Updated 2020

Diagnosis

1. Pulpal and periradicular pathosis results primarily from:

A. Traumatic injury
B. Immunological reaction
C. Bacterial invasion
D. Toxicity of dental material

2. The following periapical diagnosis, which would most likely contain pus
A. Necrosis
B. Supportive apical periodontitis
C. Apical cyst
D. Chronic apical periodontitis
E. Acute apical periodontitis

3. Occlusal reduction is indicated in cases with:

A. Irreversible pulpitis
B. Irreversible pulpitis with acute apical periodontitis
C. Chronic apical abscess
D. All of the above

4. The best treatment of irreversible pulpitis at the initial visit

A. Pulpotomy
B. Complete removal of the pulp
C. Single visit endodontics
D. Occlusal reduction to relieve pain
E. A and D

5. The differential diagnosis between apical granuloma and cyst

A. The size of the lesion in the radiograph
B. Computed tomography scan
C. Presence of hard intraoral swelling
D. All of the above

6. Case of symptomatic irreversible pulpitis and symptomatic apical perio, management is

A. debridement
B. pulp extirpation
C. pulpectomy with complete apical prep
D. Pulpotomy

7. Pt complaining from vague pain related to lower posterior left molar and radiate to
uppers. Upon examination, no RL or PA changes ,deep restorations in lower teeth and full
crowns in uppers. The next step in examination will be
A. Refer to ENT.
B. Wait till the pain is localized.
C. Cavity test in uppers.

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D. Anesthetic test.

Cavity test : An example of a situation in which this method can be used is when the tooth suspected of having
pulpal disease has a full coverage crown.

Selective Anesthesia
When symptoms are not localized or referred, the diagnosis may be challenging. Sometimes the patient may not
even be able to specify whether the symptoms are emanating from the maxillary or mandibular arch. In these
instances, when pulp testing is inconclusive, selective anesthesia may be helpful

Wait till the pain is localized

The dentist does well to tell patients that it might be necessary to wait a while for vague symptoms to localize. This is most common in pulpal
pathosis confined to the root canal space, which often refers pain to other teeth or extradental sites. It may be necessary to wait for the
inflammation to involve the attachment apparatus before it can be localized. Patients generally can be supported with analgesics until a definitive
diagnosis can be made
Torabinjad book 5th & 4th edition and Cohen older version

8. Pt complaining from vague pain related to lower posterior left molar and radiate to
uppers. Upon examination, no RL or PA changes ,deep restorations in lower teeth and full
crowns in uppers. The next step in examination will be
A. Refer to ENT
B. Wait till the pain is localized
C. Cavity test in uppers
D. Analgesic when pt feels pain

9. Patient has pain in tooth # 36 with history of new inlay 3days ago .painful tooth unable to
bite on it with severe pain .patient refuse any examination before giving him LA. Initial
Dx will be:
A. Irreversible pulpitis due to restorative procedure. ????
B. Irreversible pulpitis due to hyper occlusion.
C. Reversible pulpitis due to hyper occlusion.
D. Reversible pulpitis due to restorative procdure.

10. Patient complains from severe pain , upon examination ,#44 has deep carious lesion OD
and #45 has a deep periodontal pocket .The management will be :
A. Initiate RCT in #44.

11. Case : pt presented with swelling and pain related #24 and 25 , with history of trauma to
# 25.Waht is the Dx of #24 ?? :
A. Acute apical Abscess.

12. Pt with localized indurated swelling , the best management is :?!!

13. EPT gives accurate reading with immature open apex.... False A delta fiber not yet
myelinated

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14. case scenario pt has large PA on the #21 and #22 and she did RCT, after 6 months Lesion
increase in size to include # 11 :
A. Extraction of three teeth.
B. RCT on #11 and another follow up six months.
C. RCT on #11 followed by surgery of three teeth.
D. Refer the case to oral surgery bec of large lesion

15. pain radiated to the ear the effected tooth is:

A. MAX molar .
B. MAX premolar.
C. MAND molar .
D. MAND premolar

16. patient has sinus tract the examination:

A. tracing sinus tract buccaly or palatally and take Xray

17. EPT gives false negative results with:

A. Young teeth.

18. All drawbacks from EPT except:

A. May give false positive result.
B. May give false negative result.
C. Test teeth vitality.
D. Test integrity.

19. Percussion test:

A. Indicate infection locate in the pulp.
B. Indicate infection in the periapical area.
C. Indicate infection reaches the maxillary sinus.
D. Stimulate the proprioceptive fibers of the pulp.

