First lecture

1. Patient came to do RCT, after cleaning and shaping there is drainage, how to manage ?
A. keep it open
B. put temporary restoration
C. put composite
D. do perforation

intra canal medication:

Calcium hydroxide:
- high PH which provides antimicrobial action that leads to inactivation of microbial surface
enzymes,
- control pain and inflammation.
- Calcium hydroxide is a very helpful intracanal medicament for preventing the flare ups
that can occur in between the appointments, and management of weeping canals.

- but The research proves that Enterococcus faecalis is immune against Ca(OH)2. when
calcium hydroxide is mixed with two percent chlorhexidine digluconate that was extra
affective in opposition to Enterococcus faecalis.
- Can’t be removed completely from canal.
Ledermix,
- Combination of antibiotics and steroid (Demeclocycline hydrochloride 20m,
Triamcinolone acetonide 6.7mg)
- Effective in managing pain and inflammation related to periapical area,
overinstrumentation.
TAP: triple antibiotic paste of ciprofloxacin 500mg, metronidazole and minocycline 100mg.
- The combined action of the three medications in a single mix is extremely effective as the
chances of microbial resistance are reduced to a significant percentage.
- Used in immature teeth with apical periodontitis, periapical lesions, external inflammatory
root resorption, root fracture, and treatment flareups.
- Disadvantage: demineralizing effect on dentin due to minocycline, which causes calcium
chelation from the dentin.
- Tooth discoloration.
-
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9569130/#:~:text=TAP%20is%20an%20
%22intra%2Dcanal,1%20to%20produce%20effective%20results.
2. 30-year-old patient has sinus drain and Not responding to cold test with slight tender to
percussion What is the diagnosis?
A. irreversible pulpitis normal apical issue
B. irreversible pulpitis chronic apical abscess
C. necrotic asymptomatic periodontitis
D. Necrosis pulp with chronic apical periodontitis.
• Sinus drain = chronic.
• No response to cold (pulp test) = necrotic.
Pain on percussion = periapical issue or periodontitis
3. pt with swelling in the face started before 2 days ago, has a tooth with no response to cold
and tender to percussion in radiograph no radiolucency diagnosis ?
A. acute abscess
B. chronic abscess
C. necrotic with symptomatic periodontitis
D. necrotic with asymptomatic periodontitis

4. what is the most cause necrosis?

A. Avulsion
B. Extrusion
C. subluxation
D. concussion
• between the options…. (Concussion least, Most= intrusion if in the options)
• intrusion luxation worst sequala: pulp necrosis, ankylosis.

5. Intrinsic stains after RCT due to?

A. Trauma to dentinal tubules
B. blood from dentinal tubules
C. restoration remnant

6. Which of the following is the endodontic emergency treatment for teeth with symptomatic
irreversible pulpitis ?
A. Pulpectomy
B. trephination
C. direct pulp capping
D. incision and drainage
7. Method to assess blood flow in pulp?
A. Laser oximetry
B. doppler flowmetry
• Pulse oximetry measure= oxygen concentration in blood
• Doppler flowmetry = assess blood flow
 8. 30-year-old patient has sinus drain and Not responding to cold test with slight tender to
percussion What is the diagnosis?
A. irreversible pulpitis; normal apical tissue
B. irreversible pulpitis; chronic apical abscess
C. necrotic pulp; asymptomatic periodontitis
D. Necrosis pulp with chronic apical periodontitis

9. Most characteristic of irreversible pulpitis?

A. pain on cold, (Hypersensitivity)
B. Lingering pain on cold
C. pain in percussion (periapical area)

10. patient complain from his lower molar Xray show: lower molar with crown and
radiolucency in the apex and the lateral distal surface of the root. Pain on percussion, pocket
depth distally: more than 10mm, cold test: negative ?
A. subgingival calculus
B. lateral periodontal abscess
C. asymptomatic periapical periodontitis
11. most common organism found in chronic abscess?
A. Aerobic
B. Anaerobic
C. Mixed
• Acute endo ->anaerobic bacteria
• Chronic endo -> mixed bacteria
12. Definition of endodontic flare up?
A. Acute exacerbation of periradicular pathosis after start of RCT

