American College of Prosthodontist 2013 Mock Exam With References

American College of Prosthodontists
Mock Exam 2013

1. In a recent article on the clinical performance of porcelain veneers up to twenty years, which of the following is
true?
a. Veneers on the mandible had a higher failure rate than those on the maxilla
b. Non-vitality had no effect on the failure rate
c. Main reason for failure is fracture of the porcelain
d. Smoking has no effect on longevity
Answer: c
Reference: Beier U, Kapferer I, Burtscher D, Dumfarht H: Clinical Performance of Porcelain Laminate Veneers for
Up to 20 years. I J Prosthodont 2012; 25: 79-85.
2. Microstructural changes in 3Y-TZP (Yttria-stabilized tetragonal zirconia polycrystals) are associated with which
two phenomenons?
a. Crack shielding and dissolution
b. Dissolution and low temperature degradation
c. Stress-induced transformation and dissolution
d. Stress-induced transformation and low temperature degradation
Answer: d
Reference: Denry, I.L.; Holloway, J.A. Microstructural and crystallographic surface changes after grinding zirconia-
based dental ceramics. J. Biomed. Mater. Res. B-Appl. Biomater. 2006, 76B, 440-448.
3. Which of the following statements most accurately represents the effect of multiple firings on the marginal integrity
of veneered lithium disilicate pressed ceramic crowns?
a. The mean marginal gap decreases with each firing.
b. The mean marginal gap increases with each firing.
c. The mean marginal fit change for 5 firings is less than 1 micron.
d. The mean marginal fit change for 5 firings is more than 100 microns.
e. There is a significant increase in marginal gap during characterization and glazing.
Answer: c
Reference: Cho S, Nagy W, Goodman J, Solomon E, Koike M. The effect of multiple firings on the marginal
integrity of pressable ceramic single crowns. J Prosthet Dent Vol 107(1): 17-23. Jan 2012.
4. Which of the following factors is the most significant predictor of potential implant complications in immediately
loaded maxillary four implant fixed complete dental prosthesis?
a. Smoking
b. Presence of opposing dentition
c. Poor volume
d. Bruxism
e. Systemic factors
Answer: b
Reference: Parel S, Phillips W. A risk assessment treatment planning protocol for the four implant immediately
loaded maxilla: preliminary findings. J Prosthet Dent Vol 106(6): 359-366. Dec 2011.
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American College of Prosthodontist 2013 Mock Exam with References
5. Which of the following best describes the current evidence based prognosis for the survival rates of immediate
implants placed in sites exhibiting periapical pathology?
a. Placement in infected sites is contraindicated.
b. The prognosis in infected sites is significantly poorer than rates for placement in uninfected sites.
c. The prognosis in infected sites can be comparable to noninfected sites
d. The prognosis in infected sites is actually better than rates for noninfected sites.
e. The prognosis is poorer for placement in sites with a fistula present.
Answer: c
Reference: Fugazzotto P. A Retrospective Analysis of Immediately Placed Implants in 418 Sites Exhibiting
Periapical Pathology: Results and Clinical Considerations. Int J Oral Maxillofac Implants Vol 27(1): 194-202.
Jan-Feb 2012.
6. Which of the following statements is true regarding anterior tooth display?

a. Irrespective of the lip’s length, the ideal display for maxillary incisors is 1-2 mm.
b. The mandibular incisor display in patients over 60 years old should be approximately equal to the
maxillary incisor display in patients under 30 years old.
c. As age increases, maxillary central incisor display increases as well.
d. Women, on the average, display three times as much maxillary anterior tooth surface as men.
Answer: b
Reference: Vig RG, Brundo GC. The kinetics of anterior tooth display. J Prosthet Dent 1978;39(5):502-504.
7. A suggested maintenance and check-up protocol to minimize galling and thread profile deterioration in retaining
screws of fixed-detachable implant-supported prostheses includes all of the following except one. Which one is the
exception?
a. Replace all screws every 2-3 years of service, unless severe damage is observed in all of the screws;
in that case, change the screws every 6 months.
b. Retorque retaining screws after the first 6 months of service; after this initial adjustment, retorque
annually.
c. Once a year, rotate the middle screws with the posterior screws.
d. Evaluate screws under light stereomicroscope and replace any severely damaged screws.
Answer: a
Reference: Al Jabbari Y, et al. Mechanical behavior and failure analysis of prosthetic retaining screws after long-
term use in vivo. Part 1: Characterization of adhesive wear and structure of retaining screws. J Prosthodont 2008;
17:168-180.
8. All of the following are risk factors except one, based on patient’s history in the CAMBRA philosophy. Which one
is the exception?
a. Low educational level
b. Evidence of new restorations
c. Smoking
d. Frequent snacking
Answer: b
Reference: Featherstone JD, Singh S, Curtis DA: Caries Risk Assessment and Management for the Prosthodontic
Patient. J Prosthodont. 2011; 20: 2-9.
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9. When doing a palatogram, which of the following sentences is used to form the contours of the posterior hard
palate and soft palate?
a. Ned won many prizes
b. Ralph arrived after everyone else
c. Young men like yellow kayaks
d. King Gregory is gagging
Answer: d
Reference: Goodacre C, Garbacea A, Naylor W, Dahar T, Marchack, Lowry J: CAD/CAM Fabricated Complete
Dentures: Concepts and Clinical Methods of Obtaining Required Morphological Data. J Prosthet Dent 2012; 107:34-
46.
10. All of the following are considered as positions of a retracted tongue except one. Which one is the exception?
a. Apex of tongue curls downward from the mandibular incisors and dorsally along the frenulum, while
the radix of the tongue is elevated.
b. The apex seems to disappear into the body of the tongue and give it a squared appearance.
c. The apex of the tongue curls upward and dorsally from the mandibular incisors.
d. The body of the tongue is depressed into the floor of the mouth moving the entire mass dorsally.
e. The lateral borders of the tongue approximate the posterior occlusal plane.
Answer: e
Reference: Wright CR, et al. A Study of the Tongue and its Relation to Denture Stability. J Am Dent Assoc
1949;39:269-275.
11. According to the Griffith theory of brittle materials, microcracks are the origins of ceramic failures because they
act as stress:
a. Concentrators.
b. Dissipaters.
c. Transducers.
d. Limiters.
Answer: a
Reference: Griffith AA. The phenomena of rupture and flow in solids. Phil Trans Roy Sot A 1921;224:163-198.
12. In a recent retrospective study of 174 partial dentures, what was the survival rate of clasp-retained removable
partial dentures after 5 and 10 years, respectively?
a. 96% and 90%
b. 85% and 85%
c. 80% and 73%
d. 65% and 50%
Answer: a
Reference: Behr, Zeman, Passaeur, Koller, Hahnel, Buergers, Lang, Handel, Kolbek: Clinical Performance of Cast
Clasp-Retained Removable Partial Dentures: A Retrospective Study. Int J Prosthodont 2012;25:138–144.
13. Which is the most common erosion pattern in GERD?

a. Palatal surfaces of upper anterior teeth
b. Palatal aspect of maxillary posterior teeth
c. Mandibular posterior teeth
d. Lingual aspect of lower anterior teeth
Answer: c
Reference: Curtis: Decision-making in the management of the patient with dental erosion. CDA J;1998;39(4),259-
265.
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14. At what pH does the enamel start to demineralize?
a. 3.5
b. 6.1
c. 2.0
d. 5.2
Answer: d
Reference: Curtis: Decision-making in the management of the patient with dental erosion. CDA J;1998;39(4),259-
265.
15. Satisfaction with masticatory function is significantly associated with:
a. Age.
b. Gender.
c. Posterior occlusal contacts.
d. Number of identified foods that could be eaten without difficulty.
Answer: d
Reference: Ikebe, Morii, Matsuda, Nokubi : Discrepancy between satisfaction with mastication, food acceptability
and Masticatory Performance in older adults. Int J Prosthodont 2007; 20:161-167.
16. How much more mean occlusal force is required to stimulate the perception of occlusal load when comparing
restored dental implants to natural teeth?
a. Approximately 2 times greater for restored dental implants
b. Approximately 3 times greater for restored dental implants
c. Approximately 6 times greater for restored dental implants
d. Approximately 9 times greater for restored dental implants
Answer: d
Reference: Kinsel, Lin. Retrospective analysis of porcelain failures of metal ceramic crowns and fixed partial
dentures supported by 729 implants in 152 patients: Patient-specific and implant-specific predictors of ceramic
failure. J Prosthet Dent 2009;101:388-394.
17. Which of the following has been demonstrated to be a risk factor for porcelain fracture for implant supported fixed
dental prosthesis?
a. Location in the posterior
b. Bruxism
c. Time in service over 5 years
d. Male gender
Answer: b
Reference: Kinsel, Lin. Retrospective analysis of porcelain failures of metal ceramic crowns and fixed partial
dentures supported by 729 implants in 152 patients: Patient-specific and implant-specific predictors of ceramic
failure. J Prosthet Dent 2009;101:388-394.
18. Which one of the following statements is correct regarding wear of the implant/abutment interface following in
vitro loading between a one piece zirconia implant abutment and a titanium implant abutment?
a. Implants with titanium abutments show a greater initial rate of wear and total wear than one piece
zirconia abutments
b. Implants with one piece zirconia abutments show a greater initial rate of wear and total wear than
titanium abutments
c. Implants with titanium and one piece zirconia abutments show no signs of wear
d. Implants with titanium and one piece zirconia abutments show equal initial rates of wear and total
wear
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Answer: b
Reference: Klotz MW, Taylor TD, Goldberg AJ, Wear at the titanium-zirconia implant abutment interface: A pilot
study. Int J Oral Maxillofac Implants 2011; Sep-Oct;26(5):970-5
19. What is the possible effect of bacterial exposure on the mechanical properties of commercially pure titanium
dental implants?
a. Reduces the flexural strength and cycles to failure
b. Has no effect on the mechanical properties
c. Titanium is bacteria resistant
d. Improves the flexural strength and cycles to failure
Answer: a
Reference: Gil FJ , Rodriguez A , Espinar E , Llamas JM , Padullès E, Juàrez A, Effect of oral bacteria on the
mechanical behavior of titanium dental implants. Int J Oral Maxillofac Implants; 2012 Jan-Feb;27(1):64-8.
20. What is the average Balkwill angle?