20. The single most valuable sign of pulp necrosis:

A. Negative in EPT.
B. Negative in percussion test.
C. Negative in cold test.
D. Negative in palpation test.

Negative EPT Complete or partial necrosis 97.7% of the time

21. sinus tract found with

A. chronic apical abscess

22. sharp pain with cold but it doesn’t linger after removal
of stim. Hx of new restoration.
A. reversible pulpitis

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23. pain with heat but percussion & RG are normal

A. Irreversible pulpitis with normal PA

24. which of the following regarding pulp stimulation w cold is accurate?

A. it is best accomplished w carbon dioxide snow

25. Pt came complain of pain w/ cold that lingers , mech. Tests are normal Diagnosis is
A. Reversible pulpitis
B. Irr . pulpitis with normal PA.

26. Pt has dull , throbbing pain which nerve is involved

A. A-delta
B. b-A-beta
C. C fiber

27. Sinus traced to MB root . that means

A. Hor. Fracture of the root
B. PA infection related to MB root

28. Refrigerant spray temperature:

A. -26 to-50
B. -40 to -90

29. Pulp Polyp:

A. chronic open pulpitis.
B. pulp necrosis.

30. The common symptom of patient with acute apical periodontitis:

A. pain
B. swelling

31. Test to diagnose PA pathosis from pulp or non pulp origin:

A. Endodontic tests.
B. fluoroscopy.
C. radiographs.
D. expansion of bone.

32. Patient had a restorative procedure came next visit complaining from sharp, momentary
pain. RG no periapical involvement, palpation, percussion all within normal:
A. Reversible pulputis
B. Acute periradicular abscess
C. Normal
D. Irreversible pulputis.

33. Diagnostic tools of crack tooth syndrome ( cusp fracture diagnosis) :

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A. Tooth sluth
B. RG
C. Fibrooptic light
D. Staining
i. EPT
i. a, c, d
ii. a, b, c, d
iii. ..
iv. all of the above

34. Patient had RCT in tooth # 24 then he was given another appointment for completion of
the RCT next app pt came with acute pain on clinical examination tooth was sensitive
with percussion radiographically within normal what could be the cause:
A. overinstrumentation
B. overfilling
C. ..
D. ..

35. Patient had a complain of severe lingering pain with thermal stimuli in upper right side
he gave a history of RCT in tooth # 15 what could be the cause of pain:
A. Remaining vital tissue in the buccal canal
B. Palatal canal with short filling.
C. ….
D. Pain is from other tooth rather than # 15

36. EAL can be used for the diagnosis of:

A. Internal Resorption
B. External Apical root Resorption
C. Presence of accidental intracanal mishaps

37. FTT pulp diagnosis: it is fast fourier transform that associated with LDF to measure the
reading
A. 1.3 Hertz (equal to 18 heart beat !!)78 HEART BEAT
B. 2 Hertz peak appeared at or around 2 Hz, that is, at around 120 beats per minute of the dog’s heart
rate. When readings from teeth with non-vital pulps were analyzed,
C. 3 Hertz
D. 4 Hertz

38. Measuring tooth surface temperature in pulpal diagnosis was first suggested by:
A. Fanibunda 1985
B. Brwyet 1975
C. Selzar 1965
D. Seqira 1970

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39. Laser doppler flowmetry measures:

A. Oxygenated blood
B. Deoxygenated blood
C. Blood flow
D. Influx RBC. The average Doppler frequency shift will measure the velocity at which the red
blood cells are moving that is commonly term Blood Flux

40. Heated GP used in diagnosis causes:

A. Increase in pulpal pressure for 15 sec
B. Increase in pulpal pressure then starts to decline but not return to its original base line
C. Increase in pulpal pressure for 1 sec.
D. ..