A phoenix abscess is an acute exacerbation of a chronic periapical lesion. It is a dental

abscess that can occur following root canal treatment.
cause :due to untreated necrotic pulp (chronic apical periodontitis).
It is also the result of inadequate debridement during the endodontic procedure.
13. A 20-year-old patient is complaining of Pain in the lower right area. Upon examination, #47
responded normally to vitality testing, #46 is signs of a sinus tract or swelling. Radiograph
provided (see image) Which of the following is the appropriate treatment plan for tooth #46?
A. Extraction
B. Hemisection
C. Apicoectomy
D. Non-surgical retreatment
 14. A 57-year-old patient presented for root canal treatment of tooth 16 upon examination,
tooth responded normally to percussion and palpation, negative to cold and EPT Which of
the following is the most diagnosis of tooth #16?
A. Necrotic pulp with normal periapical tissue
B. Previously initiated with normal periapical tissue
C. Necrotic pulp with symptomatic apical periodontitis
D. Previously treated with symptomatic apical periodontitis

15. A 49-year-old woman complaining of sensitivity to both hot and cold liquids following the
placement of a full crown on tooth #17 which recently became spontaneous. Responses to
both percussion and palpation were normal and on application of Endo-Ice the patient
experienced pain that lingered after removal of the stimulus. Radiographically, there was
no evidence of osseous change Which of the following is the pulpal and periapical
diagnosis of this tooth?
A. Irreversible pulpitis; normal apical tissue
B. Irreversible pulpitis; chronic apical abscess
C. Necrotic pulp; asymptomatic periodontitis
D. Reversible pulpitis; symptomatic apical periodontitis

16. A 59-year-old patient complaining of a pimple on his gum in the upper right area, tooth #17
does not response to cold and there is no tenderness to biting or percussion. A sinus tract is
present opposite to the upper right molar. Radiograph provided Which of the following is the
recommended treatment plan for tooth #17?
A. Extraction
B. Biopsy of the lesion
C. Root canal treatment
D. Incision and drainage

17. A 36-year-old man came to the clinic with a chief complain of mild persistent pain on
biting related to tooth #15. It has previous endodontic treatment Bitewing radiograph:
shows a radiolucent line below filling margin indicating recurrent decay. Periapical
radiograph: shows a short radicular filling, obturation and periapical radiolucency related
to the apex of tooth #15. Probing depths are within normal limits. Which of the following
is the cause for failure?
A. Root fracture
B. Persistent lesion
C. Persistent bacteria in the apical lesion
D. Poor root canal treatment and coronal leakage
18. A 27-year-old asthmatic woman presents with pain on tooth #24 which is aggravated by
touch. The tooth was endodontically treated 2 years ago, but the tooth is still symptomatic.
Tooth #24 is negative to cold and EPT, and sensitive to percussion (see image) Which of
the following would be the best management for tooth #24?
A. Extraction and implant
B. Surgical endodontic treatment
C. Non-surgical endodontic treatment
D. Prescription of clindamycin antibiotic
19. Which of the following is the endodontic emergency treatment for teeth with symptomatic
irreversible pulpitis?
A. Pulpotomy
B. Trephination
C. Direct pulp capping
D. Incision and drainage
Note:

Cortical trephination: Cortical trephination is defined as the surgical perforation of the

alveolar bone in an attempt to release accumulated periradicular tissue exudates. Various
studies have evaluated the effectiveness of cortical trephination to prevent and relieve post-
treatment pain.

20. A 65-year-old patient complaining of a spontaneous dull pain in the upper right side tooth
#17 tender to biting and percussion. No clinical signs of sinus tract or swelling is present.
Radiograph provided (see image). Which of the following is the endodontic diagnosis of
tooth #17?
A. Pulp necrosis with asymptomatic apical periodontitis
B. Asymptomatic irreversible pulpitis with acute apical abscess
C. Symptomatic irreversible pulpitis with chronic apical abscess
D. Previously treated with symptomatic periodontitis

21. A 40-year-old patient presented with localized swelling in the area of tooth #16. Diagnosis
was necrotic pulp with acute apical abscess. Patient does not have time to stay for full
treatment (see image) Which of the following is the appropriate emergency treatment for
tooth #16?
A. Extraction
B. Antibiotics
C. Incision and drainage
D. Cleaning and shaping