a. 16 degrees
b. 26 degrees
c. 36 degrees
d. 46 degrees
Answer: b
Reference: Ohm E, Silness J. The size of the Balkwill angle and the height of Bonwill triangle. J Oral Rehabil
1982;9(4): 301-306.
21. Neil’s Class 2 throat form is observed in approximately what percentage of edentulous patients?
a. 20
b. 25
c. 30
d. 35
Answer: b
Reference: Huang PS, Cho TM, Chang HP, Chen JH, Lee HE, Hong HS, Moore DJ. The proportion of 3 classes of
lateral throat form. Int J Prosthodontics 2007; 20:640-642.
22. The term “Verticentric” was coined by which of the following authors?
a. George Murrell
b. Meyer Silverman
c. Howard S. Payne
d. Earl Pound
e. Max Pleasure
Answer: d
Reference: Pound E. Let /S/ be your guide. J Prosthet Dent. 1977 Nov;38(5):482-9.
23. Who described a method of determining Occlusal Vertical Dimension utilizing the patient’s neuromuscular
perception?
a. Demer
b. Lytle
c. Shanahan
d. Jankelson
e. Atwood
Answer: b
Reference: Lytle, R.B., Vertical Relation of Occlusion by the Patient’s Neuromuscular Perception. J Prosthet
Dent;1964;14:1, 12.
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24. Denture bases created by the injection molding technique show improved physical properties. Which of the
following is the exception?
a. Dimensional stability is improved
b. Decreased polymerization shrinkage
c. Diminished changes in vertical dimension
d. Increased fracture strength
Answer: d
Reference: Ucar Y, Akova T, Aysan T. Mechanical Properties of Polyamide versus Different PMMA Denture Base
Materials. J Prosthodont; Volume 21, Issue 3,173–176, April 2012.
25. The advantage of polyamide denture base materials as compared to PMMA resin is?
a. Greater flexural strength
b. Increased flexural modulus
c. Increased translucency
d. Increased hardness
e. Impact strength
Answer: c
Reference: Ucar Y, Akova T, Aysan T. Mechanical Properties of Polyamide versus Different PMMA Denture Base
Materials. J Prosthodont ;Volume 21, Issue 3,173–176, April 2012.
26. A metal ceramic crown in the esthetic zone requires a minimal vertical cervical cut-back of approximately ______
mm on the facial metal framework/porcelain facial margin to achieve an adequate esthetic result.
a. 0
b. 0.5
c. 1.0
d. 1.5
e. 2.0
Answer: c
Reference: Paniz G, Kim Y, Abualsaud H, Hirayama H. Influence of framework design on the cervical color of metal
ceramic crowns. J Prosthet Dent. 2011; Nov;106(5):310-8.
27. Regarding crack propagation in porcelain veneers after cyclic thermal fatigue, which of the following statements
is true?
a. Cyclic thermal changes have no significant effect on development of flaws in porcelain veneers.
b. Cyclic thermal changes have a significant effect on development of flaws in porcelain veneers.
c. Cyclic thermal changes decrease the development of flaws in porcelain veneers.
d. None of the above statements are true.
Answer: b
Reference: Magne P, et al. Crack propensity of porcelain laminate veneers. J Prosthet Dent, 1999;81(3):327-334.
28. The following are risk factors contributing to implant failure with a four implant immediately loaded maxillary
prosthesis. Which one is the primary risk factor?
a. Smoking
b. Distal cantilever
c. Male gender
d. Opposing complete arch implant restoration
Answer: c
Reference: Stephen M. Parel, DDS, FABP and William R. Phillips, MD, DDS A risk assessment treatment planning
protocol for the four implant immediately loaded maxilla: preliminary findings. J Prosthet Dent 2011;106:359-
366.
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29. When considering placement of two adjacent implants for restorations in the esthetic zone, the dentist should
anticipate:
a. A deficiency in inter-implant papillary height compared to that of natural teeth.
b. An increase in inter-implant papillary height compared to a natural tooth next to an implant.
c. No difference in the inter-implant papillary height compared to that of natural teeth.
d. No difference in the inter-implant papillary height compared to an adjacent natural tooth and implant.
e. An increase in inter-implant papillary height compared to that of natural teeth.
Answer: a
Reference: Tarnow D, Elian N, Fletcher P, et al. Vertical distance from the crest of bone to the height of the
interproximal papilla between adjacent implants. J. Periodontol 74(12):1785-88,2003.
30. Alteration of a patient’s occlusal vertical dimension has been recommended for all of the following except one.
Which one is the exception?
a. To produce a more Class III appearance
b. To produce a more Class II appearance
c. To control implant loading direction
d. To reduce tooth length
Answer: d
Reference: Misch CE. Clinical indications for altering vertical dimension of occlusion. Quintessence, Int 31(4):280-
2,2000.
31. Airborne-particle abrasion is one method of surface-conditioning zirconia ceramic restorations for durable resin
bonding. Alternate methods of surface conditioning for bonding include all of the following except one. Which
one is the exception?
a. Mechanical abrasion with carbide burs
b. Plasma spraying with hexamethyldisiloxane
c. Application of low fusing porcelain
d. Selective infiltration-etching
Answer: a
Reference: Kern M. Controlled airborne-particle abrasion of zirconia ceramic restorations. J Prosthet Dent
103(2):127-8,2010.
32. Jerbi’s rule of thirds is a technique that relates to:

a. Trimming of bone in immediate denture construction.
b. Trimming of the cast before immediate denture fabrication.
c. Having less room to set denture teeth.
d. Managing patients who have osteoporosis.
Answer: b
Reference: Jerbi FC. Trimming the cast in the construction of immediate dentures. J Prosthet Dent, 1966; 16:1047-
1053.
33. Although some variability is present, a general guideline for halting chemotherapy is an ANC (absolute neutrophil
count) of less than ___:
a. 10,000.
b. 5,000.
c. 1,500.
d. 1,000.
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Answer: c
Reference: Laney WR et al. Diagnosis and Treatment in Prosthodontics, 2nd Ed. Quintessence; 2011; 20.
34. Implants are defined as “immediately loaded” if they are restored by a functional, fixed interim prosthesis at the
time of surgery or within how many hours after surgery?
a. 24
b. 48
c. 72
d. 96
Answer: b
Reference: Ghoul WE, Chidia JJ. Prosthetic requirements for immediate implant loading: A review. J Prosthodont
21, 2012, 141-154.
35. In a recent study using a standardized brushing machine action on extracted teeth; the only significant wear
occurred primarily from the _______:
a. Use of toothpaste.
b. Use of a hard toothbrush.
c. Intensity of the toothbrush stroke.
d. Pattern of the toothbrush stroke.
Answer: a
Reference: Dzakovich JJ, Oslak RR. In vitro reproduction of noncarious cervical lesions. J Prosthet Dent 2008:
100:1-10.
36. Selection criteria of appropriate radiographs for use in the diagnostic process by the prosthodontist are guidelines
that ____:
a. Help in selecting radiographs to request.
b. Aid in determining proper time intervals for radiographs.
c. Help to minimize radiation exposure for the patient.
d. Produce maximum diagnostic information.
e. All of the above.
Answer: e
Reference: White SC, Atchison KA, Hewlett ER, et al. Efficacy of the FDA guidelines for prescribing radiographs
for detecting denal and intraosseous conditions. Oral Surg Oral Med, Oral Path Oral Radiol Endod 80:108-
14,1995.
37. Denture adhesive use is considered appropriate for all of the following except one. Which one is the exception?
a. Adequately made complete dentures do not satisfy the stability expectations of the patient
b. Adequately made complete dentures do not satisfy the retention expectations of the patient
c. When supplemental retention is needed for psychological reasons
d. When supplemental stability is needed for psychological reasons
e. When supplemental retention is needed for ill-fitting complete dentures
Answer: e
Reference: Munoz CA, Gendreau L, Shanga G, et al. A clinical study to evaluate denture adhesive use in well-fitting
dentures. J Pros 21(2):123-9, 2012.
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38. Which of the following have been shown to be effective in alleviating pain in patients with TMD?
a. Occlusal devices
b. Behavioral therapy
c. Jaw exercises
d. Postural training
e. All of the above
Answer: e
Reference: List T, Axelsson S. Management of TMD: evidence from systematic reviews and meta-analysis. J Oral
Rehabil 37:430-451, 2010.
39. Which of the following statements accurately represent the indirect spruing method in the production of fixed
prosthodontic metal restorations?
a. Molten alloy flows directly from the crucible into the pattern area of the heated mold.
b. A wax runner bar is used to form a component of the indirect sprue former design.
c. The indirect sprue is intended to house sufficient molten alloy capable of drawing additional alloy
from the pattern during the cooling process.
d. Use of a straight sprue that includes a reservoir ball pattern.
Answer: b
Reference: Naylor, PW. Introduction to Metal-Ceramic Technology, 2nd Ed. Quintessence, 2009, 84-85.
40. All of the following statements are considered basic principles of casting in the fabrication of a fixed prosthesis
except one. Which one is the exception?
a. Position the restoration’s wax pattern in the “heat center” of the investment mold and the sprue’s
reservoir system in a “cold zone”.
b. Attach the sprue former to the thickest part of the restoration’s wax pattern.
c. A sprue system reservoir must have sufficient molten alloy to accommodate solidification shrinkage
as the cast restoration cools.
d. In general, turbulence of the molten alloy should be minimized, if not totally eliminated.
Answer: a
Reference: Naylor, PW. Introduction to Metal-Ceramic Technology, 2nd Ed. Quintessence, 2009; 97-100.
41. What is the purpose of the benzoyl peroxide in poly(methyl methacrylate) resin systems?
a. Serves as an inhibitor to prevent undesirable polymerization during storage
b. Serves as an inhibitor to slow polymerization when the powder and liquid components are mixed
c. Serves as an initiator responsible for starting the polymerization process
d. Serves as a stabilizer to assure reasonable shelf life of the material
Answer: c
Reference: Phoenix RD. Denture base resins. In: Phillips’ Science of Dental Materials, 11th Ed., 2003,722-723.
42. To permit soft tissues of denture-supporting areas to recover and return to normal form, how long prior to
impression making should the dentures be removed?
a. 4 hours
b. 10-12 hours
c. 24 hours
d. 48-72 hours
Answer: d
Reference: Lytle RB. The management of abused oral tissues in complete denture construction. J Prosthet Dent
1957;7:27-42.
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43. In the House Diagnostic Classification System for palatal throat form, the Class 2 condition is best represented by
which of the following statements?
a. Large and normal in form; relatively immovable resilient band of tissue 5-12 mm posterior to line
drawn across the palate at distal edge of tuberosities.
b. Large and normal in form; relatively immovable resilient band of tissue 5-12 mm anterior to line
c. Medium and normal in form; relatively immovable resilient band of tissue 3-5 mm posterior to line
d. Abrupt downturn of soft palate 3-5 mm anterior to line drawn across the palate at distal edge of
tuberosities.
Answer: c
Reference: House MM. The relationship of oral examination to dental diagnosis. J Prosthet Dent 1958;8:208-219.
44. According to the shortened dental arch (SDA) concept, all of the following statements are true except one. Which
a. SDA patients with all anterior teeth and at least two opposing posterior occlusal units have sufficient
adaptive capacity to maintain oral function.
b. Increased number of missing occlusal units and arch asymmetry are significant predictors for the
presence of chewing complaint.
c. Missing occluding pair of first molars is a key factor for choosing prosthetic restoration in SDA
patients.
d. From a quality of life perspective, patients with shortened dental arch and missing anterior teeth
perceive benefits from removable partial dentures only if anterior teeth replacements are included.
Answer: a
Reference: Fueki K, Garashi Y, Maeda Y, Baba et al Factors related to prosthetic restoration in patients with
shortened dental arches: a multicenter study. J Oral Rehabil ;2011 38; 525–532. Armellini D, Heydecke G, Witter
D and Creugers N. Effect of removable partial dentures on Oral Health-Related Quality of Life in subjects with
shortened dental arches: A 2-center cross-sectional study. Int J Prosthodont 2008;21:524–530.
45. All of the following are true regarding the titanium partial removable dental prostheses except one. Which one is
the exception?
a. The use of titanium for the production of cast RDP frameworks has gradually increased.
b. There are no reports of metallic allergy apparently caused by commercially pure titanium dentures.
c. The laboratory drawbacks still remain, such as the lengthy burn out, inferior castability and
machinability, reaction layer formed on the cast surface, difficulty of polishing and high initial cost.
d. Titanium RDP frameworks have been reported to fail catastrophically.
Answer: d
Reference: Ohkubo C, Hanatani S, and Hosoi T: Present status of Ti removable dentures- a review of the literature. J
Oral Rehabil 2008 35; 706–714.
46. All of the following statements are true regarding the use of zinc containing denture adhesives except one. Which
a. The most serious consequences of the chronic and excessive use of denture adhesives reported to date
are potential neurotoxicity related to the presence of zinc as a component of the adhesive.
b. The daily recommended allowances for zinc are 8 mg for women and 11 mg for men. Acute overdose
can lead to nausea, vomiting, loss of appetite, cramps, diarrhea and headaches.
c. Improper use of zinc containing denture adhesives may have adverse systemic effects. Therefore, as a
precautionary measure, zinc containing denture adhesive should be avoided.
d. There are many long term studies to investigate the potential effects of adhesive build up on hard or
soft oral tissue if the patient fails to remove the adhesives completely.
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Answer: d
Reference: David Felton, et al. Evidence-Based Guidelines for the Care and Maintenance of Complete Dentures. J
Prosthodont. Volume 20, Feb 2011, Supplement S1, S1-S12.
47. All of the following statements are true regarding the etiology of denture stomatitis except one. Which one is the
exception?
a. Poor denture hygiene
b. Continual and night time wearing of removable dentures
c. Metallic denture base
d. Bacterial and yeast contamination of denture surface
Answer: c
Reference: Linda Gendreau, Zvi Loewy: Epidemiology and Etiology of Denture Stomatitis. J Prosthodont. 2011
June; 20 (4): 251-260.
48. Cement extravasation with abutment supported implant restorations is a problem that may be remedied by ___:
a. Sealed abutment.
b. Open abutment.
c. Internal vented abutment.
d. Titanium abutment.
Answer: c
Reference: Wadhwani C et al, Effect of Implant Abutment Modification on the Extrusion of Excess Cement at the
Crown-Abutment Margin for Cement Retained Implant Restorations; Int J Oral Maxillofac Implants; 2011; 26;
1241-1246.
49. Which of the following ceramics exhibits the least slow crack growth?
a. Vitreous porcelain
b. Leucite based porcelain
c. Leucite based glass ceramic
d. Lithium disilicate glass ceramic
e. Glass infiltrated alumina composite
Answer: d
Reference: Gonzaga CC et al, Slow Crack Growth and Reliability of Dental Ceramics; Dental Materials; 2011;
27:394–406.
50. In a recent study evaluating the gingival thickness biotypes, a correlation may exist between the thickness of
gingiva and ______:
a. Width of the zone of keratinized gingival tissue of maxillary anterior teeth.
b. Periodontal sulcus depth.
c. Degree of gingival stippling.
d. Morphology of crowns of teeth.
Answer: a
Reference: Egreja AMC et al; Relationship Between the Zone of Keratinized Tissue and the Thickness of Gingival
Tissue in the Anterior Maxilla;Int J Perio Rest Dent;2012;32;573-579.
51. Chipping of layering porcelain in zirconia based restorations occurs due to ____:
a. Rate of heating.
b. Rate of cooling.
c. Coefficient of thermal expansion mismatch.
d. Feldspathic content of veneering porcelain.
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Answer: b
Reference: Tan JP et al, The Use of Slow Heating and Slow Cooling Regimens to Strengthen Porcelain Fused to
Zirconia; J Prosthet Dent; 2012;107;163-169.
52. Which of the following is not factored into the margin location?
a. Periodontal
b. Esthetics
c. Retention
d. Finishing
e. Pulpal health
Answer: e
Reference: Gardner FM, Margins of Complete Crowns, JPD, 1982,Vol. 48, 386-399.
53. What is considered the most critical factor for implant success at both surgical and functional stages?
a. Bone quality
b. Implant length
c. Implant width
d. Occlusal load on implant
e. Thread design
Answer: a
Reference: Kim Y, Oh T-J, Misch CE, Wang H-L, Occlusal Considerations in Implant Therapy: Clinical
Guidelines with Biomechanical Rationale. Clin. Oral Impl. Res. 16, 2005; 26-35.
54. According to Tjan’s research in 1984, all of the following are characteristics that a typical or average smile has
a. The overall cervicoincisal length of the maxillary anterior teeth is displayed.
b. Gingiva does not show (except the interproximal gingival).
c. The incisal curvature of the maxillary anterior teeth parallels the inner curvature of the lower lip.
d. The six maxillary anterior teeth and the first or second premolars are displayed.
e. Anterior teeth follow the golden proportion.
Answer: e
Reference: Tjan AH, Miller GD, The JG. Some Esthetic Factors in a Smile. J Prosthet Dent; 1984;51(1):24-28.
55. Which of the following denture cleaning solutions has been implicated to significantly decrease the retentive
value of pink Locator attachments?
a. NaOCl
b. Listerine
c. Efferdent
d. Polident Overnight
Answer: a
Reference: You W, Masri R, Romberg E, Driscoll CF. The Effect of Denture Cleaning Solutions on the Retention of
Pink Locator Attachments after Multiple Pulls: An In Vitro Study. J Prosthodont 20 (2011) 464-469.
56. There are several differences in the accuracy of reversible hydrocolloid impressions made with different types of
impression trays. One of them is:
a. Certain degree of distortion can always be expected regardless of the type of impression tray used.
b. Hydrocolloid impressions made with non-perforated stock trays tend to be undersized.
c. Perforated custom impression trays obtain the most accurate reproduction of the palatal vault.
d. Clinically significant inaccuracies are found in impressions made with non-perforated custom and
stock trays but not on perforated ones.
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Answer: a
Reference: Mendez, A.: The influence of impression trays on the accuracy of stone casts poured from irreversible
hydrocolloid impressions. J. Prosthet. Dent. 54, 383-388. 1985.
57. All of the following statements are incorrect about tooth preparation for fixed Prosthodontics in relation to
gingival tissues except one. Which one is the exception?
a. Sub-gingival finish lines should be placed 1 mm short of the epithelial attachment because this is the
most vulnerable of the supporting structures of the tooth.
b. Insufficient axial reduction in the cervical third of a tooth may result in poor esthetic results but better
gingival health with all porcelain restorations.
c. The reason why chamfer and beveled shoulder finish lines should be avoided is that they require part
of the rotary instrument to be positioned outside the peripheral tooth contours, increasing the potential
for gingival trauma.
d. Gingival retraction cord can be placed before preparing the tooth as long as the preparation process
does not take longer than 15-20 minutes.
Answer: a
Reference: Goodacre, C.: Gingival Esthetics. J. Prosthet. Dent. 1990; 64, 1-12.
58. All of the following parameters are important for maxillary implant placement with immediate loading except
one. Which one is the exception?
a. Adequate maxillary residual ridge
b. Class I skeletal jaw relationship
c. 4 mm minimal width of ridge in anterior maxilla
d. Maxilla that did not require preprosthetic surgery
e. Adequate interocclusal space
Answer: c
Reference: Wiam El Ghoul, ChD et al. Prosthetic Requirements for Immediate Implant Loading: A Review. J
Prosthodont; 21 (2012) 141–154.
59. Which muscle is responsible for mandible flexure?