41. Patient came with sinus intraorally related to soft tissue. The first step in diagnosis is:
A. Periapical Radiographic film.
B. Sinus tracing test.
C. Pulpation.
D. None of the above.

42. Patient came with periapical lesion related to tooth #21 (Asymptomatic) and history of
trauma, normal response to tooth #11. The most accurate diagnosis for tooth #21 is :
A. Chronic apical periodontitis.
B. Necrotic pulp.
C. Irreversible pulpitis.
D. All of the above.

43. The best diagnostic tool for differentiating between an acute apical abscess and an cute
periodontal abscess is:
A. Radiographic examination
B. Pulp sensitivity (vitality) test
C. Palpation
D. Anesthesia test

44. Percussion of a tooth with a mirror handle tests the presence of:
A. hyperalgesia.inc pain to painful stimuli
B. hypersensitivity.
C. referred pain.
D. allodynia. pain to normal stimuli

45. Diagnostic tests:

A. Repeat evocable stimuli.
B. Test teeth vitality.
C. Restorability.
D. Periodontal involvement.

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46. Pulp tissue

A- Neural in origin
B- All collagenous
C- Fiber are type A 800 with straia
D- Non

47. Case scenario: pt presented with pain , history of Trauma in teeth # 44 & 45 , in 44 there
was a distal caries while teeth # 45 is not responding to apical test , management will be:
A. #44 caries examination and GI build up , and for #45 RCT

48. Case scenario two teeth indicated for RCT, one is necrotic without PA, the other one has
PA . which tooth you will treat first ? :
A. the one with no PA

49. Cristiane Rutsatz,(2012), to assess, in vivo, the influence of periodontal attachment loss
and gingival recession on responses to pulp sensibility tests (PSTs) with: (current)
A. HOT
B. Cold
C. EPT

50. Patient age 11 years came with dull pain, intraoral examination revealed swelling
related to tooth # 21 , treatment :
A. drain the abscess
B. Extraction.
C. Antibiotic.

51. Patient came with dull pain related to upper right quadrant ,normal pulp tests
,radiographs reveals only OM caries. During caries excavation, 2mm pulp exposure ,
Diagnosis ?
A. Irreversible pulpitis.
B. Necrosis
C. Reversible pulpitis.
D. PA periodontitis

52. Narrow vertical probing + necrotic pulp + mild periodontal disease ?

A. A inus tract
B. Vertical root fracture
C. Fistula
D. periodontal abscess

53. Treatment in single visit :

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A. symptomatic PA periodontitis
B. asymptomatic PA periodontitis
C. AAA
D. painful irreversible pulpitis

54. Patient presented to your clinic complaining to pain related to tooth #26, upon clinical
examination tooth sensitive to cold test with persistent pain after stimulus was removed.
Radiographic examination was within normal limit.Dx will be :
A. irreversible pulpitis

55. Condensing osteitis:

A. Young patients
B. pulp respond to low grade irritants with increased bone density
C. pulp respond to low grade irritants with decreased bone density
D. pulp respond to high grade irritants with increased bone density

56. Chronic suporative periradicullar periodontitis

A. Present of acute inflammatory cells
B. Perapical pathosis with cyst
C. Perapical pathosis with sinus tract

57. Scenario: Clinical pic of #46 with amalgam onlay was removed from tooth & #45
prepared for crown, patient present to clinic with severe pain on biting, increased for
last 2 days and become continuous and he can’t eat, he gave u a history of permanent
crown on #45 & #46 onlay cementation 3 days ago, pt refuse to touch the tooth without
anesthesia:
A. irreversible pulpitis becoz of resto work
B. irreversible pulpitis becoz of open margin,
C. reversible pulpitis because of high occlusion
D. reversible pulpitis ……………..