22. A 27-year-old healthy woman presents to the dental clinic for checkup. Upon examination,
tooth #16 did not respond to thermal and electrical stimulation. A sinus tract was noted in
the attached gingival between #16 and #17. All upper right premolar and molar teeth
responded normally to percussion and palpation tests. Periodontal probing ranged between
2 – 3 mm (image) Which of the following is the recommended management for tooth #16?
A. Tooth extraction
B. Root canal treatment
C. Excision of sinus tract
D. Prophylactic antibiotic
Note: Confirmation by sinus tract tracing as diagnostic aid for non vital 16
23. 27-year-old woman presents for dental check-up. Patient mentioned a history of traumatic
blow to the lower right premolar area received about 4 years ago. Tooth #44 did not respond
to thermal and electric pulp stimulation. Palpation, percussion and periodontal tests were
normal. No swelling or sinus tract were noted. Patient is keen to save the tooth if possible
(see image) Which of the following is the most appropriate management for tooth #44?
A. Pulpotomy
B. Apical curettage
C. Extraction and implant
D. RCT
24. A 22-year-old woman was seen in clinic for a dental abscess in the mandible due to no35.
She was treated with oral antibiotics. She returned to the clinic with persistent abscess and
pain. Which of the following could have prevented the persistence of the infection?
A. Prescribe mouthwash
B. Incisional and drainage
C. Endodontic treatment
D. Extract the offending tooth

25. A patient came to the clinic suffering from intense pain from tooth #46. The tooth showed
severe tenderness to percussion and biting. What is most appropriate periapical diagnosis?
A. Condensing osteitis
B. Chronic apical abscess
C. Symptomatic apical periodontitis
D. Asymptomatic apical periodontitis
26. A 47-year-old patient referred to Endodontic Clinic evaluate tooth #45. Upon examination,
tooth #45 had root canal treatment 3 years ago and is sensitive to percussion (see image)
Which of the following is diagnosis of tooth #45?
A. Previously treated with normal apical abscess
B. Previously treated with acute apical abscess
C. Previously treated with symptomatic apical periodontitis
D. Previously treated with asymptomatic apical periodontitis

27. A 50-year-old woman presents to the dental clinic for evaluation of upper left premolar-
molar teeth. Patient stated that she had a severe spontaneous pain 6 weeks ago while on
holiday. The pain has eventually subsided without dental intervention. Teeth #24,26 and
27 responded normally to all endodontic tests. Tooth #25 did not respond to cold. A sinus
tract was noted in the alveolar mucosa buccal to #25 e image Which of the following is the
endodontic diagnosis for tooth #25?
A. Pulp necrosis with chronic apical abscess
B. Previously treated with acute apical abscess
C. Symptomatic irreversible pulpitis with symptomatic apical
Sinus tract: chronic case, no pulp response: necrosis.
28. A 36-year-old patient-complaining of sharp spontaneous pain waking him up at night.
Tooth 47 responds Lingering pain and tender to neither percussion nor biting No sinus tract
or swelling present clinically. Radiography provided (see image) Which of the following
is the endodontic diagnosis of tooth # 47?
A. Reversible pulpitis with acute apical abscess
B. Pulp necrosis with asymptomatic apical periodontitis
C. Symptomatic irreversible pulpitis with normal periapical area.
D. Asymptomatic irreversible pulpitis with chronic apical abscess

29. A 60 years old patient presented with intermittent pain in tooth #26 that is associated with
sinus tract upon examination, tooth #26 is sensitive to percussion and palpation,7mm
probing depth in mesiopalatal area of the tooth and grad II mobility. Which of the following
is the most probable diagnosis of tooth #26?
A. Previously treated with acute apical abscess
B. Previously treated associated with vertical root fracture
C. Previously treated associated symptomatic apical periodontitis
D. Previously treated with asymptomatic apical periodontitis

30. 42-year-old-healthy woman presents with moderate pain to cold drinks and sweets in the
upper left side of the jaw. On examination, Application of Endo Ice to tooth #25 elicited a
sharp, momentary pain. Tooth #25 responds normally to percussion, while #26 is
percussion positive (see image) Which of the following is the source of patient complaint?
A. Pulpal tissues of tooth #25
B. Periapical tissues of tooth #25
C. Pulpal tissues of tooth #26
D. Periapical tissues of tooth #26
Note: the Q didn’t mention anything about pulp test to 26, so we consider source of
diffused pain related to pulp condition of 25.

