1.

What is the definition of apical patency according to the American Association of Endodontics
(AAE)?

 A. Complete removal of debris from the apical third of the root canal

 B. Ensuring the apical portion of the canal is free of debris by using a small file through the apical
foramen

 C. Creating a wider space at the apical foramen for better irrigation

 D. Filling the canal space up to the radiographic terminus

2. What distinguishes apical patency from apical clearing?

 A. Apical patency involves mechanical cleansing, while apical clearing involves chemical
disinfection.

 B. Apical patency aims to prevent blockage of the foramen, while apical clearing determines the
working width.

 C. Apical patency ensures a smooth glide path, while apical clearing prevents iatrogenic errors.

 D. Apical patency involves passive insertion, while apical clearing involves active
instrumentation.

3. Which of the following is NOT an advantage of maintaining apical patency in endodontic

procedures?

 A. Facilitation of length determination

 B. Minimization of apical blockage

 C. Promotion of biofilm formation

 D. Prevention of accidental errors

4. What role does apical patency play in irrigation efficiency?

 A. It reduces the need for irrigation solutions.

 B. It facilitates the movement of irrigants in the apical third, enhancing interaction and clearing
of debris.

 C. It increases the risk of debris organization and dentin plug formation.

 D. It prevents the formation of biofilms within the root canal.

5. How does apical patency contribute to the prevention of iatrogenic complications?

 A. By promoting apical blockage

 B. By facilitating canal transportation and zipping

 C. By ensuring a smooth glide path and preventing ledges and perforations

  D. By inducing post-operative sensitivity

6. What is one limitation in achieving apical patency?

 A. Blocked canals due to physiological deposition of cementum

 B. Insufficient irrigation solutions

 C. Lack of appropriate instrumentation

 D. Inadequate radiographic imaging

7. How can blocked canals be addressed in the context of achieving apical patency?

 A. By ignoring the blockage and continuing with instrumentation

 B. By recommending surgical approaches immediately

 C. By using viscous chelating agents and pre-curved files for canal negotiation

 D. By avoiding regular follow-ups and waiting for spontaneous resolution

8. What is the primary goal of maintaining apical patency in endodontic procedures?

 A. Achieving complete obliteration of the root canal space

 B. Promoting the formation of biofilms for enhanced healing

 C. Ensuring a patent apical foramen for effective irrigation and obturation

 D. Preventing access to the apical third of the root canal

9. Which technique involves passively inserting a small file beyond the established working length to
maintain apical patency?

 A. Step-back technique

 B. Lateral condensation

 C. Balanced force technique

 D. Patency filing

10. How does apical patency contribute to minimizing post-operative sensitivity?

 A. By inducing acute inflammatory responses

 B. By promoting apical extrusion of debris

 C. By preventing the formation of biofilms within the root canal

 D. By preventing apical extrusion of debris and reducing the risk of acute inflammatory
responses
What is the master apical file (MAF) in endodontics?

A. The smallest file used for initial canal negotiation

B. The largest file that binds slightly at the corrected working length
C. A file used for lateral condensation of gutta-percha
D. A file designed for biofilm disruption within the root canal

According to Weine (1972), how is the master apical file (MAF) size determined in endodontics?

A. By enlarging the apical portion of the root canal system one size larger than the initial apical file (IAF)

B. By enlarging the apical portion of the root canal system two sizes larger than the first file that bound
at working length

C. By enlarging the apical portion of the root canal system three sizes larger than the first file that bound
at working length

D. By enlarging the apical portion of the root canal system four sizes larger than the initial apical file
(IAF)

What is the primary purpose of pre-operative diagnostic radiographs in endodontics?

A. To determine the quality of obturation

B. To evaluate the success of endodontic therapy

C. To detect pathosis and provide information on root and pulp anatomy

D. To verify the working length of the canal

Quiz: Understanding the Step-Back Technique in Endodontics

1. What is the primary emphasis of the step-back technique in endodontics?

A. Enlarging the coronal third of the canal

B. Gradually tapering the canal from apical to coronal

C. Focusing on lateral canal preparation

D. Creating a wide apical preparation

2. How is the step-back technique divided according to Mullaney?

A. Phase I: Preparation of the coronal third, Phase II: Preparation of the apical third

B. Phase I: Preparation of the apical third, Phase II: Preparation of the coronal third

C. Phase I: Preparation of the entire canal, Phase II: Final shaping of the canal
D. Phase I: Preparation of the middle third, Phase II: Preparation of the coronal third

3. What is the purpose of recapitulation during Phase I of the step-back technique?

A. To remove debris from the coronal third of the canal

B. To evaluate the carious tooth before treatment

C. To break up apical debris and irrigate the canal

D. To refine the root canal with larger files

4. How are Gates Glidden drills used in the step-back technique?

A. To prepare the apical third of the canal

B. To remove debris from the canal walls

C. To create coronal flaring in the root canal

D. To recapitulate the canal with smaller files

5. Which statement best describes the advantage of the step-back technique?

A. It reduces the risk of pushing debris into periradicular tissues

B. It straightens the curved canal efficiently

C. It is a time-saving technique compared to other methods

D. It provides better tactile awareness and maintains a gradual taper from apical to coronal

6. What is a disadvantage of the step-back technique?

A. It tends to transport the canal and create ledges

B. It is difficult to insert instruments into the canal

C. It does not provide proper apical stop preparation

D. It is not effective for curved canals

7. Which type of step-back technique involves starting the procedure 2–3 mm short of the minor
diameter/apical constriction?

A. Modified Step-Back Technique

 B. Passive Step-Back Technique

C. Aggressive Step-Back Technique

D. Dynamic Step-Back Technique

8. What is the primary advantage of the modified step-back technique?

A. It reduces procedural errors like canal transportation

B. It provides better tactile awareness during instrumentation

C. It creates a wide apical preparation

D. It enables preparation of the entire canal in a single phase

9. Which type of step-back technique involves a combination of hand and rotary instruments?

A. Modified Step-Back Technique

B. Passive Step-Back Technique

C. Dynamic Step-Back Technique

D. Aggressive Step-Back Technique

10. What is the key recommendation to remember during the step-back technique?

A. Work in a dry field and avoid irrigation

B. Recapitulate the canal infrequently

C. Use rotary instruments exclusively

D. Work in a wet field, irrigate often, and recapitulate often

Answers:

1. B. Ensuring the apical portion of the canal is free of debris by using a small file through
the apical foramen
2. B. Apical patency aims to prevent blockage of the foramen, while apical clearing
determines the working width.
3. C. Promotion of biofilm formation
4. B. It facilitates the movement of irrigants in the apical third, enhancing interaction and
clearing of debris.
5. C. By ensuring a smooth glide path and preventing ledges and perforations
6. A. Blocked canals due to physiological deposition of cementum
7. C. By using viscous chelating agents and pre-curved files for canal negotiation
8. C. Ensuring a patent apical foramen for effective irrigation and obturation
9. D. Patency filing
10. D. By preventing apical extrusion of debris and reducing the risk of acute inflammatory
responses

Answers:

1. B. Gradually tapering the canal from apical to coronal

2. B. Phase I: Preparation of the apical third, Phase II: Preparation of the coronal third
3. C. To break up apical debris and irrigate the canal
4. C. To create coronal flaring in the root canal
5. D. It provides better tactile awareness and maintains a gradual taper from apical to
coronal
6. A. It tends to transport the canal and create ledges
7. A. Modified Step-Back Technique
8. A. It reduces procedural errors like canal transportation
9. B. Passive Step-Back Technique
10. D. Work in a wet field, irrigate often, and recapitulate often