58. Scenario: 12 years old male patient known of cardiac valve disease, went to GP and he
did RCT on Tuesday for his molar tooth and gave him amoxicillin 500mg, he come to u on
Thursday with a facial swelling & intraoral swelling opposite to the operated tooth and
he took prophylaxis AB 1 hour before, what is the diagnosis?
A. Necrotic w acute apical abscess (it should be previously initiated with acute apical abscess
but this choice was not included in the answers)

59. Scenario: what is ur management of the previous case?

A. Do nothing as he is on AB
B. Incision and Drainage
C. Extraction

60. RG with J Shape Radiolucency of lower left molar of 55 yrs old, most probable diagnosis:
A. vertical root fracture

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61. The differences between acute apical abscess and phenix abscess is that phonix abscess
has
A. Radiolucency in RG.
B. Swelling.
C. Pain
D. all of the above

62. which instrument measure the blood flow of th pulp

A. laser dropler flow meter
B. therma
C. EPT
D. Percussion
63. Sinus tract related to MB root of 26:
A. Chronic supportive periodontits.
B. Phenix abscess.
C. Horizontal fracture of MB root

64. the best restoration for cracked tooth

A. amalgam
B. post and core
C. crown

D. cast inlay

65. Regarding laser Doppler flowmetry it gives an idea about

A. Integrity of Aα fibers
B. Integrity of C fibers
C. Status of oxygenated bl. Hg pulse oximetry
D. Moving & static red bl cells

66. According to the new diagnostic terminology. Asymptomatic Irreversible pulpitis is

defined as a clinical diagnostic category:

A. In which the pulp is free from inflammation and abnormal response to vitality testing
B. Based upon subjective and objective findings indicating that the inflammation should
resolve and the pulp return to normal
C. Indicating that the vital inflamed pulp is incapable of healing and no clinical symptoms
D. Indicating that the pulp is partially necrotic and non responsive

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67. One of the following tests is considered the vitality test :

A. Pulse oximetry
B. Co2 snow
C. Endo-Ice
D. Test fty

68. The reliable method in determining apical pathology site:

A. Measuring tooth length from radiograph

B. Placing a piece of aluminum foil over apical place
C. Prior knowledge of root length
D. All of the above

69. The purpose of electric pulp tester:

A. Determine the stage of reversible pulpitis

B. Differentiate b/w vital & non vital sensory n. fibers ( I believe this is the right answer )
C. Determine the prognosis of the affected tooth
D. Differentiate b/w reversible & irreversible pulpitis ( are you sure ) ???? !!!!!

70. The following periapical diagnosis, which would most likely contain pus
A. Necrosis
B. Abscess
C. Apical cyst
D. Chronic apical periodontitis
E. Acute apical periodontitis

71. Abscess relate to apex of upper incisor complete root formed with history of trauma
A. start RD & pulpectomy

72. patient complain from pain in cold and bitting in examination forn tooth e crack, but
otherwise healthy, Tx by:
A. CROWN

73. 40 years old patient with caires ,tooth respond to cold and radiograph normal after
removal of ALL carious & during finishing of the cavity, pin-point exposure, it will be
used as abutment for a bridge, Tx of choice is:

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A. Ca(OH)2
B. RCT
C. …

74. least reliable on deciduous teeth:

A. EPT
B. HOT test
C. Palpation

75. 22 year old patient came complain from pain to cold and percussion subside after
stimulus removed , history of bridge placement before 2 days ago
A. Irreversible pulpitis
B. Symptomatic apica
C. Non of above

76. Pt came back after long time of finishing RCT on recall RG tooth shows signs of failure the
best treatment is:

A. Apical surgery

B. Root canal retreatment

C. Extraction and implant

D. Reimplantation

77. Scenario, female patient with Pain in upper right maxillary area for a month, and patient
reported pain was not evoked with certain stimulus, has multiple large intact amalgams
restorations in #15,16,17, ur next step:
A. refer to ENT
B. replace amalgam and place temporary
C. anesthesia test
D. cavity test

78. Case scenario: U r in doubt about restorability of a tooth with big occlusal filling, next
step:
A. angled PA
B. BTW
C. CBCT