31. A 63-year-old patient complaining throbbing pain in the upper left area, tooth #26 does not
respond to cold and is tender to both percussion and biting No clinical signs of swelling or
sinus tract are present. Radiograph provided (see image) Which of the following is the
endodontic diagnosis of tooth #26?
A. Pulp necrosis with symptomatic apical periodontitis
B. Symptomatic irreversible pulpitis with normal apical tissue
C. Asymptomatic irreversible pulpitis with chronic apical abscess
D. Previously initiated therapy with asymptomatic apical periodontitis

32. A 43-year-old patient presented to the dental clinic with severe lingering pain related to the
mandibular right posterior teeth. The pain was tolerable until last night, which was severe
interfered with sleeping. Clinically, all teeth were negative to percussion and palpation,
periodontally sound. The cold test revealed an exaggerate lingering response in the first
molar. while a sharp momentary response disappeared after stimulus removal on the second
premolar and second molar (see image) Which of the following treatments would resolve
patient symptoms?
A. RCT of the first molar
 B. RCT of the second premolar
C. Direct pulp capping of the first molar
D. Indirect pulp capping of the second molar

33. A 64-year-old man presents to the dental clinic complaining that he cannot chew on the
lower right side of the jaw. Pain started 4 weeks ago and has intensifies over the last 3 days.
On examination, application of cold to tooth #46 elicited an extraction in that lasted for
about 1 minute. Tooth tender Adjacent premolar and molar teeth responded normally to
pulpal, periapical and periodontal tests (see image) Which of the following is the
endodontic diagnosis for tooth #46?
A. Pulp necrosis with acute apical abscess
B. Reversible pulpitis with symptomatic apical periodontitis
C. Asymptomatic irreversible pulpitis with symptomatic apical periodontitis
D. Symptomatic irreversible pulpitis with symptomatic apical periodontitis

34. How can a periodontal abscess be definitely differentiated from an endodontic abscess?
A. Location
B. Pain source
C. Pulp vitality
D. Radiographic appearance

35. A 61-year-old man presents with severe sensitivity to cold drinks in the lower left molar
region. On examination, application of Endo Ice to tooth #37 produced a strong pain that
lasted for 45 seconds, while percussing the tooth produced a sensitive response. Which of
the following is the endodontic diagnosis for #37
A. Reversible pulpitis with normal apical tissues
B. Necrotic pulp with symptomatic apical periodontitis
C. Necrotic pulp with asymptomatic apical periodontitis
D. Symptomatic irreversible pulpitis with symptomatic apical periodontitis

36. A 52-year-old patient complaining of pain in the upper right area. Tooth #17 did not
respond to cold, and is tender to biting and percussion, no sinus tract or swelling is present,
radiograph provided. Which of the following is the endodontic diagnosis of tooth #27?
A. Reversible pulpitis with normal apical tissues
B. Pulp necrosis with symptomatic apical periodontitis
C. Symptomatic irreversible pulpitis with chronic apical abscess
D. Asymptomatic irreversible pulpitis with acute apical abscess

37. A patient presents to the dentist complaining of severe unlocalized pain on lower right side.
On clinical examination, he had multiple questionable teeth. An attempt was made to
localize the offending tooth using thermal testing. Tooth #45 had severe pain that lasted 1-
2 seconds after removal of the stimulus. Which of the following is the most likely
diagnosis?
A. Normal
B. Necrotic pulp
 C. Reversible pulpitis
D. Irreversible pulpitis

38. A 30-year-old woman complains of throbbing pain in the maxillary right quadrant. The
pain is spontaneous and lasts for hours. All tests are normal expect radiographs (see report).
Radiographic examination: showed large carious lesion in the maxillary first premolar.
Pulpal exposure of 2 mm is encountered after excavating all caries. Which of the following
is the most likely diagnosis?
A. Necrosis
B. Reversible pulpitis
C. Irreversible pulpitis
D. Hyperplastic pulpitis
Hyperplastic pulpities: young age, good blood supply.

39. What is the diameter size of 3 Gates Glidden in millimeter?

A. 0.5
B. 0.7
C. 0.9
D. 1.1
Note: The diameter of the cutting bud on the GGD #1 is 0.5 mm, #2 is 0.7 mm, #3 is 0.9 mm, #4
is 1.10 mm, #5 is 1.3 mm and #6 is 1.5 mm.
40. Which of the following irrigants has the highest antimicrobial activity against endodontic
infection?
A. EDTA
B. Cetrimide
C. Chlorhexidine
D. Sodium hypochlorite

Note: Cetrimide belongs to a class of drugs called 'antiseptic' primarily used to

treat gum problems like swollen, bleeding, spongy, or loose gums.