a. Lateral Pterygoid
b. Masseter
c. Buccinator
d. Mylohyoid
Answer: a
Reference: Constance Law et al, Mandibular Flexure and Its Significance on Implant Fixed Prostheses: A Review: J
Prosthodont; 20 (2012) 219–224.
60. In complete denture patients, the graphic method of recording CR is preferred over the interocclusal check record
method if the:
a. Ridges are excessively flabby.
b. Patient has uncontrolled abnormal mandibular movements.
c. Jaws are abnormally related.
d. Patient has a retracted tongue position.
Answer: c
Reference: Zarb-Bolenders, Prosthodontic Treatment for Edentulous Patients, 12th Ed, Mosby,241.287.
13
61. All of the following are reasons to avoid using gypsum-bonded investments when casting metal-ceramic alloys
a. Gypsum is unstable at the high temperatures required 
b. Sulfide contamination of the alloy can occur
c. With some alloys obtaining adequate expansion might be difficult
d. Depletion of oxides affecting porcelain ceramic bonding  
Answer: d  
Reference: Rosenstiel, Contemporary Fixed Prosthodontics. 4th Ed; (part 2), 87.
62. Dental plaque consists of ____:

a. 25% bacteria and 75% intracellular matrix consisting of CaPO4, proteins, and carbohydrates.
b. 70% bacteria and 30% intracellular matrix consisting of carbohydrates, proteins, calcium ions and
phosphate ions.
c. 50% bacteria, 25% intracellular matrix, and 25% gingival crevicular fluid.
d. 25% bacteria, 50% calcium and phosphate ions, and 25% gingival crevicular fluid.
Answer: b
Reference: Newman HN: Calcium, matrix polymers, and plaque formation. J Periodontol 53:101, 1982.
63. The parotid gland secretes mostly _____ fluid which compromises ______ % of total saliva.
a. Serous, 20%
b. Serous, 80%
c. Serous and mucus, 80%
d. Serous and mucus, 20%
e. Mucus, 20%
Answer: a
Reference: Ana Diaz-Arnold, Cindy Marek. The impact of saliva on Patient Care: A Literature Review.JPD, 2002.
64. The most common complication associated with conventional fixed dental prostheses is:
a. Need for endodontic treatment.
b. Loss of retention.
c. Porcelain fracture.
d. Caries.
Answer: d
Reference: Goodacre CJ, Bernal G, Rungcharassaeng K, Kan, JY. Clinical complications in fixed prosthodontics. J
Prosthet Dent 2003;90:31-41.
65. All of the following are advantages of lingualized occlusion except one. Which one is the exception?
a. Cusp form is more natural in appearance compared to nonanatomic tooth form
b. Easier to arrange in reverse articulation
c. Good penetration of the food bolus is possible
d. Vertical forces are centralized on the mandibular teeth
Answer: b
Reference: Becker CM, Swoope CC, Guckes AD. Lingualized occlusion for removable prosthodontics. J Prosthet
Dent 1977;38:601-608.
14
66. All of the following are methods for controlling occlusal loads on implants except one. Which one is the
exception?
a. Splinting multiple implants
b. Narrowed occlusal table
c. Increased cusp inclination
d. Forces directed along implant axis
Answer: c
Reference: Kim Y, Oh T, Misch C, Wang H. Occlusal considerations in implant therapy: clinical guidelines with
biomechanical rationale. Clin Oral Impl Res 2005;16: 26–35.
67. The average width/length ratio for maxillary central incisor is:
a. 78%
b. 72%
c. 86%
d. 68%
Answer: a
Reference: Magne P, Gallucci GO, Belser UC. Anatomic crown width/length ratios of unworn and worn maxillary
teeth in white subjects. J Prosthet Dent 2003;89:453-461.
68. The primary muscle involved in mandibular protrusion is:

a. Infrahyoid
b. Medial pterygoid
c. Temporalis
d. Inferior lateral pterygoid
Answer: d
Reference: Okeson, Jeffrey P.; Management of Temporomandibular Disorders, 8th Ed; Mosby, Chapter 1, Elsevier,
2012.
69. According to ADA Specification No. 5, a noble metal will:

a. Have a noble metal content of at least 25%.
b. Have a minimum of 25% gold.
c. Have a noble metal content at least 60%.
d. Have a minimum of at least 40% gold.
Answer: a
Reference: Powers, John, and Sakaguchi, Ronald L.; Craig’s Restorative Dental Materials, 12th Ed, 2011,369.
70. Comparing the survival of implants placed in mature bone with the survival of implants placed in fresh extraction
sockets in the same patients, which of the following is correct?
a. The survival rate of implants placed in fresh extraction sockets is similar to that of implants placed in
mature bone irrespective of the location of the implants in the mandible and maxilla
b. A significantly higher failure rate is seen with immediate implants in the posterior maxilla
c. Splinted implants in the posterior mandible and maxilla have a significantly higher success rate than
un-splinted implants
d. A significantly higher failure rate is seen with immediately placed implants in patients older than 70
years.
Answer: b
Reference: Penarrocha-Diego, M. et al. A Retrospective Comparison of 1022 Implants: Immediate Versus Non-
Immediate. Int. J. Oral Maxillofacial Implants 2012; 27;421-427.
15
71. The three dimensions of color are ____:
a. Chroma, saturation, brightness.
b. Hue, chroma, value.
c. Hue, value, brilliance.
d. Value, dimension, saturation.
Answer: b
Reference: RC Sproull, JD Preston Understanding Color. Esthetics in Dentistry, Vol. 1;Decker;1998.207-220.
72. One of the anatomic structures that determine the boundaries of the distolingual flange of a mandibular complete
denture is the ____:
a. Ramus of the mandible.
b. Retromylohyoid curtain.
c. Palatopharyngeus muscle.
d. Pterygomandibular raphe.
Answer: b
Reference: Zarb-Bolenders, Prosthodontic Treatment for Edentulous Patients, 12th Ed, Mosby,241.
73. The TiUnite surface texture produced by Nobel Biocare is commonly performed by ____:
a. Using a solution of hydrochloric acid and sulfuric acid.
b. Blasting with 250 to 500 mm corundum grit followed by acid etching in a hot solution of hydrochloric
acid and sulfuric acid.
c. Anodically oxidizing the titanium surface in a proprietary electrolytic solution.
d. Heating titanium particles to a nearly molten state which sprayed at the surface using inert gas plasma.
Answer: c
Reference: Puleo, D. Thomas, M. Implant Surfaces. Dent Clin N Am 50;2006;323–338.
74. All of the following oral sedatives can be crushed prior to sublingual delivery during conscious sedation except:
a. Alprazolam.
b. Diazepam.
c. Triazolam.
d. Lorazepam.
Answer: a
Reference: Mitchell, J. Oral Dosage forms that should not be crushed. Institute for Safe Medication Practices. Nov.
2009.
75. Use of right hamular notch to left hamular notch measurement plus ___ provides a useful method for determining
the width of the 6 maxillary anterior teeth for complete denture patients with medium and large cast sizes.
a. 5 mm
b. 20 mm
c. 10 mm
d. 15 mm
e. 0.5 inches
Answer: c
Reference: Baker PS, Morris WJ, Lefebvre CA, Price GA, Looney SW, Relationship of Denture Cast Measurements
to Width of Maxillary Anterior Teeth. JPD, 2011,Vol. 105, Issue 1, 44.
16
76. Clasp-retained removable partial dentures showed a survival rate of approximately 90% after 10 years of oral
service. What was (were) the predominant complication(s) during oral service?
a. Caries lesions
b. Loss of abutment teeth
c. Fracture of clasps
d. All of the above
Answer: d
Reference: Behr M, Zeman F, Passauer T, Koller M, Hahnel S, Buergers R, Lang R, Handel G, Kolbeck C, Clinical
Performance of Cast Clasp-Retained Removable Partial Dentures: A Restrospective Study, Int J Prosthodont
2012; 25:138-144.
77. Which is not an antiflux?

