MCQ 3

1. Patient has dull pain related to lower molar tooth which was endodontically treated 3
years ago as shown in the image below. What is the likely reason for failure?

A. Missed canal
B. Vertical root fracture
C. Short endodontic and inadequate filling
D. Coronal leakage
This question has confusing answers mainly the endo treatment isn’t good, the first
impression. If there is more diagnostic information we can consider VRF as there is
large restoration and J shape radiolucency..
2. How can you differentiate between endodontic and non-endodontic pathosis
A. Radiographic appearance
B. Radiographic location
C. Pulp sensibility testing
D. Percussion test
3. A patient gives history of previous intrusion of incisors. PA shows loss of periodontal
ligament space and progressive root resorption. What is your conclusion?
A. Inflammatory resorption
B. Replacement resorption
C. Surface resorption
D. Cervical root surface resorption
Replacement resorption :a pathologic loss of tooth substance (cementum, dentin, and
PDL) with subsequent replacement of these tissues by bone, which results in fusion of
the root to the surrounding bone. This type of resorption occurs following severe
trauma to teeth—such as intrusion, lateral luxation or avulsion—where the PDL and a
large portion of the root surface have been damaged (typically, more than 20% of the
root surface). The initial process is known as ankylosis which is defined as loss of the
PDL
4. Successful endodontics using rotary techniques is achieved by
A. Use of EDTA
B. Pre-enlarged coronal flare
C. Proper irrigation
D. Good obturation
 5. EDTA is primarily used to
A. Dissolve organic matter
B. Dissolve inorganic matter
C. Kill bacteria
D. Prevent sealer from extruding out of the canal space
6. In the treatment of an acute periodontal abscess, the most important first step is to
A. Prescribe systemic antibiotics
B. Reflect a periodontal flap surgery
C. Obtain drainage
D. Prescribe hot salt mouth washes
7. Removal of old gutta percha from canal is best done by
A. Chemical
B. Mechanical
C. Thermal
D. Combined heat and chemical methods
8. When you want to instrument a curved root, you insert a file by:
A. Putting gauze on the file & bend it by hand
B. Bend the file by pliers
C. By bare finger
D. By twist
9. Proteolytic irrigant used in root canal treatment is
A. Water
B. Sodium hypochlorite
C. Saline
D. EDTA
10. Material used for managing weeping canal
A. Glass ionomer cement
B. Compomer
C. Calcium hydroxide
D. Sodium hypochloride
11. Rarefaction of bone diagnosis is by:
A. pain from the cold
B. pain by percussion.
C. cortical bone resorption
D. radicular bone resorption
Bone rarefactions (thinning of bony tissue sufficient to cause decreased density of
bone )arising from dental lesions are commonly thought to be sustained by the
microbiol component or by the toxins spread out into the surrounding bone by the
disintegrated pulp.
12. Constituent of AH26
A. Formacresol
B. Zinc oxide
C. Epoxy Resin
D. Xylene
13. Main content in gutta percha obturating material
A. Zinc oxide
B. Gutta percha
C. Choloroform
D. Zinc acetate
14. The most common cause of discoloration of a single tooth
A. Endodontic treatment
B. Tetracycline stain
C. Dentiogenesis imperfecta
D. Amelogenesis imperfecta
15. Which is always associated with a non-vital tooth
A. Chronic apical periodontitis
B. Internal resorption
C. Hyperplastic pulptitis
D. Condensing ostetitis
16. Identify the below lesion

