoplakia restore root caries lesion
B. Nicotinic stomatitis E. No treatment is necessary.
C. Chronic lip chewing
D. Psoriasis
E. Smokeless tobacco hyperkeratosis 1 8 5 . Each of the following statements is true concerning
impacted teeth #17 and #32 EXCEPT one. Which
one is the EXCEPTION?
180. Which o f t h e following represents the structure
indicated by the arrows on the radiograph? A. Alveolar osteitis in the removal of bony
impactions might occur (5-20%).
A. Innominate line B. The alveolar nerve is not likely to be injured
B. Lateral border of the orbit during this extraction.
C. Pterygoid plate of the sphenoid C. Horizontally impacted teeth are considered
D. Zygomatic process of the maxilla the most difficult mandibular impactions.
E. Posterior border of the maxillary sinus D. Asymptomatic bony impactions are not
recommended for extraction in patients over
35 years-of-age.
181. Prior to undergoing scaling and root planing, how
should this patient be treated?
1 8 6 . The position of tooth #26 will complicate the design
A. Amoxicillin (Amoxil®), 2 gm, 1 hour prior to of a maxillary prosthesis.
procedure
Maxillary tuberosity reduction on the patient's left
B. Cephalexin (Keflex®), 3 gm, 1 hour prior to
side would facilitate prosthesis fabrication.
procedure
C. Clarithromycin (Biaxin®), 600 mg, 1 hour A. Both statements are true.
prior to procedure B. Both statements are false.
D. Clindamycin (Cleocin®), 2 gm, 1 hour prior C. The first statement is true, the second is
to procedure false.
E. No antibiotic treatment is necessary. D. The first statement is false, the second is
true.

182. Which of the following risk factors is most likely to

contribute to future attachment loss in this patient? 1 8 7 . Prior to dental treatment using local anesthesia
without sedation the patient should be instructed to
A. Probing depths greater than 3 mm take his usual dose of insulin and eat a normal
B. Insulin administration diet.
C. Occlusion
D. Nutrition If the patient is to have local anesthesia with
E. Smoking sedation, the patient should be instructed to reduce
the usual dose of insulin and not eat.

183. There is a vertical defect on the mesial of tooth #2. A. Both statements are true.
B. Both statements are false.
There is a crater defect between tooth #2 and C. The first statement is true, the second is
tooth #3. false.
D. The first statement is false, the second is
A. Both statements are true. true.
B. Both statements are false.
C. The first statement is true, the second is
false.
D. The first statement is false, the second is
true.

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© 2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.

I
 193. Which of the following is the most likely diagnosis
Case B#'s 188-200 for the radiolucency distal to the apical third of the
root of tooth #13?
(see page 31)
188. Which of the following is the most likely periodontal A. Metastatic carcinoma
diagnosis for this patient? B. Lateral periodontal cyst
C. Chronic periradicular periodontitis
A. Plaque-induced gingivitis D. Extension of the maxillary sinus
B. Chronic periodontitis
C. Aggressive periodontitis
D. Necrotizing ulcerative periodontitis 194. Which of the following is the most appropriate
restorative therapy for the patient's lower incisors?

