ENDODONTICS-PERIODONTICS REVALIDA 2

1. Gingivectomy is indicated in the following, except:

A. Leukemic gingival enlargement

B. Idiopathic fibromatosis of the gingiva
C. Dilantin gingival enlargement
D. Nifedipine gingival enlargement

2. The following are true regarding shaping procedures, except:

A. Shaping is performed after cleaning of the apical one third of the canal to ensure
patency.
B. Shaping facilitates placement of instruments to the working length by increasing the
coronal taper.
C. Shaping permits a more accurate assessment of the apical, cross-sectional canal
diameter.
D. Shaping is a necessary procedure because calcification occurs from the coronal
portion of the canal to the apex.

3. With a mechanically exposed pulp, the BEST prognosis is offered by:

A. Direct pulp cap

B. Indirect pulp cap
C. Resection
D. Pulpotomy
E. Pulpectomy and root canal obturation

4. In cases involving conventional endodontics, the MOST frequent cause of failure is:

A. Incomplete obliteration of the main canal

B. External root resorption
C. Apical overfilling of the canal
D. The presence of coexistent periodontal lesion
E. Inadequate filling of accessory canals

5. . The most important route of bacteria into the dental pulp is from:

A. General circulation via anachoresis.

B. Exposure to the oral cavity via caries.
C. The gingival sulcus.
D. None of these.
6. Which of the following should be FIRST in the sequence of treatment?

A. Resolution of the lesions associated with the mandibular left first molar
B. Correction of marginal ridge discrepancy between mandibular right second premolar and
first molar
C. Removal of overhanging restoration on the maxillary left first molar
D. Endodontic therapy on the first maxillary left lateral incisor
E. Scaling and root planing of all teeth, except the mandibular left first molar

7. All of the following are clinical signs of bruxism. Except?

A. Cracked teeth of fillings

B. Wear facets on teeth
C. Muscle soreness
D. Periodontal pocket formation
E. TMJ symptoms

8. Based on clinical and radiographic examinations, which of the following teeth has the
POOREST long-term prognosis

A. Maxillary left canine

B. Maxillary right second molar
C. Mandibular left second molar
D. Maxillary right second premolar
E. Mandibular right second premolar

9. Which of the following is an indication for RCT of primary teeth?

A. Radiographic evidence of internal root resorption

B. Periapical lesion
C. Mechanical or carious perforation of the chamber floor
D. Dentigerous cysts

10. The most reliable factor that will help determine if the canal is ready for obturation is:

I. tooth is asymptomatic and functional

II. negative culture test result
III. no foul odor
IV. all of the choices

11. Radiographically, which of the following statements regarding canals that appear calcified
are accurate?

A. They are seldom able to be instrumented.

 B. They have a different appearance than the surrounding dentin.
C. They should be opened up with rotary rather than ultrasonic instruments.
D. All of the above.

12. In the older patient, the exit of the canal is:

A. Closer to the radiographic apex.

B. easier to detect tactilely
C. Closer to the true apex
D. More variable because of cementum formation

13. Which of the following teeth is most likely to exhibit C Shaped morphology?

A. Maxillary first premolar

B. Mandibular first premolar
C. Maxillary first molar
D. Mandibular first molar

14. A patient complains of intermittent and spontaneous pain on a tooth that was previously pulp
capped. Radiographs disclose no periapical pathology. The tooth is not sensitive to percussion.
Both cold and heat stimulate a severe and lasting pain. The most probable diagnosis is:

A. reversible pulpitis.
B. Irreversible pulpitis
C. Cracked tooth syndrome
D. Acute apical periodontitis
E. Chronic apical periodontitis

15. Elective endodontic treatment is contraindicated in which of the following?

A. Patient is a borderline diabetic.

B. Patient has had a heart attack within the last 6 months.
C. Patients have had numerous opportunistic infections secondary to HIV infection
D. Patient has an implanted pacemaker

16. The literature suggests that the majority of vertical root fractures of endodontically treated
teeth result from:

A. traumatic occlusion
B. condensation forces during gutta-percha fill
C. locking temporaries into prepared teeth
D. cementing the cast post and core
E. permanent cementing crown
17. Pulpal and periradicular pathosis results primarily from:

A. Traumatic injury caused by heat during cavity preparation.

B. Bacterial invasion.
C. Toxicity of dental materials.
D. Immunologic reactions

18. Microorganisms that colonize periodontal abscess have been reported to be primarily:

A. Gram-positive anaerobic cocci

B. Gram-negative anaerobic rods
C. Gram-positive aerobic cocci
D. Gram-negative aerobic rods

19. Which cells of the immune system possess receptors for the complement component C3q
by which they participate in immediate inflammation?