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79. Clinical pic of GP tracing & RG tracing) Intern dentist came to u and ask y we do this test?
A. GP to full the space from gingiva to the abscess
B. To diagnose which tooth cause the problem

80. Case scenario, patient complain from right lower side, #46 recent composite placed 2
days ago, #47 old deep amalgam, while doing cold test, #46 responds for 10 seconds &
#47 for 3 seconds, what is your management:
#47 replace the restoration
#46 RCT

81. A periapical lesion is seen radiographically related to the mandibular 1st premolar
.clinically the tooth responds normally to the pulp tests. This Radiolucent area might be:
A. Mental foramen

82. Bridging technique is useful to be used to diagnose cases with :

A. Tooth with full crown coverage
B. Long span fitted bridge

83. most accurate test to diagnose full coverage crown tooth:

A. Carbon dioxide Greatest temp reduction ?? OR TFE best method for crown as long as 30 sec
B. EPT
C. Ethyl chloride

84. temperature of Tetrafluroethan:

A. -26.1 0c

85. Heating the tooth will result in:

Increase intrapulpal pressure

86. sensibility is a term used to describe:

A. Tissue ability of being response to stimulus

87. Chronic suppurative absess characterized by :

A. Pus that drain through sinus tract

88. Neoplastic Charecteristic of the pain:

A. Parasthesia

89. The only site where the perforation in lower molars will result in periodontal damage
even if it is healed:
A. Apical
B. Furcation
C. Mesial surface of the root
D. ….

90. The difference between Crack and Vertical root fracture when diagnosed
radiographically:

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A. Crack is not detected but the fracture can be seen clearly

91. Periodontal probing is an examination to detect all except:

A. Periradicular condition
B. Remaining tooth structure assessment
C. Detection of the perforation at cervical level

92. To establish a good diagnosis:

A. Mediacl and dental history’
B. Patient complain
C. Dental & radiographic examination
D. All of the above

93. Kontakiotis 2015 (A prospective study of the incidence of asymptomatic pulp necrosis
following crown preparation)
A. EPT is not effective
B. Electric pulp testing remains a useful diagnostic instrument for determining the pulp
condition.

94. Refrigerant spray temperature:

A. -26
B. -40 to -90

95. Tooth with a false negative pulp testing is:

A. Vital with no response
B. Non vital with response
C. Vital with response

96. Single tooth discoloration related to:

A. After RCT
B. Hypoplastic defect
C. Tetracycline

97. Reflection of light from glossy surface is called:

A. Specular
B. Diffuse

98. In Endo, no recall follow up less than one year , if a tooth is W/O S/S for one year, it is
assure that endo is succeed :
A. a)First statement is false, second is false
B. b)First statement is true, second is true
C. c)First statement is false, second is true
D. d)First statement is true, second is false
Torabinejad , p.334

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99. Dens in dent is most common:

A. a)Max lat. incisor
B. b)Max cent. incisor
C. c)Max pm
D. d)Lower canine

100. Which of the following may give false negative response of the pulp to EPT:
A. Primarily in anterior teeth
B. In patient with history of trauma
C. Most often in teenagers
D. In the presence of periodontal disease

101. which of the following the most likely indicates pain that is not of pulpal origin :
A. unilateral pain that radiates over the face to the ear .
B. pain that has parasthesia as a component .
C. pain that is described as throbbing and intermittent .
D. pain that is increased with mastication .

102. the most common cause of pulpalgia is :

A. increased intra pulpal pressure.
B. Highly polymerized ground substance .
C. cut dentinal tubules .
D. two other choices .

103. Acute Maxillary sinusitis is a common condition create diagnostic confusion because
A. it may mimic tooth pain in maxillary molar quadrant:

104. Extra oral facial swelling of odontogenic origin typically is:

A. Common endodontic abscess.

105. Positive response to palpation may indicate:

A. An active inflammatory process but doesn’t indicate weather if endodontic or periodontal
origin.

106. Pain to percussion indicate:

A. Inflammation of periodontal ligament.

107. Which of these condition will give false positive response from electrical pulp test:
A. If electrode contact metallic restoration.