41. Gutta-percha is currently the standard and universally accepted core obturating material in
most of root canal treatments. Which of the following is disadvantage of this material?
A. Not easily manipulated
B. Difficult to be removed from a canal
C. Shrinkage if softened by heat or solvents
D. Poor adaptation to canal wall with compaction

42. Which of the following is the cross-section of the Flax-R file?

A. Round
B. Square
C. Triangular
D. Quadrangular
43. Which one removes the smear layer ?
A. ETDA
B. Sodium hypochlorite
C. Chlorhexidine

44. Best location & size of root perforation that is favorable?

A. Small perforation below height of bone crest
B. Large perforation below height of bone crest
C. Small perforation at height of bone crest
D. Large perforation at height of bone crest

• Perforation near cervical → Poor prognosis. Perforations in the coronal third of the
root adjacent to the crestal alveolar bone have the worst prognosis compared to
perforations in the other areas of the root. If left untreated, apical migration of the
periodontal attachment (i.e., pocket formation) happens relatively quickly. Once the
pocket is formed, persistent inflammation of the area is expected due to continuous
bacterial ingress through the pocket .
• Perforation near apical → Good prognosis.
• Perforation subcrestal→ Bad prognosis. Can’t be achieved for repairing.
• Perforation supracrestal→ Good prognosis better accessibility for repair.

45. Best way to apply sealer into the canal?

A. Files
B. Peeso reamer
C. Lentulo spiral (Lentulo spiral instrument used to spread sealer in the canal )
46. What does a localized periodontal defect around an endodontically treated tooth suggest?
A. Gingivitis
B. Internal resorption
C. External resorption
D. Vertical root fracture
VRF
• J-shaped radiolucency around endodontically treated tooth
• Techniques for detecting vertical crown/root fractures:

In vital teeth the most common reason for a fracture is trauma. In non-vital teeth trauma
may also be a contributory factor but endodontic treatment followed by post reinforcement
is a common cause.
How to diagnose:
1. Fibre optic examination.
2. Wedging and staining .
3. Radiographic examination. (J shape defect)
4. Thorough dental history.
5. Bite tests. (pain on biting)
6. Periodontal probing. (localized pocket)
7. Restoration removal. (from pulp champer)
8. surgery.

47. How is a vertical root fracture best confirmed?

A. Bite test
B. Percussion
C. Exploratory surgery
• Best radiograph for diagnosis of root fracture cbct.
• Best method to diagnose root fracture: exploratory surgery

48. Patient have bone lose in lower 6 it's about 7mm in mesial side, so the diagnosis is ?
A. Hemi section
B. Vertical fracture
C. RCT
D. Extraction

49. 60 years old patient presented with intermittent pain in tooth #26 that is associated with
sinus tract upon examination, tooth #26 is sensitive to percussion and palpation,7mm
probing depth in the mesiopalatal area of the tooth and grade II mobility. Which of the
following is the most probable diagnosis of tooth #26?
A. Previously treated with acute apical abscess
B. Previously treated associated with vertical root fracture
C. Previously treated associated without vertical root fracture
D. Previously treated with asymptomatic apical periodontitis
50. A 22 - year-old man presented to the clinic complaining of shooting pain on biting his
maxillary left tooth, which subsided as soon as he released the bite. On clinical
examination, tooth # 25 had a large disto-occlusal composite filling, and was tender to both
vertical and horizontal percussion. The patient mentioned that he was dieting and
frequently ate nuts. The gingival tissue around the tooth was healthy. There were other
teeth in his mouth that required simple filling (see report) Radiographic examination:
showed that the tooth was root canal treated and the restoration margins were intact. Which
of the following is the most likely diagnosis of this tooth ?
A. Cracked tooth
B. Root resorption
C. Periapical abscess
D. Periapical periodontitis

- Vertical percussion: periapical area.

- Horizontal percussion: periapical area.
Cracked tooth syndrome: defined as a fracture plane of unknown depth, which originate
from the crown, passes through the tooth structure and extends subgingivally, and may
progress to connect with the pulp space and/or periodontal ligament.

When the fractured portions of the tooth move independently of each other, it causes
sudden movement of fluid present in the dentinal tubules.
This causes activation of myelinated A-type fibers within the dental pulp and results in
acute pain.
Hypersensitivity to cold may occur due to the seepage of toxic irritants through the crack.
This leakage of toxic irritants causes the release of neuropeptides, and a concomitant
lowering in the pain threshold of unmyelinated C-type fibers within the dental pulp.