A. Nasopalatine cyst
B. Nasolabial cyst
C. Periapical cyst
D. Residual cyst
- periapical cysts present as a unilocular radiolucency at the apex of the tooth
demonstrating well-defined borders, which may be corticated.
- Radiographically, a periapical cyst cannot be differentiated from a periapical
granuloma.
- The radiolucency associated with a periapical cyst is generally round to ovoid, with a
narrow, opaque margin that is contiguous with the lamina dura of the involved tooth.
- Cysts range from a few millimeters to several centimeters in diameter, although most
measure less than 1.5 cm. In long-standing cysts, root resorption of the offending tooth
and occasionally of adjacent teeth may be seen.
17. A 2% taper endodontic file means:
A. Distance of the file from DO to D16
B. 0.02 mm is the diameter at tip, increase is from the tip to the handle
C. 0.2 mm is the diameter at tip, increase is from the tip to D16
D. 0.02 mm increase in diameter per 1 mm increase in length
18. Apical foramen located
A. Lateral to apex
B. At apex
C. At lateral canal
D. At accessory canal
19. Size of 20 file at tip is
A. 20 mm
B. 2 mm
C. 0.02 mm
D. 0.2 mm
20. There is a horizontal root fracture in the middle third of the root of central incisor in an
11-year- old patient. The tooth is mobile and vital. Vitality tests show no response. How
should this be treated?
A. Extract
B. Pulpectomy immediately and splint
C. Splint and observe
D. Do nothing and follow-up in 10 to 14 days
21. The most suitable description to describe NiTi file is
A. Rigidity
B. Low fracture
C. Stainless
D. Hard

22. Cause of Ni-Ti breakage in endodontic

A. Cyclic fatigue
B. Torsional stress
C. Rigidity
D. A and B
23. Material used in the majority of areas of perforation
A. Mineral Trioxide Aggregate
B. Gutta percha
C. CaOH
D. GIC
24. Continuous condensation technique for GP filling is
A. Obtura I
B. Obtura Il
C. Ultrafill
D. System B
25. Stieglitz pliers is:
A. Used to contour matrix bands
B. Used to hold the silver point
C. Used to remove roots during hemisection
D. Used to place rubber dam clamp on the tooth

26. Best method to protect the teeth after bicuspidization is

A. Composite restoration
B. Amalgam restoration
C. Crown
D. Onlay

27. Minimum length of Gutta Percha that is required to be left when preparing for a post
preparation to avoid leakage and reinfection
A. 3-4mm
B. 4-6mm
C. 6-8 mm
D. Post length is not important
Some articles; To maintain the integrity of the apical sealing, it is necessary to leave 7
mm of GP in the apical third of the root canal. The “standard gold” of 5 mm of the apical
seal with GP cannot prevent apical leakage.
https://www.wjoud.com/doi/pdf/10.5005/jp-journals-10015-1512
To maintain an adequate seal, 4 to 5 mm of gutta-percha should remain apically,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10056096/#:~:text=To%20maintain%
20an%20adequate%20seal,the%20crown%20height%20%5B20%5D.
28. The main link between the pulp and the periodontium is
A. Apical foramen
B. Dentinal tubules
C. Accessory canals
D. PDL
29. Access opening of maxillary lateral incisor
A. Triangular
B. Oval
C. Trapezoidal
D. Round
30. You want to remove gutta percha to prepare post space. What is the best method to
maintain obturation integrity and reducing perforation risk?
A. Mechanical drill
B. Chemical solvent
C. Heated plugger
D. Ultrasonic
31. Patency file is
A. File that reach apical constriction
B. File that you use with irrigation for recapitulation
C. Recapitulation with bleach
D. Rotate the file circumferentially at the walls to remove any block of lateral canals
32. Within the root of internal resorption, the pulp shows
A. Reversible pulpitis
B. Irreversible pulpitis
C. Necrosis
D. Normal
33. Endodontic instrument standardization is based on
A. Height
B. Length
C. Width of tip
D. Handle
34. The radiographic criteria used for evaluating the success of endodontic therapy
A. Reduction of the size of the periapical lesion
B. No response to percussion and palpation test
C. Extension of the sealer cement through lateral canals
D. None of the above
35. A patient presents to your clinic with pain on biting (relief when open) related to tooth
with big amalgam restoration. Thermals pulp testing results were normal, so was the
xray. What is the best method to confirm the diagnosis?
A. Periapical X ray
B. Electric pulp test
C. Tooth slooth
D. Percussion
Tooth Slooth® White - Fracture Detector. Helps locate cracked teeth that normally
cannot be detected