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108. Which is correct about limited field of cone beam:

A. Increase resolution.

109. Management of craze line include:

A. No treatment.

110. Reversible pulpitis is stimulating:

A. delta fiber.

111. Periradicular condensing osteitis is characteristic of:

A. host resistance to pulp irritation.
B. acut exacerbation of chronic abscess
C. sharp pain.
D. decrease in bone density

112. how one dose treat vertical root fracture:

A. splint and observe
B. surgery with amalgam in facture line
C. extraction
D. do nothing

113. 40 years black female with diagnosis:

a) chronic apical periodontitis
b) periapical cemental dysplasia

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114. degeneration of acute pulpal inflammation;

a) asymptomatic
b) positive to pulp tests
c) tooth doesn’t need treatment

115. what pulpal diagnosis will cause a periapical lesion that resembles chronic
periodontitis”? or “state of the pulp which effect periapical?” question was not v clear!
a) reversible pulpitis
b) irreversible pulpitis
c)necrotic pulp
d)internal resorption

116. 14 years old, trauma , incisor has fracture + small pulp exposure , sharp non
lingering pain upon cold test , all anterior teeth are tender what is the diagnosis?
A. Reversible pulpitis + symptomatic apical periodontitis
B. Asymotiomatic irriversible pulpitis + symptomatic apical periodontitis
C. irriversible pulpitis + Asymptomatic apical periodontitis

117. RG of anterior teeth with external resorption after ortho , normal response to cold + pain
on biting → Normal pulp + apical periodontitis
118. During routine x-ray examination you found radiopaque area apical to the lower centrals,
teeth were vital what is the diagnosis → Cemental dysplasia

119. case: type I diabetic female pt, came with necrotic pulp & chronic apical abscess,
you start RCT, next day patient presented with pain & swelling intraorally, what is
your new diagnosis?
A. previously started with chronic apical periodontitis
B. previously started with acute apical abscess

120. According to Baumgartner et al 1984 the sinus tract of endodontic origin are lined:

A. Granulation tissues
B. Almost all of these were lined by epithelium at the surface –epith. Interface
C. 70% of them were lined by epithelium to the PA leasion
D. Intermittent pattern of lining of granulation tissue and epith.
121. kim used microsphere to measure
A. Blood flow

122. Patient with caries, and showed sever non lingering pain with cold test,
normal response to palpation and percussion, during caries excavation there
was pulp exposure, what is the diagnosis:

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A. Asymptomatic irreversible pulpitis with normal apical tissue _

B. Asymptomatic Reversible pulpitis with normal apical tissue _
C. Symptomatic irreversible pulpitis with normal apical tissue _
D. Symptomatic Reversible pulpitis with Symptomatic apucal periodontitis

123. pt. Referred to the clinic for root canal treatment for tooth #15, pt.
Feeling severe pain, with cold test gave severe lingering pain, tender to
percussion, What is the Diagnosis? _
(RG attached, tooth seems previously initiated just in the coronal half, with
cotton pelet and TF !)
A. Symptomatic irreversible pulpitis w/ symptomatic apical priodontitis _
B. Symptomatic Irreversible pulpitis w/ Assymptomatic Apical periodontotis
C. Previously initiated w/ symptomatic apical periodontitis _
D. Symptomatic revirsable pulpitis with Symptomatic apical periodontitis

124. tooth showed negative response with EPT and thermal, sensitive to
percussion
(RG showing GP tracing sinus tract in the furcation)
A. necrotic pulp with chronic apical abcess
B. necrotic pulp with Symptomatic apical periodontitis
C. Symptomatic revirsable pulpitis with Symptomatic apical periodontitis
D. Necrotic pulp with acute apical abcess

125. pt. came complaining of severe pain with diffuse facial swelling, thermal
and EPT gave negative response, tooth tender to percussion:
A. Necrotic pulp with chronic apical abscess
B. Necrotic pulp with Symptomatic apical periodontitis
C. Symptomatic revisable pulpitis with Symptomatic apical periodontitis
D. Necrotic pulp with acute apical abscess