51. A 22-year-old patient has upper #12 fractures with pinhole pulp exposure 12? before 1
hour, what is the Tx?
A. RCT (more than 1 hour)
B. Direct pulp capping
C. Pulpotomy
• Note: According to the time we will decide, if less than 1 h= DPC (Direct Pulp Capping)
or pulpotomy + Depending on size of pinhole < 0.5

52. Crown fracture involving enamel, dentin and exposing the pulp, classify?
A. Crown infarction ( Def: shallow crack that is entirely contained within the enamel and
does not continue into the dentin )
B. complicated crown fracture
C. uncomplicated crown fracture
• Uncomplicated involving enamel +dentin
• Complicated involving enamel +dentin +pulp
53. what is your diagnosis for this picture

A. internal resorption
B. external resorption

Pink tooth: This pink discoloration is caused by the dentine being replaced internally by
soft ('fibro-vascular') tissue with the overlying shell of enamel remaining intact.

54. location of second canal in lower canine ?

A. Mesial
B. Distal
C. Labial
D. Lingual

55. In the mid of root suddenly the canal disappears means?

A. Second canal (in x-ray)
B. Internal resorption
C. calcified canal

A “fast break” is a term used to describe a situation where a root canal disappears on a
radiograph as you move apically. This happens when the main canal splits into multiple
smaller canals that are not discernible on a radiograph.

56. Dentist doing RCT, suddenly bleeding occurred through the canal. The dentist noticed that
the rubber stopper on the file has moved from it's original location? What is happened?
 A. Internal resorption
B. External resorption
C. Perforation
D. Ledge

57. Pt came on a routine checkup. Dentist noticed an overextended cone 5 mm on #14. Patient
had his RCT 10 years ago. Asymptomatic no signs of peri apical pathosis on x-ray.
Management?
A. Follow up.
B. Surgical removal of the extended cone

58. A 30-year-old patient complains of severe pain in #36, x-rays were performed and it was
found that the canal curved. What is the appropriate system?
A. rotary
B. hand instrument only
C. both
D. avoid Gates glidden

59. Which tooth constant number of canal ?

A. Maxillary central incisor
B. Mandibular central incisor
C. Maxillary canine
D. Mandibular canine

60. Which of the following canals in(6) is most difficult to locate?

A. palatal.
B. Distobuccal.
C. Mesiobuccal.

61. what is the most cause necrosis?

E. Avulsion
F. Extrusion
G. subluxation
H. concussion
• between the options…. (Concussion least, Most= intrusion if in the options)

62. Carrier based technique ?

A. Obtera 3
B. Thermafil
Note:
• Carrier-Based Gutta-Percha = thermafil + pro taper + SuccessFil case
• Thermomechanical compaction = McSpadden Compactor
compactor is used which resembles a reverse H-file. A cone coated with sealer is placed
in the root canal, engaged with a rotary instrument (running between 5,000 and 10,000
rpm) that frictionally warms, plasticizes and compacts it into the root canal.

• thermoplastic injection technique = Obtura II (internal resorption)

Obtura II is a popular warm gutta-percha technic that uses a "gun" to warm and inject
the gutta-percha filling into the root canal.

• warm vertical compaction + continuous wave compaction technique =System B +

injectable GP.
63. System-B obturation technique is?
A. Cold GP. Condensation
B. Warm GP. Condensation
C. Continuous condensation
System B
Continuous wave of condensation is an obturation technique that applies a heated “plugger”
into a single custom fit greater tapered master cone of gutta-percha.
The heat plugger is placed through the master cone to within 3-5mm of the predetermined
working length.
64. Best material to repair Perforation in furcation ?
A. GIC
B. Zinc oxide eugenol
C. Calcium hydroxide
D. Bio-ceramics

65. Where is the narrowest diameter in root?

A. Anatomical apex
B. Radiographic apex
C. Physiological apex
D. apical constriction
66. The pt have PFM crown and he needs RCT but he doesn't want to remove the crown, the
access cavity will be done by ?
A. Carbide bur
B. Dimond bur
C. Diamond for poreclin and transmetal bur for metal

67. Pulp exposure in trauma for 3 days?

A. Pulpectomy
B. Pulp capping
C. Cervical pulpotomy.
D. Pulpotomy
68. Negative rake angle in ?
A. K-files
B. H- files
• K file -ve rake angle. H file +ve rake angle

RAKE ANGLE: In the cross-section, this is the angle formed by the leading edge and the radius
of the file.