36. If a maxillary first molar is affected by periodontal disease it is expected that the
furcation which will be involved first is the:
A. Distal furcation
B. Buccal furcation
C. Mesial furcation
D. All furcation have the same possibility
 Furcation involvement located according to CEJ. Mesial first then buccal then
distal.
https://periobasics.com/furcation-involvement-and-its-
management/#:~:text=There%20are%20three%20furcation%20entrances,mm%
2C%20respectively%203%2C%204.
37. A patient came complaining of severe pain on biting, related to a certain tooth. Upon
examination no pulpal or periodontal findings were found, and pulpal vitality is positive,
and there was no pain on percussion your diagnosis is
A. Complete root fracture
B. Partial fracture with pulp involvement
C. Partial fracture without pulp involvement
D. Irreversible pulpitis
38. The Ideal form for the wall of root during RCT preparation is
A. convergent toward occlusal surface
B. flaring toward the occlusal surface
C. parallel toward occlusal surface
D. Angled toward occlusal surface

39. Active fibers in necrotic pulp

A. A fibers
B. B fibers
C. C fibers
D. No fibers
40. A patient of 48 years comes to clinic with complain of missing tooth. He is ideally
looking for a FPD for a missing tooth as he cannot afford implant. You want to find the
right abutment for the FPD. After examination you find that the abutment you chose
will need RCT first because the pulp is stressed. What is the meaning of stressed pulp?
A. Pulp exposure with severe pain
B. Non restorable tooth
C. Tooth has large old restorations
D. Broken tooth
Stressed pulp: clinical concept that describes pulps that have received repeated previous
injury and survived with diminished responses and lessened repair potentials
41. A patient of 34 years and male comes to your clinic with complaint of brief sharp pain.
A tooth cusp is broken and dentine is exposed. What is the pulpal status?
A. Reversible pulpitis
B. Irreversible pulpitis
C. Activated A fibers
D. Normal pulp
42. Endodontic files are of lengths
A. 21, 23, 25 mm
B. 21, 25, 31 mm
C. 21, 31, 41 mm
D. 21, 27, 31 mm
43. A 25 year old patient present your clinic complaining of discomfort in his mandibular
second premolar. After taking an x-ray, you view it under good lighting to note that
there's a sudden dark disappearance of the canal on mid root. Most probable explanation
is: (question about diagnosis of missed canal during treatment)
A. Hypertrophic calcification in apical part
B. Secondary dentin apically
C. Polyp
D. Bifurcation area (fast break)

44. A patient came to your clinic with pain in his mouth. On trying to find the source of the
pain through history, it was apparent that the patient was unable to locate the pain. You
decide to do an anesthesia test. Which area will you start the test?
A. Mandibular anteriors first
B. Maxillary molars first then anteriors
C. Maxillary premolars
D. Mandibular canines
Anesthesia test:
- The most posterior tooth in the area where the pain resonates undergoes anaesthesia by
either infiltration or intraligamentary injection until pain diminishes.
- If the pain is still present, the procedure is repeated on the mesial teeth, one by one until
the pain diminishes and is gone.
- If one can still not determine the source of the pain, the procedure will be repeated on
the opposite arch.
- In the case that the pain cannot be localized to either the maxillary or mandibular arch,
an inferior alveolar nerve block would be used.
- If the pain stops, such would imply that it involves teeth of the mandibular arch.
https://en.wikipedia.org/wiki/Dental_pulp_test#:~:text=Anaesthesia%20testing,-
When%20pulp%20testing&text=The%20most%20posterior%20tooth%20in,pain%20d
iminishes%20and%20is%20gone.