126. complicated crown fracture, pt. asymptomatic came after 2 hours to the
clinic, normal to percussion and palpation, what is the definitive pulpal and
periapical diagnosis:
A. Asymptomatic irreversible pulpitis with normal apical tissue _
B. Asymptomatic Reversible pulpitis with normal apical tissue _
C. Symptomatic irreversible pulpitis with normal apical tissue_
D. Symptomatic Reversible pulpitis with Symptomatic apical
periodontitis

127. Case scenario: negative response to thermal and EPT, patient

complaining from continuous discharge through the pocket of the tooth,
what is you diagnosis:
A. Necrotic pulp with Symptomatic apical periodontitis

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B. Symptomatic revirsable pulpitis with Symptomatic apical periodontitis

C. Necrotic pulp with acute apical abcess
D. Necrotic pulp with chronic apical abcess

128. Teeth with attrition & PA Radio opaque lesions ?

A. Hypercementosis ***

129. 13 YO pt complaining of pain in upper post area which of the following test has higher
specificity?
A. Cold test ***
B. EPT
C. Heat test

130. Pt. came to ER clinic with pain and he cannot localized from where ?
A. Selective anesthetize ***

131. About laser Doppler flowmetry?

A. Assess micro-vascular ***

132. EPT used to detect:

A. vitality of nerves ***

133. Pt. Presented with trauma & fractured crown, cold test: sharp pain & perucssion:
painful. Dx:
A. Symptomatic Irrev pulp, Symp. Apical periodontitis
B. Asymptomatic irrev pulp, symp. Apical periodontitis

134. Patient has sinus tract in the marginal gingiva, next step is :
A. AB
B. call the periodontist
C. trace the sinus ***

135. Pt came with sinus tract tooth is slight pain with percussion. Best LA for this case?
A. pirlocain ??
B. Articain ??
C. mepivecain ??
D. bupivecain ??

136. Tooth was non-vital and there was PA radio opacity:

A. Diffuse sclerosing osteomyelitis
B. Focal sclerosing osteomyelitis ***

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C. Focal cemento ossous dysplasia

D. Idiopathic sclerosis

137. Picture of tooth #12 treated with Silver cone (no apparent radiolucency, slight widening
of the PDL) Pt came for evaluation of tooth #12. Tooth is only tender to percussion. What
the appropriate tx plan ?
A. Non-surgical RCT ***
B. Surgical RCT
C. Follow up

138. Patient came complaining from pain with cold, what is the best test method?
A. Ice
B. Cold water
C. Refrigerant spray ***
D. Heated GP

139. Patient came with severe pain and swelling of the labial fold upon examination teeth
23,22 tender to palpation the next sequential step after that is ?
A. CBCT
B. Cold test for teeth #23,22 ***

140. Pt has pain upon release of bite when bite test was used:
A. Cracked tooth

141. Picture of patient have tooth preparation for crown without coolant . Patient came next
visit with red discoloration tooth ?
A. intrapulpal hemorrhage ***

142. Tooth planed for crown and post .. what to do?

A. follow up
B. RCT ***

143. Radiograph → (pulpotomy) tx ,normal apical what the dx

A. Previously intaited ,SAP
B. Previoust treated, SAP
C. Previously intaited , normal apical
D. Previously treated ,normal apical

144. Case: patient I.O.E and radiograph , what is your dx: ??

A. Necrtotic w/ asymptamic

145. Radiograph → poor RCT tx ,pain on biting what the dx

A. Previously intaited ,SAP
B. Previoust treated, SAP
C. Previously intaited , normal apical
D. Previously treated , sap

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146. Scenario: patient complains from pain on upper left side, pt has hay fever &
Rheumatic arthritis. OPG showed #26 #36 has big amalgam filling which they
responded to cold normally, teeth are slightly tender to percussion. What is the cause of
pain?
A. Referred pain
B. Sinusitis

147. Nerve fiber responsible for dull pain

- C fibers

148. Which fiber transfer cold test

A. A delta
B. A beta
C. C fibers

149. Scenario: #11 pink spot at the gingival margin, pulp responded normally to cold
test, RG showed normal PA tissue… what is the diagnosis
External cervical resorption

