jate: 2/1 /2019 A preoperative radiograph of mandibular first molar showed periradicular _radiolucency ‘associated with the distal root. Clinically, a deep wide periodontal defect can be probed distally with generalized gingival recession. Your diagnosis is a) Primary endodontic secondary periodontal disease. b) Primary periodontal secondary endodontic disease. ©) None of the above. d) Further diagnostic test should be performed Developmental defect when the cementum and enamel do not meet at CE) leaving an arca of exposed dentine considered as: a) Physiological pathway of communication between pulp and periodontium. b) Anatomical pathway of communication between pulp and periodontium ©) Iatrogenic pathway of communication between pulp and periodontium 4) None of the above. Panoramic radiograph showed generalized bone loss that Is accentuated In relation to the mesiat root of lower first molar with calculus present but separate periapical radiolucency to the mesial root root of mandibular molar. ‘Clinical examination revealed deep proximal decay of the tooth Involved. Pulp sensitivity tests were negative. Your diagnosis is : a} Primary endodontic secondary periodontal lesion. 'b) Primary periodontal secondary endodontic lesion. Janomaly of the masillary incisors, Incisors more influenced than centrals a direct Bere’ — the oral Misr International University Faculty of Oral and Dental Medicine Final Written Exam, Fall 2018 istructors: Prof,Dr.Salma Elashry/ Prof.Dr. Abeer Elgendy /Assoc. Dr. Maram Obeid Assoc. Dr. Ahmed Ghobashy / Dr. Manar Galal/ Dr Mohamed Fakhr of questions:4 No. of exam 1estion no. 1: Choose the Right answer: ( one mark each) Department: Conservative Department Grades: 25 marks(75 points/3) Time: two hours pages 4 [Attempt all questions 4d) Carabelli groove Periodontally treated teeth may demonstrate rophy and canal narrowing due to: Microbial colonization Root cracks toss of cemental layer All of the above. oprade pulpitis is caused by : Deep caries in the occlusal surface of molars Root amputation Guided tissue regeneration None of the above s) 6) a a) The disease in which the lesion proceeds from the ingival margin towards the root apex causing pulp inflammation is called n 3), Retrograde periodontitis with pulpitis b) Marginal periodontitis with retrograde pulpitis €) Marginal periodontitis wit acute pulpltis d) None of the above: The success rate of primary Endodontic treatment Is about: a) 100% b) 80% «) 95% 3) 90% Periapical lesions decrease the success rate of endodonticaly treated teeth by: a) 20% b) 5% ) 30% J) SO% 10) Periapical lesions don't appear on periapical radiographs until they reach the: 2). Periodontal membrane space b) lamina dura ©) spongy bane 4) Cortical plate of bone 11) The average distance between the minor apical constriction and apical foramen is; a) 12mm b) O5-Imm ¢) 23mm d) They have the same location _Date 2772013 — ”2) Periapical lesions usually heat after endodontic treatment unless the lesion present Is 2: 3) Periapical granuloma b) Pocket cyst od) Truceyst 4) None of the above 3) One of the main causes of preoper failure is: —— a) Incorrect diagnosis b)_ Missed root canals 4). Overestended canal obturation 4) Absence of a coronal seal ) 9 coronal restoration has fallen, endodontic retreatment must be done ifthe duration exceeds: 3) day b) 1 week ©) 2weeks 4) 2 months ) During access cavity preparation, the pulp chamber at the cemento-enamel junction of all teeth Is located at the: a) Mest b) Distat Center d) Buccal ) One of the main causes of canal ledges i: a} Inabilty to negotiate canal curvatures b) using sodium hypochlorite ©) using EDTA 4}. Missing root canals, ) Closing furcation perforations is best done with: a) Amalgam b)Giassionomer paste €)- Bioceramic paste 4) Composite resin ) Heithersay classified 9 well- defined Invasive external cervical resorptive lesion that has penetrated close to the coronal pulp chamber but shows little or no extension into radicular dentin as: a) Class b) Class2 ©) Ciass3 d) Class ) Damage of protective odontoblast layer and ‘exposing the underlying mineralized dentine to ‘odontoclasts and micro-organisms is the main ‘cause for: a) Lateral Root Resorption b}_ External Cervical Resorption ©) Internal root Resorption 6) External replacement resorption Intracanal medications used in treatment of Jnlammatory root resorption: a) Ca (OHj2 ive endodontic Pape2ora b) Ledermix ©). Bisphosphonates 4d) Allof the above Teeth with perforating small resorptive defect that do not communicate with gingival sulcus were treated with: a). Recaleification with Ca (OH)2 b)_ MTA application. ©) Root amputation d) ABB 22) Pink tooth Is diagnostic for: a) Pulp polyp: b)_ Internal root Resorption €) Lateral root resorption d)_Externat replacement resorption 23) Which of the following obturating techniques used in case of internal root resorption? a) Lateral condensation b} Vertical condensation ©) Theemoplasticized injected e d)_ None of the above. 