a. Graphite (C)
b. Whitening (ZnO2)
c. Rouge (Fe2O3)
d. Fluoride (F)
Answer: d
Reference: Byrne G. Soldering in Prosthodontics – An Overview, Part I. J Prosthodont 20 (2011) 233- 243.
78. A _______ margin is recommended for a complete titanium crown preparation when using both casting and
milling methods.
a. Shoulder
b. Chamfer
c. Knife edge
d. All of the above
Answer: b
Reference: Han HS, Yang HS, Lim HP, Park YJ. Marginal Accuracy Fit of Machine-Milled and Cast Titanium
Crowns. J Prosthet Dent 2011; 106:191-197.
79. All of the following arise from the 1st branchial arch except one? Which one of the following is the exception?
a. Meckel’s cartilage
b. Muscles of mastication
c. Trigeminal nerve
d. Muscles of facial expression
e. Sphenomandibular ligament
Answer: d
Reference: Hiatt, J. and Gartner, L. Textbook of Head and Neck Anatomy. 3rd Ed., 2002.
80. Ideal properties of dental luting agents include all of the following accept?
a. Biocompatible
b. High compressive strength
c. Low solubility
d. Adhesion
e. Technique sensitive
Answer: e
Reference: Rosenstiel S. Land M. Crispin B. Dental luting agents: A review of the current literature. JPD;1998.
17
81. Which is not a determinant of anterior guidance:
a. Phonetics.
b. Condylar border movements.
c. Positional relationships of the maxillary and mandibular posterior teeth.
d. Esthetics.
e. Positional relationships of the maxillary and mandibular anterior teeth.
Answer: c
Reference: Broderson SP. Anterior guidance – the key to successful occlusal treatment. J Prosthet Dent 1978;39:396-
400.
82. Proper etching for Lithium Disilicate reinforced dental ceramic is ___:
a. 9% HF for 60 sec.
b. 4-5% HF for 20 sec.
c. 9% HF for 2 min.
d. 4-5% HF for 60 sec.
Answer: b
Reference: Duarte, S. et al; Ceramic Systems: An Ultrastructural Study; QDT, 2010,42.
83. In a study on axial wall modification and retention of cement retained crowns______:
a. Abutments with all 4 walls had the highest retention of all groups.
b. Abutments with 2 opposing walls had significantly higher retention than that of all other groups.
c. Abutments with one wall had equal retention to abutments with 3 walls.
d. Abutments with one wall had significantly less retention than abutments with 2 walls.
Answer: b
Reference: Tan, K. M. et al; Effect of Axial Wall Modification on the Retention of Cement-Retained, Implant-
Supported Crowns; JPD, 2012; 107:80-85.
84. Increased roughness of dental ceramics _____:

a. Decreases the perceived Value.
b. Decreases the perceived Chroma.
c. Increases the perceived Value.
d. None of the above.
Answer: a
Reference: Obregon A, Goodkind RJ, Schwabacher WB. Effects of opaque and porcelain surface texture on the
color of ceramometal restorations. J Prosth Dent;1981;46:330-40. Also: Cho M-S, et al. Changes in optical
properties of enamel porcelain after repeated external staining. J Prosthet Dent 2006;95:437-43.
85. What element(s) is/are responsible for the ability to heat soften/harden gold alloy?
a. Zn
b. Ag
c. Ru and Mb
d. Zr
e. Cu
Answer: e
Reference: Sakaguchi R, Powers JM. Craig's Restorative Dental Materials. Chapter 10, Mosby, St. Louis, 2011.
18
86. All of the following statements are correct regarding Silver-Palladium alloys except one. Which one is the
exception?
a. Is less ductile than Palladium-Silver and more difficult to cast
b. Is considered a substitute for Type III gold
c. Ideal for porcelain application
d. Silver is more dominant, could be up to 60-70%
Answer: c
Reference: Palladium-silver alloys: A review of the literature. Goodacre; JPD 1989; 62:34-7.
87. According to Wical and Swoope’s method for measuring mandibular ridge resorption on a panoramic radiograph,
which of the following will give an estimate of the original alveolar ridge crest height:
a. The distance between the lower border of the mandible and the upper border of the mental foramen
multiplied by three.
b. The distance between the lower border of the mandible and the upper border of the mental foramen
multiplied by two.
c. The distance between the lower border of the mandible and the lower border of the mental foramen
multiplied by three.
d. The distance between the lower border of the mandible and the lower border of the mental foramen
multiplied by two.
Answer: c
Reference: Wical KE, Swoope CC. Studies of residual ridge resorption. I. Use of panoramic radiographs for
evaluation and classification of mandibular resorption. J Prosthet Dent 1974 Jul;32(1):7-12.
88. All of the following are incorrect regarding the vertical determinants of occlusal morphology as affected by
lateral translation movement except one. Which one is the exception?
a. The looser the TM ligament, the greater the movement and the longer the posterior cusps.
b. The greater the movement, the smaller the angle between laterotrusive and mediotrusive pathways.
c. The greater the immediate mandibular translation, the shorter the posterior teeth.
d. The anterior and posterior movement of the rotating condyle determines the cusp height.
Answer: c
Reference: Jeffrey P. Okeson. Management of Temporomandibular Disorders and Occlusion. 5th Ed, Mosby.
89. In the classic study by Crispin et al. regarding the marginal fit of polymethyl methacrylate interim restorations,
which statement is correct?
a. The marginal accuracy by direct formation interim restoration to the tooth preparation was
significantly more accurate than the model-based indirect technique.
b. The marginal accuracy made by the indirect technique was significantly better than the direct
technique.
c. There was no difference in the marginal accuracy between the techniques.
d. Development of periodontal pockets of greater than 3 mm were associated with direct technique.
e. Increased plaque and gingival inflammation were associated with the indirect method.
Answer: b
Reference: Crispin BJ, Watson JF, Caputo AA. The marginal accuracy of treatment restorations: a comparative
analysis. J Prosthet Dent 1980;44:283-90.
90. Immediate mandibular translation occurs _____:

a. Before any forward movement of condyle.
b. During first 5-6 mm movement of condyle.
c. During first premature occlusal contact after rotation of condyle.
d. During immediate rotation of condyle.
19
Answer: a
Reference: Okeson, J. Management of Temporomandibular Disorders and Occlusion 7th Ed. Chapter 6;
Elsevier,2013, p. 94
91. Complete denture patients prefer which of the following when chewing tough foods?
a. Molar region for chewing
b. Premolar region for chewing
c. It makes no difference since chewing tough foods is not possible with complete dentures
d. Monoplane occlusal scheme
Answer: b
Reference: Zarb-Bolenders, Prosthodontic Treatment for Edentulous Patients, 12th Ed, Mosby,16.
92. What is the amount of free monomer left in heat activated acrylic dentures after processing?
a. 0 - 0.5%
b. 0.6 - 1.0%
c. 1.1 - 1.5%
d. 1.6 - 2.0%
Answer: a
Reference: Phillips’ Science of Dental Materials, 11th Ed., 2003, W.B, Saunder's Co., pg. 736.
93. When the mandible moves from centric occlusion to the right, the path of the mesio-lingual cusp of tooth #15
traces a path on the opposing molar. Which of the following describes the direction of the path?
a. Diagonally, posteriorly, buccally
b. Diagonally, posteriorly, lingually
c. Diagonally, anteriorly, buccally
d. Directly medially, toward the lingual
Answer: a
Reference: Okeson, J. Management of Temporomandibular Disorders and Occlusion 7th Ed. Chapter 19;
Elsevier,2013.
94. Which material has the highest contact angle?

a. Polysulfide rubber
b. Addition silicone
c. Hydrocolloid
d. Polyether
Answer: b
Reference: Phillips’ Science of Dental Materials, 11th Ed., 2003, W.B, Saunder's Co., pg. 222.
95. Based on the CAMBRA protocol, 0.12% Chlorhexidine gluconate rinse use should be limited to _____:
a. Seven consecutive days a month.
b. Three consecutive days a month.
c. Five consecutive days every other month.
d. Seven consecutive days every six months.
Answer: a
Reference: Featherstone, Singh, Curtis: Caries Risk Assessment and Management for the Prosthodontic Patient, J
Prosthodont; Vol 20, Issue 1, January 2011, 2–9.