150. Scenario: on routine check up u find an internal resorption on a tooth which

responded to cold normally, no PA lesion what is the diagnosis:
A. Reversible pulpitis with normal apical tissue
B. Asymptomatic pulpitis with normal apical tissue
C. Symptomatic pulpitis with normal Apical tissue
D. Necrotic pulp with normal apical tissue

151. EPT reading means

A. Lower reading means pulp is inflamed
B. Higher numbers mean pulp inflamed
C. It just gives you either response or no response

152. False negative test happens in

A. Liquefaction necrosis
B. Apprehensive patent
C. Necrosis
D. Recent trauma

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153. Scenario RG of #26 with recurrent caries on mesial side that just penetrate dentine,
patient feels pain on cold that lasts for seconds, not tender to percussion, what is the
diagnosis:
A. Normal pulp
B. Reversible
C. Asymptomatic irreversible
D. Symptomatic irreversible

154. RG of a female, lower anterior teeth with vital teeth but PA lesions
- PA cemental dysplasia

155. scenario patient with post and crown, but no obturation material were seen
radiographically, what is the diagnosis
A. previously initiated
B. previously treated

156. scenario: patient came to clinic for #26 (RG showed mesial shallow caries lesion no
PA) tooth responded to cold for (10 seconds?), not TTP your diagnosis:
A. Normal pulp with normal apical tissue
B. reversible pulpitis with Normal apical tissue
C. Asymptomatic irreversible pulpitis with normal apical tissue

157. Scenario: #36 had recent MOD amalgam filling presented with sever pain on biting.
patient refuses to touch tooth without anesthesia, what is the diagnosis
A. Irreversible pulpitis becoz of high occlusion
B. Reversible pulpitis becoz of resto work

158. Scenario: #36 had recent onlay (or crown) presented with sever pain on cold. patient
refuses to touch tooth without anesthesia, what is the diagnosis
A. Irreversible pulpitis ……
B. Reversible pulpitis ……

159. Scenario, type II Diabetic patient has a deep pocket in lingual middle aspect of a
lower central incisor which was treated endodontically, there is a PA lesion
radiographically, deep pocket caused by
A. VRF
B. Endo Perio lesion
C. 2nd missed canal

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160. Pt now complain from pain in his endodontic treated tooth , he did the RCT long time ago
Whats the cause? ( they did not explain the type of pain )
A. missed MB2 canal
B. short palatal canal obturation 3 mm
C. high occlusion
D. defective margin

161. Pt under ortho treatment , PA X-Ray shows central with open apex “ they did not give the
age “ responed to vital test, but pain on percussion , what’s the diagnosis?
A. necrotic with SAP
B. normal pulp SAP
C. normal pulp and periapical area
D. necrotic with normal PA

162. Since tract with lesion in PA X-Ray involving the furcation ,, what’s the next procedure?
A. trace the Since tract
B. immediately start RCT
C. Peridontal consultation

163. Attrition most commonly associated with ?

A. hypercementosis
B. Ankylosis
C. Internal resorption
D. external resorption

164. Tooth diagnosed reversible with normal pulp testing , then during excavation pathologic
pulp exposure whats the Dx:
A. symptomatic irreversible pulpitis
B. asymptomatic irreversible pulpitis
C. reversible pulpitis

165. Question about case with pocket depth 6 mm only in the middle,, in #47 ,, X-Ray showing
huge lesion involving the furcation and Periapical area of teeth ,, tooth is poorly endo treated
previously with pain in percussion and palpation:
A. primary endo secondary perio
B. primary perio secondary endo
C. endo lesion

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166. Question about SHARP pain characteristic ?

A. A-delta fibers
B. C fibers

167. PA radiograph with lesion involving the furcation and periapical area of #46 single deep
probing around 6-7 mm in the middle buccal of #46
A. Didn’t give us any details about History of the case
B. primary endo 2nd perio
C. primary perio 2nd endo
D. crack

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26
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28
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