24) One of the following instruments has w-shape cross section design: a) Race b) profile ©) Protaper 4d) Kereamer 25) InProtaper instrument, the apicalone thirds of the root canal is finished using a) Fland St b) s2andF2 Sead F3 4) FLBF2 26) During rotary canal instrumentation, of copious amount of irrigation and lubrication is indicated to: a) shape the canal b)_ Increase stress on the instrument ©) Decrease stress on the instrument 4) Perforate the canal 27) Rotary Instrument fracture could occur during the following conditions except: a) sudden change in direction of the Instrument b) start rotation with instrument inside the canal €) stop rotation inside the root canal 4) remove the Instruments from the canals while they are rotating 28) Which of the following statements is not true about the profile instrument a) Its Nexible b)_ thas Different taper ©) It Looks like a gates glidden drill 4d) Its used in low speed percha Date 2/1 72019stion no. 2: Tick True or False for Each Statement: (half mark each) In adequate endodontic treatment of lower first molar with localized distal periodontal lesion is termed marginal periodontitis. ‘An iatrogenic error that create 3 communication pathway between pulp and peridontium is bicuspidization Clinically, it ig common to observe advanced periodontitis spreading to the causing pulpal necrosis and is called marginal pulpitts. apical foramen and Iatrogenic problems as root perforations result in direct communication between the pulp and the periodontium. ‘Apical foramen is considered as the most direct route of communication between the pulp and periodontium. Pulpal degeneration results in necrotic debris, bacterial byproducts, and other toxic trtants that can move toward apical foramen causing periodontal tissuc destruction apically then migrating, toward the gingival margin which is known as “retrograde pulpitis”. Pathological conditions of the pulp of bacterial origin that invade the periodontium through accessory canals resulting in clinical condition of necrotic teeth that can be misdiagnosed as a periodontal pathosis is termed primary endodontic lesion ;. Periapical Pocket cysts don’t heal after root canal therapy ). Periapical x rays are more accurate in showing per pical lesions compared to Cone beam CT 10. Sinus tracts must open exactly above the apex of the infected tooth 411, The apical foramen opens always at the tip of root apex 12. Underextended actess preparations can result in remnant microorganisms in the pulp chamber 13,A ledge fs the accumulation of debris apically within the canal causing an inability to reach the working length 14, Perforations must be closed immediately after their occurrence 15. Overextended gutta percha from the canal can cause periapical mechanical irritation 16. Absence of a coronal restoration with cuspal coverage over an endodontically treated tooth may h ma ically treate ” 17. To determine the success of a root canal treatment you must follow up the case until 3 years. 28, During surgical repositioning of avulsed tooth, the root surface should be treated with Emdogain eS ¢ treated wit! ; Emdogain to 19. osteoclastic bone resorption, so it used for the treatm: F the t Calcitonin inhibits = a vatment of inflammatory root bleaching results in internal root resorption. , when non Surgical approach have been unsuccessful, a surgical approach Is consequence of non-vi L -vital intacoronal bleaching. ovestimate the working length and to determine the cemento-dentinaladiograph gives two dimensional representation of the root canal ps. Sudden change in direction is possible during rotary instrumentation. 7, Rotary instrumentation safe time and effort. Gates Glidden & Peso Drills, if used properly could result in damage to the root canal anatomy. no. 3: Complete the following: (half mark each) . The communication pathways between pulp and periodontal tissue include vascular ways such as ~~ N=, and ~(c)—- The presence -—-(a)—— has a major protecting rule that guard the pulp in the presence of periodontal inflammation. ‘The anesthetic action in pulpal injection is due to ...{a).... |. The pain associated with C fibers resulted in ... on no. 4: Give short account: (6 marks each) 1. The most important factor in the treatment of perio-endo lesions Is a correct diagnosis, Discuss ‘Discuss alternative treatment options in a case with extensive disteuction or perforation of the] {furcation area in mandibular first molar where endodontic and periodontal treatment faied operative causes of failure during canal shaping) and discuss the{Causes\and differen of fractured files within root canals. of success of root canal treatment of internal and external root resorption are endodontic challenges| ————— ———— Searmed with CarSearner