189. Which ofthe following is the strongest radiographic A. Splint together with composite resin
evidence that tooth #10 requires endodontic B. Remove failing margins and rough surfaces,
treatment? and place new composite restorations where
indicated
A. Pulp chamber calcification C. Place porcelain fused to metal crowns
B. Periodontal bone loss coronally D. No treatment is indicated.
C. Extent of coronal restoration
D. Widened apical periodontal ligament space
195. Which of the following approaches would be best
in determining why the patient has had infrequent
190. Which of the following is the best, most dental care in the past?
conservative restorative treatment for teeth #6 and
#11? A. "Why haven't you gone to the dentist more
often? The more you avoid the dentist the
A. All-ceramic crowns worse your dental fear will become."
B. Porcelain fused to metal crowns B. "It is costly to have two daughters in college,
C. Restore proximal surfaces as needed with you should go to the dentist more often or
composite resin you will need expensive dental treatment."
D. Apply fluoride C. "Can you tell me why someone with a
medical history as bad as yours has stayed
away from the dentist for so long?"
191. Which of the following treatments will achieve the
D. "You have had many dental problems in the
best esthetic results for teeth #7, #8, #9 and #10?
past. If you had seen the dentist regularly as
A. Place all-ceramic crowns on all four teeth you should have you wouldn't have had as
B. Place ceramic crown on tooth #7, and place many. What could possibly have kept you
composite resin restorations on teeth #8 - away?"
#10 E. "Could you tell me more about your past
C. Place all-ceramic crowns on teeth #7 and dental experiences and present dental
#9, replace MI composite resin restoration concerns?"
on tooth #8, remove facial caries on tooth
#10 and restore with composite
D. Restore caries on the facial surface of tooth
196. Following root canal therapy on tooth #10, which of
the following foundation options, prior to crown
#7, polish composite resin restorations on preparation, is most appropriate?
teeth #8 and #9, and place crown on tooth
#10 A. Bonded composite resin
E. Place porcelain fused to metal crowns on B. Pin retained composite resin
teeth #7, #9, and #10. and restore the C. Prefabricated post and composite resin core
mesial surface of tooth #8 with composite D. Composite resin into canal continuous with
core
192. Which ofthe following is the best means to
evaluate the pulpal vitality of tooth #13?

A. Application of cold to teeth #12 and #13

B. Percussion testing on teeth #5 and #13
C. Electric pulp testing of teeth #12 and #13
D. Palpation in the buccal vestibule from teeth
#12-#14
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24
1 2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.
 197. Which of the following options is the best to
replace the missing mandibular teeth?

A. Mandibular removable partial denture

B. Fixed partial denture teeth #20 to #22 and
removable partial denture
C. Fixed partial denture teeth #28 to #31 and
removable partial denture
D. Fixed partial denture teeth #18 to #22 and
fixed partial denture #28 to #31

198. Which of the following is the best diagnosis for the

radiolucency apical to teeth #23-#26?

A. Mental fossa
B. Coalesced periapical granulomas
C. Periapical cemental dysplasia
D. Central giant cell granuloma
E. Traumatic bone cyst

199. Following initial therapy, oral hygiene is good and

there is a 1 mm reduction in probing depths.
Periodontal treatment ofthe mandibular anterior
teeth would include

A. another round of scaling and root planning.

B. flap surgery.
C. soft tissue grafting.
D. regenerative therapy.
E. periodontal maintenance therapy only.

200. In addition to oral hygiene instructions and scaling

and root planing, which ofthe following course of
actions is most appropriate during initial
periodontal therapy?

A. Systemic tetracycline administration for 10

days
B. Subgingival irrigation with 0.12%
chlorhexidine
C. Consultation with physician concerning
diabetes mellitus
D. Tooth grinding for occlusal adjustment and
equilibration ofthe dentition

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12009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.
 Dental
CASE A History
Sporadic visits for emergency extractions.
Age 38 YRS
©
N3 Sex EH MaleD Female
O
O
CD Height 5' 10"
>
3
Weight 154 LBS
CD
B/P 125/78 7)
o Chief "I don't like the spaces in my
CD
Complaint upper teeth." CD
0)
</)
CD
Q.
Medical
o
o
History CD
3
en Diabetes Social O
Patient had a hang-gliding accident 3 years ago History O
D
with r esultant knee replacement. Bartender
5' He smokes 1 pack of cigarettes per day and uses CD
D
(I
chew ng tobacco.

Current
Medications o
insulin (Hur Tiulm R ) (A
CD
CO

a
c
Q. TM

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 CASE A

®
o
ADULT CLINICAL EXAMINATION
o
CD

> 5 6 7 8 9 10 11 12 13 14 15 16 Current Oral Hygiene Status

3 Probe Fair
CD 555 444 434 333 333 323 223 333
facial
O
CD

Cfl
o
o
R
Supplemental Oral Examination Findings
o 1. Diffuse irregular white patches on lower labial
3"
O
o
mucosa.
3
3

Probe,1 655 544 434 333 433 333 323 334

£2. Probe
o' 534 433 333 434 I 535 I 545 I 543 I 554 I 444 323 I 334
o
CD

m
x

o'