20
96. Which of the following represents an UNCOMMON complication 10 years post insertion associated with metal-
resin and metal-ceramic implant-supported fixed complete prostheses?
a. Veneering material chipping/fracture
b. Fabrication of new opposing denture
c. Loss of access hole filling
d. Bone loss greater than 2 mm around implant
e. Patient dissatisfaction
Answer: e
Reference: Papaspyridakos P et al, A Systematic Review of Biologic and Technical Complications with Fixed Implant
Rehabilitations for Edentulous Patients. Int J Oral Maxillofac Implants; Vol 27(1): 2012; 102-110.
97. According to a recent report on shorter implants in clinical practice, what is the cumulative success rate for single
implants placed simultaneously with osteotome sinus augmentation in the posterior maxilla?
a. 98.9%
b. 94.5%
c. 90.9%
d. 84.9%
Answer: a
Reference: Fugazzotto, Shorter Implants in Clinical Practice: Rationale and Treatment Results, Int J Oral Maxillofac
Implants, 2008 23(3):487-96.
98. Which one of the following statements is TRUE regarding the use of engaging abutment in implant borne screw
retained 3-unit fixed cantilevered prostheses?
a. The usage of engaging abutment in 3-unit fixed cantilevered prostheses is contraindicated.
b. The usage of engaging abutment away from the cantilever showed increased resistance to fracture of
the abutment screw.
c. The usage of engaging abutment next to the cantilever showed increased resistance to fracture of the
abutment screw.
d. The position of the engaging abutment has no effect in the survival of the screw retained 3-unit fixed
cantilevered prostheses.
Answer: b
Reference: Dogus et al, Effect of engaging abutment position in implant-borne, screw-retained three-unit fixed
cantilevered prostheses. J Prosthodont; 2011; 20;348–354.
99. All of the following are considered acceptable methods of assessing occlusal vertical dimension in edentulous
patients except one. Which one is the exception?
a. Tactile sense
b. Physiologic rest position
c. Measurement of closing forces
d. Deglutition
e. Mandibular border movements
Answer: e
Reference: Turrell A. Clinical assessment of vertical dimension. J Prosthet Dent 1972;28:238-45.
100. All of the following are part of Turner’s classification of wear except one. Which one is the exception?
a. Excessive wear with loss of occlusal vertical dimension
b. Excessive wear without loss of occlusal vertical dimension and with limited space
c. Excessive wear without loss of occlusal vertical dimension but with space available
d. Excessive wear with loss of occlusal vertical dimension and with limited space
21
Answer: d
Reference: Turner and Missirlian; Restoration of the worn dentition. JPD; 1984; 4:52.
101. One desires an alloy with high ductility. What would you look for in the material?
a. Low proportional limit
b. High percent elongation
c. High resiliency
d. Low toughness
Answer: b
Reference: Phillips’ Science of Dental Materials, 11th Ed., 2003, W.B, Saunder's Co., Pgs. 95-96.
102. According to a published systematic review on accuracy of fit of fixed screw-retained implant frameworks
fabricated by different methods, the following were concluded with one exception. Which of the following is the
exception?
a. Cast Noble metal frameworks provide a predictable fit
b. Base metal castings do not provide satisfactory level of fit without additionally refined
c. CAD/CAM is the least consistent and most technique sensitive of these methods
d. Spark erosion framework bonding to prefabricated abutment cylinders, and CAD/CAM have the
potential to provide implant frameworks with an excellent fit.
Answer: d
Reference: Abduo J, et al. Fit of screw-retained implant frameworks fabricated by different methods: A systematic
review. Int J Prosthodontics, 24:3, 207-220, 2011.
103. All of the following are guidelines for preparation of teeth for complete coverage crowns except one. Which
a. Total occlusal convergence (TOC) should ideally range between 10 and 20 degrees.
b. Minimal occlusocervical/incisocervical dimension of anterior teeth and premolars prepared within the
recommended TOC is 3 mm.
c. Minimal occlusocervical dimension of molars prepared with the recommend TOC should be 2 mm.
d. Ratio of the occlusocervical/incisocervical dimension of a prepared tooth to the faciolingual
dimension should be at least 0.4 or higher for all teeth.
Answer: c
Reference: Goodacre CJ, Campagni WV, Aquilino SA. Tooth preparations for complete crowns: an art form based
on scientific principles. J Prosthet Dent. 2001 Apr;85(4):363-76.
104. What is the most commonly reported complication for implant-supported fixed dental prostheses in edentulous
patients?
a. Screw loosening
b. Veneer fracture
c. Framework fracture
d. Screw fracture
Answer: b
Reference: Bozini T, et al. A meta-analysis of prosthodontic complication rates of implant supported fixed dental
prosthesis in edentulous patients after an observation period of at least 5 years: Int J Oral Maxillofac Implants
2011;26:304–318.
22
105. All the following statements are correct regarding the use of shorter implants in clinical practice except one.
a. Successful outcomes were coupled with appropriate diagnosis and multidisciplinary care.
b. Successful outcomes were obtained with appropriate osseous regenerative therapy allowing ideal
positioning of implants.
c. Successful outcomes were obtained by atraumatic placement of the implant utilizing manual torque
wrenches to minimize lateral pressure on the osteotomy walls.
d. Implant success rates of greater than 98% was determined after 73 to 84 months in function for both
single crowns placed in various areas of the mouth.
Answer: c
Reference: Fugazzotto, Shorter Implants in Clinical Practice: Rationale and Treatment Results, Int J Oral Maxillofac
Implants, 2008.
106. Quality of life is:

a. An objective concept
b. An individual’s perceived life experience
c. Based on different multiple individuals’ (external) frame of reference
d. Based on a consensus definition
Answer: b
Reference: Mack F, et al. The impact of tooth loss on general health related to quality of life among elderly
Pomeranians: results from the study of health in Pomerania, (SHIP-0). Int J Prosthodont 2005; 18:414-419.
107. Which of the following is correct when comparing milled bar retention to telescopic crown retention when used
with removable four implant supported mandibular overdentures?
a. Milled bars demonstrated higher retention.
b. Milled bars have lower values for plaque and calculus accumulation.
c. Telescopic crown retention demonstrated significantly less percentage of peri-implantitis.
d. Prosthodontic maintenance was significantly higher for bar retention.
Answer: a
Reference: Krennmair G, Sütö D, Seemann R, Piehslinger E. Removable four implant-supported mandibular
overdentures rigidly retained with telescopic crowns or milled bars: a 3-year prospective study. Clin Oral
Implants Res. 2012 Apr;23(4):481-8.
108. Recent recommendations for patients who have taken an oral bisphosphonate for more than three years with
or without any concomitant prednisone or other steroid medication should _____:
a. Contact the provider to consider discontinuing the bisphosphonate for three months prior to oral
surgery if conditions permit.
b. Advise the patient to discontinue the bisphosphonate for six months prior to oral surgery.
c. Not perform the oral surgery.
d. Continue taking the bisphosphonate as directed and continue with the surgery.
Answer: a
Reference: Ruggiero SL, et al. Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-
related osteonecrosis of the jaws--2009 update. J Oral Maxillofac Surg. 2009 May;67(5 Suppl):2-12.
109. When comparing the shear bond strengths of highly cross-linked denture teeth bonded to heat-polymerized
PMMA using diatorics or bonding agent:
a. The diatorics showed higher shear bond strength.
b. The bonding agent showed higher shear bond strength.
c. The combination of both showed higher shear bond strength.
d. There is no difference in shear bond strength.
23
Answer: d
Reference: Fletcher-Stark ML, Chung KH, Rubenstein JE, et al. Shear bond strength of denture teeth to heat- and
light-polymerized denture base resin. J Prosthodont. 2011; 20(1):52-59.
110. Which of the following describes the behavior of prosthetic screw reverse torque values following repeated
tightening/loosening cycles for prosthetic abutments to implants?
a. No significant difference in reverse torque values will be observed in up to 35 tightening/loosening
cycles.
b. Significant reductions in reverse torque values will be observed when more than 10
tightening/loosening cycles are employed.
c. Thread fractures can be expected when more than 20 tightening/loosening cycles are employed.
d. Reverse torque values that are clinically unacceptable are routinely produced with 2-4
tightening/loosening cycles.
e. Slight increase in torque values due to accumulative wear debris.
Answer: b
Reference: Guzaitis K, Knoerschild K, Viana M. Effect of repeated screw joint closing and opening cycles on
implant prosthetic screw reverse torque and implant and screw thread morphology. J Prosthet Dent Vol
106(3):159-169. Sept 2011.
111. Which of the following patient systemic factors is known to create a significantly greater risk of implant failure
compared to the risk of placement in a similar site in an uncompromised patient?
a. Active smoking habit
b. Well controlled insulin dependent diabetes
c. Age over 65
d. History of treated and well maintained chronic periodontitis
Answer: a
Reference: Anner R, Grossmann Y, Anner Y, Levin L. Smoking, diabetes mellitus, periodontitis, and supporting
periodontal treatment as factors associated with dental implant survival: A long-term retrospective evaluation of
patients followed for up to 10 years. Implant Dent. 2010 Feb;19(1):57-64.
112. All of the following decrease the time required to clinically fit a cast post except one. Which one is the
exception?
a. Investing the post pattern with one ring liner
b. Using a burn-out temperature of 600° F
c. Inward expansion of the investment toward the mold space
d. Decreasing the volume of investment liquid
Answer: d
Reference: Otun A, Lee H, Geminiani A, Shirakura A, Ercoli C, Feng C. Ring liner and burn-out temperature affect
the clinical time required to fit a cast post. J Prosthet Dent. 2009 Oct;102(4):224-8.
113. When comparing axial and tilted implants for mandibular full-arch fixed prostheses, photoelastic stress analysis
reveals tilted implants reduced the maximum stress in the distal crestal bone of the distal implant by
approximately how much?
a. 0-5%
b. 15-20%
c. 45-50%
d. 70-75%
Answer: b
Reference: Kim et al. Biomechanical Comparison of Axial and Tilted Implants for Mandibular Full-Arch Fixed
Prostheses. IJOMI. 2011. 26(5): 976-984.
24
114. All the following statements are true when comparing smile characteristics of U.S. white, U.S. Asian Indian,
and Indian populations except one. Which one is the exception?
a. The gender of the evaluator affected the perception of smile.
b. Few differences were noted in the perception smile esthetics.
c. Ethnicity had a significant effect on the esthetic choices for Buccal Corridor and Smile Arc.
d. There were no significant differences noted for gingival display, vertical overlap, lateral incisal step,
maxillary midline to mid- face, and maxillary to mandibular midline.
Answer: a
Reference: Sharma N, et al. Smile characterization by U.S. white, U.S. Asian Indian, and Indian populations. JPD.
2012, 107(5):327-335.
115. All of the following statements are true regarding feldspathic veneered zirconia crowns fabricated with knife-
edge margins except one. Which one is the exception?
a. Knife-edge margins allow clinical performance similar to that reported with other margin designs
b. A common indication for knife-edge preparations is for periodontally involved teeth
c. Knife-edge margins with zirconia crowns allow for less invasive preparations when compare to other
margin designs
d. Knife-edge margins demonstrated significantly greater gingival inflammation
Answer: d
Reference: Poggio CE, et al. A retrospective analysis of 102 zirconia single crowns with knife-edge margins JPD,
2012, 107(5):316-321.
116. All of the following statements regarding Obstructive Sleep Apnea (OSA) are true except one. Which one is the
exception?
a. OSA increases risk for in-office sedation using oral or parental benzodiazepines or use of oral opioids
for postoperative pain
b. Central sleep apneas (CSA) are best treated with oral appliance therapy
c. A neck circumferences of 17 inches or more (males) or 16 inches or greater (females) were at greater
risk for OSA
d. The total number of apneic and hypopneic episodes per hour of sleep is referred to as the Apnea-
Hypopnea Index (AHI)
Answer: b
Reference: p 170 Simmons, M.S., et al: Dentistry-based Approaches to Sleep-disordered Breathing, Algorithms, and
Multidisciplinary Perspectives. Journal of the California Dental Association Feb 2012, 168-181. Ivanhoe JR,
Cibirka RM, Lefebvre CA, et al: Dental considerations in upper airway sleep disorders: a review of the literature.
J Prosthet Dent 1999;82:685-698.
117. Which of the following parameters relates to higher failures when restoring posterior teeth with inlays and
onlays?
a. Non-vital teeth showed a significantly higher risk of failure
b. No greater risk of failure associated with existing parafunction (bruxism)
c. Survival of restored premolars was not statistically different than molars after 15 years.
d. Glass-ceramic onlays and inlays efficacy is less than cast gold restorations.
Answer: c
Reference: Beier US et al; Clinical Performance of All-Ceramic Inlay and Onlay Restorations in Posterior Teeth; Int
J Prosthodont;2012;25:395-402.
25
118. _________________, also known as freeform fabrication, is a rapid prototyping concept that assembles
geometries for dental restorations in a layer-by layer process.
a. Autocasting
b. Digicasting
c. 3D-casting
d. Roboscanning
e. Robocasting
Answer: e
Reference: Silva NR, et al. Additive CAD/CAM Process for Dental Prostheses, JP 20 (2011):93-96, 2010.
119. A recent multi-center case-control study on bisphosphonates and osteonecrosis of the jaw (ONJ) showed the
greatest risk factor was _____:
a. Extractions.
b. Pre-prosthetic surgery.
c. Surgical endodontic procedures.
d. Surgical periodontal procedures.
e. All of the above.
Answer: a
Reference: Barasch A, Cunha-Cruz J, Curro F, Derouen T, Gilbert GH, Hujoel P, Safford MM, Vena DA, Voinea-
Griffin AE, Wu H; for the CONDOR Collaborative Group. Dental risk factors for osteonecrosis of the jaws: a
CONDOR case-control study.Clin Oral Investig. 2012 Dec 2.
120. According to a recent report on shorter implants in clinical practice, which procedure should be avoided during
the surgical placement of a short implant?
a. Simultaneous internal sinus lift procedure
b. Use of manual torque wrench
c. Conservative instrumentation of the implant site
d. Use of hand piece for the implant placement
Answer: b
Reference: Fugazzotto, Shorter Implants in Clinical Practice: Rationale and Treatment results, Int J Oral Maxillofac
Implants, 2008.
121. A recent evaluation of small diameter (3.3 mm) implants determined that the significant factor associated with
failure was ______________.
a. Infection/Inflammatory processes.
b. Type 4 bone placement.
c. Marginal bone loss.
d. Loading stress.
Answer: b
Reference: Romeo, E. Lops, D. Amorfini, L. Clinical and Radiographic evaluation of small-diameter (3.3)
implants followed for 1-7 years: A longitudinal study. Clin Oral Implants Res 2006; 17: 139-148.
122. During implant/prosthesis loading, which of the following variables demonstrate the greatest amount of torque
under load to the components?
a. Horizontal implant offset
b. Apical implant offset
c. Implant inclination
d. Cuspal inclination of the prosthesis
26
Answer: d
Reference: Weinberg, L. Kruger, B. A comparison of Implant/Prosthesis Loading with four clinical variables. JPD
Vol. 8, Number 5, 1995; 421-433.
123. Which of the following muscle responses measured by EMG are associated with canine-guided disclusion of the
posterior teeth?
a. Increased activity all the muscles associated with mandibular elevation.
b. The medial pterygoid muscle undergoes isotonic muscle contraction.
c. The EMG activity of the temporal and masseter muscles is decreased.
d. The anterior temporal muscle shows increased activity during lateral slide from centric occlusion.
e. There is no significant change on the EMG activity of the temporal and masseter muscles.
Answer: c
Reference: Williamson, EH, et al. Anterior guidance: Its effect on electromyographic activity on the temporal and
masseter muscles. J Prosthet Dent 1983; 49:816-823.
124. Which muscle is active in mandibular depression?

a. Medial pterygoid
b. Superior pharyngeal constrictor
c. Palatopharyngeus
d. Superior belly of the lateral pterygoid
e. Levator veli palatini
Answer: d
Reference: Okeson, Jeffrey P.; Management of Temporomandibular Disorders, 8th Ed; Chapter 1, Elsevier, 2012.
125. The local anesthetics, Lidocaine and Mepivicaine, belong to which of the following classifications?
a. Esters
b. Amides
c. Proteins
d. Sulfonamide
e. Glycosides
Answer: b
Reference: Malamed SF. Handbook of Local Anesthesia, 6th Ed. Mosby, 2012.
126. Which of the following statistical test is most appropriately used to analyze two (unpaired) treatment groups
with parametric data?
a. Mann-Whitney test
b. Unpaired t-test
c. Chi-squared analysis
d. Analysis of variance
e. Kruskal-Wallis test
Answer: b
Reference: Baumgardner K. A review of key research design and statistical analysis issues. Oral Surg Oral Med Oral
Pathol Oral Radiol Endod. 1997 Nov;84(5):550-6.
27
127. All of the following statements regarding the support of a maxillary complete denture by the hard palate are
correct except one. Which one is the exception?
a. Rugae contribute to the stress-bearing role
b. Horizontal hard palate is the primary area of support
c. Submucosa posterolateral to the median palatal suture contains glandular tissue and is non-
displaceable
d. Submucosa anteriolateral to the median palatal suture contains adipose tissue and is displaceable
e. Submucosa of the medial palatal suture is very close to underlying bone and has to be relieved
Answer: c
Reference: Zarb, GA, Bolender, CL, & Carlsoon, GE. Boucher’s Prosthodontic Treatment for Edentulous Patients.
11th Ed. Mosby, Inc. 1997:142.
128. Which of the following dental impression materials utilizes a ring-opening mechanism to reduce polymerization
shrinkage?
a. Polysulfide
b. Addition polyvinyl siloxane
c. Polyether
d. Irreversible hydrocolloid
e. Condensation polyvinyl siloxane
Answer: c
Reference: Powers, John, and Sakaguchi, Ronald L.; Craig’s Restorative Dental Materials, 12th Ed.
129. All of the following statements regarding the design a rotational path RPD are correct except one. Which one is
the exception?
a. Increasing the number of minor connectors increases the potential difficulty of rotating the framework
into place.
b. All block outs of interferences must be determined by radii that are extended at right angles from the
axis of rotation.
c. Increased block out is required as the distance of the minor connector from the axis of rotation
increases.
d. The closer the minor connector is to the axis of rotation the greater the curvature of the arc that it must
follow.
Answer: c
Reference: Krol AJ. Removable partial denture design: Outline syllabus. 5th Ed.
130. The most complete list of the structures within the retromolar pad is best described by which of the following?
a. Pterygomandibular raphe, buccinator, and superior constrictor fibers
b. Mucous glands, pterygomandibular raphe, buccinator, masseter and superior constrictor fibers.
c. Mucous glands, temporal tendon, pterygomandibular raphe, buccinator, and superior constrictor
fibers.
d. Temporal tendon, pterygomandibular raphe, buccinator, temporal and superior constrictor fibers.
Answer: c.
Reference: Rahn AO, Ivanahoe JR, and Plummer KD. Textbook of Complete Dentures, 6th Ed. PMPH USA, 2009.
131. A Siebert’s Class II ridge defect is best described by which of the following?
a. Faciolingual loss of tissue width with normal ridge height.
b. Loss of both ridge height and width.
c. Loss of ridge height with normal ridge width.
d. Loss of ridge width with normal ridge height.
28
Answer: c
Reference: Rosenstiel SF, Land MF, Fujimoto J. Contemporary Fixed Prosthodontics, 4th Ed. Elsevier, 2006, p 618.
132. All of the following statements are correct regarding the innervation of the tongue except one. Which one is the
exception?
a. Cranial nerve VII (facial) innervates anterior 2/3 of the tongue for taste
b. Cranial nerve IX (glossopharyngeal) innervates the posterior 1/3 of the tongue for taste and general
sensory
c. Cranial nerve XII (hypoglossal) innervates most of the intrinsic and all of the extrinsic muscles of the
tongue
d. Cranial nerve V-3 (lingual) innervates anterior 2/3 of the tongue for general sensory
e. Cranial nerve X (vagus) innervates the palatoglosseous muscle
Answer: c
Reference: Agur A and Lee MJ. Grant’s Atlas of Anatomy. 10th Ed. P. 592.
133. All of the following are structural incompatibilities of the articular surfaces of the TM joints except one. Which
a. Spontaneous dislocation
b. Deviation in form
c. Subluxation
d. Adhesion
e. Protective co-contraction
Answer: e
Reference: Okeson, Jeffrey P.; Management of Temporomandibular Disorders, 8th Ed; Chapter 1, Elsevier, 2012.
134. Nikolsky’s Sign is a clinical dermatologic test useful in the diagnosis of which of the following entities?
a. Erythema multiforme
b. Pemphigus vulgaris
c. Lupus erythematosus
d. Systemic sclerosis
e. Psoriasis
Answer: b
Reference: Polifka M, Krusinski PA. The Nikolsky sign. Cutis 1980;26:521-26.
135. A side effect of the NSAID ibuprofen is ____:

a. Increased bleeding time.
b. Reduced bleeding time.
c. Increased platelet function and no effect on bleeding time.
d. No effect on bleeding time.
e. Possible pancreas dysfunction.
Answer: a
Reference: Yagiela JA, et al. Pharmacology and Therapeutics for Dentistry, 6th Ed, Mosby, 2010.
136. All of the following are features of a retracted tongue except one. Which one is the exception?
a. The tongue is pulled back and the floor of the mouth is exposed.
b. The lateral borders are either inside or posterior to the ridge.
c. The tip of the apex of the tongue sometimes lies in the posterior part of the floor of the mouth or may
be withdrawn into the body of the tongue.
d. Retracted tongue positions occur in about one of every four patients.
e. Retracted tongue is problematic for both dentate and edentulous patients.
29
Answer: e
Reference: Wright, C. et al.: A study of the tongue and its relation to denture stability, J. Am. Den. Assoc. 39:269-
275, 1949.
137. Which Aramany classification of partially edentulous maxillectomy patients describes the resection along the
midline of the maxilla maintaining the teeth on one side of the arch?
a. Class I
b. Class II
c. Class III
d. Class IV
e. Class V
Answer: a
Reference: Aramany, Mohamed. Basic principles of obturator design for partially edentulous patients. Part I:
Classification. J Prosthet Dent 1978;40: 554-557.
138. When analyzing nominal data, the following statistical method may be used ___:
a. Simple linear regression.
b. Correlation - r.
c. Paired t-test.
d. Kruskal-Wallis test
e. Chi-squared test.
Answer: e
Reference: Bland, M. An introduction to medical statistics. 3rd Ed. Oxford University Press.
139. Metamerism describes:

a. Pairs of objects with the same hue that appears different under the same light.
b. Two objects with different value that appears similar under a certain light.
c. Pairs of objects that have different spectral curves but appear to match when viewed in a given hue.
d. An object that appears to have the same color under different light conditions.
Answer: c
Reference: The Glossary of Prosthodontic Terms, 8th Ed. JPD 2005, 94(1).
140. Craniofacial implants used to retain facial prosthesis have the highest survival rates in which of the following
sites?
a. Orbital
b. Piriform/nasal
c. Frontal bone
d. Auricular
e. Zygoma
Answer: d
Reference: Roumanas ED, et al. Implant-retained prostheses for facial defects: an up to 14-year follow-up report on
the survival rates of implants at UCLA. Int J Prosthodont 2002, 15:325-32.
141. The following statements are advantages for removable partial dentures using Krol’s RPI concept except one?
a. The mesial rest acts as a point of rotation, exerting a force on the adjacent tooth.
b. The rest, proximal plate and I-bar prevent migration of abutment.
c. Physiologic relief is required for the proximal plate when pressure is exerted on the denture base.
d. The I-bar moves in a mesiobuccal direction under a masticatory load.
30
Answer: a
Reference: Krol AJ. RPI (rest, proximal plate, I bar) clasp retainer and its modifications. Dent Clin of North Am
1973;17(4):631-49.
142. Moderate sleep apnea is defined by an Apnea-Hypopnea Index (AHI) between the following values ____.
a. 0 – 5.
b. 6 – 14.
c. 15 – 30.
d. 31 – 44.
e. 45+.
Answer: c
Reference: American Academy of Sleep Medicine. International Classification of Sleep Disorders, 2nd Ed.
Westchester: American Academy of Sleep Medicine. 2005:1-298.
143. Which of the following is the most common complication encountered with the distraction osteogenesis
procedure?
a. Infection
b. Paresthesia
c. Compromised esthetics
d. Need for additional soft tissue grafting
e. Alveolar bone loss
Answer: d
Reference: Froum SJ, et al. Distraction osteogenesis for ridge augmentation: prevention and treatment of
complications. Thirty case reports. Int J Periodontics Restorative Dent 2008;28(4):337-45.
144. Which of the following is an initiator in light-activated resin restorative materials?

a. Glycol Dimethacrylate.
b. Hydroquinone.
c. Benzoyl Peroxide.
d. Camphorquinone.
e. Dimethyl-p-toluidine.
Answer: c
Reference: Anusavice KJ. Phillips’ Science of Dental Materials, 11th Ed. St. Louis: Saunders, 2003:408.
145. Each of the following statements regarding basic obturator design and classification for the partially edentulous
patient is correct EXCEPT one. Which one is the exception?
a. When treatment planning with the surgeon, the prosthodontist should make recommendations directed
toward converting a potential Aramany Class II defect into an Aramany Class I defect.
b. In Aramany Class III cases the defect is located in the central portion of the hard palate and the design
is based on quadrilateral configurations.
c. Aramany’s Classification System is divided into six different groups based upon the relationship of
the defect area to the remaining abutment teeth with class sequence being a reflection of frequency of
occurrence.
d. In Aramany Class IV cases the defect includes the pre-maxilla on the nonsurgerized side and the
design is linear.
Answer: a
Reference: Aramany MA. Basic principles of obturator design for partially edentulous patients. Part I:
Classification. J Prosthet Dent 2001;86(6):559-61.
31
146. Each of the following statements regarding gold-palladium (Au-Pd) alloys is correct EXCEPT one. Which one
is the exception?
a. The Au-Pd alloys exhibit a “white gold” color and have been commercially successful.
b. Due to the Au-Pd alloys’ low silver content, porcelain does not discolor, castability is improved and
the coefficient of thermal expansion is increased.
c. The only significant disadvantage of the Au-Pd alloys is their poor sag resistance.
d. The Au-Pd alloys were developed in an attempt to overcome the two major problems associated with
silver-containing alloys: porcelain discoloration and a high coefficient of thermal expansion.
Answer: c
Reference: Roberts HW, et al. Metal-Ceramic Alloys in Dentistry: A Review. J Prosthodont 2009;18(2):188-94.
147. The Weibull Modulus is:

a. A measure of the material elasticity.
b. A measure of failure for ceramics.
c. Smaller for homogeneous materials.
d. A measure of the flaw distribution.
Answer: d
Reference: Kelly JR, Campbell SD, Bowen HK. Fracture- surface analysis of dental ceramics. J Prosthet Dent
1989;62(5):536-41.
148. Xerostomia may be produced by prolonged use of antihistamines resulting from the following cause.
a. Direct depression of salivary gland cells.
b. Anticholinergic action.
c. Inhibition of histamine-induced salivation.
d. Cholingergic action.
Answer: b
Reference: Holroyd CV, Wynn RL. Clinical Pharmacology in Dental Practice, 4th Ed. St. Louis: Mosby.
149. Which is the most important factor for achieving retention of a maxillary complete denture?
a. Undercuts
b. Cohesion
c. Peripheral Seal
d. Atmospheric Pressure
e. Adhesion.
Answer: c
Reference: George A, Zarb CL, Bolender SE, Eckert AH, Fenton RF, Jacob R, Mericske-Stern R. Prosthodontic
Treatment for Edentulous Patients: Complete Dentures and Implant-Supported Prostheses, 12th Ed. St Louis:
Mosby, 2004, Chapter 22.
150. Which mineral constituent of modern dental porcelains is responsible for increasing the coefficient of thermal
expansion?
a. Tridymite
b. Amorphous “glassy” phase
c. Quartz
d. Kemite
e. Leucite
Answer: e
Reference: Craig RC. Restorative Dental Materials, 9th Ed. St. Louis: Mosby, 1993:495.
32

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American College of Prosthodontists

Mock Exam 2013

6. Which of the following statements is true regarding anterior tooth display?

13. Which is the most common erosion pattern in GERD?

20. What is the average Balkwill angle?

32. Jerbi’s rule of thirds is a technique that relates to:

59. Which muscle is responsible for mandible flexure?

62. Dental plaque consists of ____:

68. The primary muscle involved in mandibular protrusion is:

69. According to ADA Specification No. 5, a noble metal will:

77. Which is not an antiflux?

84. Increased roughness of dental ceramics _____:

90. Immediate mandibular translation occurs _____:

94. Which material has the highest contact angle?

106. Quality of life is:

124. Which muscle is active in mandibular depression?

135. A side effect of the NSAID ibuprofen is ____:

139. Metamerism describes:

144. Which of the following is an initiator in light-activated resin restorative materials?

147. The Weibull Modulus is:

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