- If the angle formed by the leading edge and the surface to be cut is obtuse, the rake angle
is said to be positive or cutting.
- If the angle formed by the leading edge and the surface to be cut is acute, the rake angle
is said to be negative or scraping.
 The rake angle of an endodontic file can be negative ( A ), neutral ( B ) or positive ( C ).

69. The length of working part in file 20 is?

A. 12
B. 16
C. 21
70. Which of the following is the endodontic emergency treatment for teeth with symptomatic
irreversible pulpitis ?
A. Pulpectomy
B. trephination
C. direct pulp capping
D. incision and drainage

71. Which of the following is an error occurs during obturation of the root canal ?
A. voids (improper compaction).
B. ledge formation
C. broken instrument
D. filling lateral canal

72. What is the use of root canal Sealer in endodontics?

A. Fill the voids
B. Increase strength of RC filling
C. Disinfect the canal
D. Irrigation of canal

73. percentage of gutta percha in composition?

A. 100% gutta percha
B. 50%gutta percha 50% wax
C. 70% gutta percha 30% zinc oxide
D. 20%gutta percha 80%zinc oxide
74. Root Resorption inhibition property after replantation of avulsed teeth?
A. Edta
B. Ledermix
C. Sodium perborate

LEDERMIX dental powder contains mixture of antibiotic and corticosteroid

(demeclocycline hydrochloride and triamcinolone acetonide). used to reduce swelling
or inflammation. tooth, and as a dressing during the treatment of the root canal.
incomplete development of hard tooth surface.

75. Material used for Apexification?

A. Caoh
B. mta

76. Conditioning of resected root end by ?

A. Citric acid.
B. EDTA!!!!
C. Phosphoric acid.
D. H202
77. best storage medium for avulsed teeth ?
A. Hbss (Hanks' Balanced Salt Solution)
• from best to worst media: 1-cell culture media HBSS 2-low fat cold milk 3-
physiological saline. 4-Saliva 5-water

78. Coronal Lateral perforation observed with no. 15 K file small in size and supracrustal
location, managed with MTA, what's the prognosis?
A. Good
B. Bad

Factors Affecting Prognosis of Perforation Repair:

• Visibility and accessibility – Better the access and visibility to the site of perforation,
better is the clinician’s ability to repair it
• Time – Faster the perforation repair better is the prognosis
• Esthetics – It is to be considered when the perforation repair is in case of anterior or
premolar teeth
• Associated periodontal condition
• Location –
• Perforation in the furcation area has a poor prognosis.
• Perforation occurring in mid-root and apical part of root does not have communication
with oral cavity and thus has good prognosis.
• Size - A smaller perforation has less tissue destruction and inflammation, thus having
better prognosis than larger sized perforation

Most common anatomic site in the tooth where perforation occurs:

• Maxillary incissors – facial aspect

• Mandibular incissors – facial, mesial or distal aspect
• Maxillary premolars – mesial or distal aspects
 • Mandibular premolars – facial aspect
• Mandibular molars – lingual aspect
• Maxillary and mandibular molars within pulp chamber – furcation area

It can be classified

• Cervical canal perforation occurs mainly during location of canal orifice and flaring of
the coronal third of the root canal
• Mid-root perforation occurs due to over instrumentation and over-preparation of thin
wall of root or concave side of the curved canals
• Apical root perforation occurs when instrument goes beyond the confines of the root
canal and by overuse of chelating agents along with straight and stiffer large-sized
instruments to negotiate ledge, canal blockage, or zipping, etc.

79. Method to assess blood flow in pulp?

C. Laser oximetry
D. doppler flowmetry
• Pulse oximetry measure= oxygen concentration in blood
• Doppler flowmetry = assess blood flow
80. Instrument fracture at middle part, management ?
A. Bypass
B. Retrieve it
• Instrument fracture and management according to root curvature level:
• Above curvature level: retrival.
• Below curvature level: bypass.
▪ Apical = RCT and follow up
▪ Middle =bypass
▪ Coronal =retrieve it
81. Yellowish discoloration of tooth after RCT due to?
A. Hemorrhage from pulp
B. Incomplete debridement of pulp tissuev
C. Leaving Gutta percha in pulp chamber
D. Hemorrhage from canal + leaving Gutta percha