CO
Q Clinically visible carious lesion

^- Clinically missing tooth

en
facial
Probe 545 I 4 3 3 7 333 434 I 545 I 545 \ 5451 554 I 434
TM
323T335 A Furcation

32 31 30 29 28 27 26 25 24 23 22 21 20 19 18 17 • "Through and through" furcation

initial probing depth

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Probe 1:

Probe 2: probing depth 1 month after

scaling and root planing
 TM

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CO
<
o

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i 2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.
 Q
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) 2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.
 Dental
CASEB History
Patient has had infrequent dental care.
Age 50 YRS
Sex KIMaleD Female
Height 6'0"
Weight 210 LBS
B/P 130/80
Chief "I'm not happy with my front teeth.
Complaint They feel rough."

Medical
History
Patient says he had a "mild stroke" 3 years ago. Social
arrythmias History
diabetes mellitus Type II Patient is a building contractor with two daughters in college.
hypertension

Current
Medications
metformin (Glucophage*)
metoprolol (Lopressor*)
aspirin

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 CASE B

©
O ADULT CLINICAL EXAMINATION
5
P
> 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Current Oral Hygiene Status
3
CD
Probe 2 Fair
755 576 646 545 444 434 [555 I 545 I666 I 544 445 566 667
O
facial
CD

fig
O
o
o
=1
Supplemental Oral Examination Findings
o
O
o
3
3
m'
ro Probe,1 666 656 555 454 454 434 555 545 666 544 545 556 667

Probe
555 555 555 666 I 565 I 667 I 756 I 555 I 655 666 545
CD

Clinically visible carious lesion

Clinically missing too:h

facial
Probe 1 555 555 555 656 I 566 I 567 I 755 I 655 I 755 565 545 A Furcation

32 31 30 29 28 27 26 25 24 23 TM
22 21 20 19 18 17 • "Through and through' furcation

Probe 1: initial probing depth

PDF Editor
Probe 2: probing depth 1 montn after
scaling and root planing
 ^^^k .J

E38

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•

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*-

i0frr y l

|£ J J

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© 2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.
 TM

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© 2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.
 PART 2 KEY
The key below may be used to determine correct and incorrect answers; howevnr, for this item set, it is not possible
to convert a raw score numher correct to a standard score or associated pass/foil status

1 B 51 B 101 E 151 C
52 D 102 A 152 D
2 c 53 R 103 C 153 D
3 A
A 54 C 104 D 154 E
4
5 D 55 B 105 C 155 A
6 D 56 B 106 A 156 A
57 D 107 C 157 E
7 c 58 A 108 B 158 D
8 D
59 C 109 A 159 A
9 C
60 D 110 B 160 B
10 C
11 E 61 B 111 B 161 D
12 B 62 B 112 A 162 D
63 D 113 C 163 C
13 C
14 A 64 C 114 D 164 D
65 C 115 B 165 E
15 C
16 D 66 D 116 C 166 D
17 C 67 A 117 A 167 C
18 D 68 B 118 D 168 A
19 C 69 B 119 B 169 B
20 E 70 B 120 A 170 A
21 A 71 E 121 C 171 A
22 D 72 C 122 C 172 B
23 B 73 B 123 C 173 C
24 A 74 C 124 D 174 D
25 D 75 B 125 E 175 B
26 B 76 E 126 A 176 B
27 D 77 B 127 D 177 C
28 B 78 E 128 A 178 D
29 D 79 A 129 C 179 E
30 B 80 A 130 E 180 D
31 C 81 D 131 E 181 A
32 D 82 E 132 B 182 E
33 E 83 C 133 B 183 D
34 E 84 E 134 A 184 C
35 C 85 A 135 B 185 C
36 D 86 C 136 B 186 A
37 A 87 C 137 E 187 A
38 D 88 E 138 D 188 B
39 B 89 A 139 B 189 D
40 B 90 D 140 B 190 C
41 A 91 B 141 C 191 A
42 C 92 A 142 C 192 A
43 B 93 B 143 E 193 C
44 B 94 C 144 B 194 B
45 A 95 B 145 D 195 E
46 B 96 D 146 D 196 C
47 C 97 C 147 A 197 B
48 B 98 D 148 B 198 A
49 C 99 B 149 D 199 B
50 A 100 B 150 E 200 C

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© 2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.