A. Monocytes
B. Natural killer(NK) cells
C. Peripheral dendritic cells
D. Dermal dendrocytes (histiocytes)

20. Moderate extrusion of obturating materials beyond the apex is undesirable because of which
of the following?

A. There is more likelihood of postoperative discomfort.

B. Sealer and gutta-percha cause a severe, inflammatory reaction in periradicular tissue.
C. The prognosis is poorer.
D. All of the above

21. The patient with rheumatic heart disease should be of special concern to a dentist during
endodontic treatment because

A. Under Instrumentation during treatment of vital cases results in bacteremias

B. Over instrumentation during treatment of infected cases results in bacteremias
C. Endodontic infections are caused by the etiologic agent responsible for streptococcal
sore throat
D. Bacteremias occur during and following the cutting of enamel or dentin with high-speed
instruments
E. All of the above

22. Which of the following regarding gauging and tuning is correct?

A. Gauging is performed in the coronal portion of the canal to confirm if the coronal
 enlargement is complete
B. Tuning identifies the most apical, cross-sectional diameter of the canal.
C. Gauging and tuning verify the completed shaping of the apical portion of the canal.
D. Gauging and tuning produces a uniform, cylindric diameter to the canal in the apical 2 to
3mm that enhances obturation and sealing.

23. Based on clinical and radiographic examinations, the MOST appropriate treatment for the
mandibular left first molar is:

A. Hemisection of e mesial root and subsequent restoration

B. An autogenous bone graft
C. Hemisection of the distal root and subsequent restoration
D. None of the above
E. Extraction and subsequent replacement with a suitable prosthesis

24. The MOST probable reason for root canal; therapy of a mandibular incisor having a
relatively high failure rate is the:

A. Common distal curvature of the root

B. High incidence of accessory canals
C. High incidence of pulpal calcific degeneration
D. Narrow mesiodistal dimension of the root canal
E. High incidence of the two canals

25. In which of the following is one-visit root canal treatment not recommended?

A. The pulp is necrotic and not symptomatic

B. The pulp is necrotic and symptomatic.
C. The pulp is necrotic and there is a draining sinus tract.
D. The pulp is vital and symptomatic.
E. None of the above.

26. Which of the following statements regarding sodium hypochlorite used as a root canal
irrigating solution is accurate?

A. It is buffered to a pH of 12 to 13, which increases toxicity.

B. It exhibits a chelating action on dentin.
C. It should be used in higher concentrations because of the increased free chlorine
available.
D. It is a good wetting agent that permits the solution to flow into canal irregularities.
E. All of the above statements are accurate.

27. A patient complains of thermal sensitivity in her front teeth. Pulp tests indicate a vital tooth
but the radiograph shows a radiolucency in the middle of the root of the maxillary left central
incisor. The MOST probable diagnosis and treatment are

A. Questionable diagnosis- observe and take radiograph in 6-12 months

B. Internal resorption- check vitality and take a radiograph in 6-12 months
C. Internal resorption-extract the tooth
D. Internal resorption- institute root canal therapy
E. Questionable diagnosis- place a root canal filling and perform surgery to repair
the defect

28. Post operative pain after obturation occur when:

A. there is excess cement

B. there is excessive force applied during lateral condensation
C. patient failed to take analgesic after treatment.

29. Which of the following are considerations in coronal pretreatment of an endodontic case?

1. removing caries 2. removing occlusal contacts 3. preventing leakage during therapy 4.

providing for secure position of the rubber-dam clamp

A. 1, 2 & 3
B. 1, 2 & 4
C. 1, 3 & 4
D. 2 & 3 only
E. 2, 3 & 4

30. Which of the following is the MOST difficult pulpal or periapical pathosis to diagnose

A. Chronic pulpitis
B. Necrotic pulp
C. Internal resorption
D. Chronic suppurative apical periodontitis
E. Acute apical abscess

31. Blood at the tip of the paper point removed from the root canal indicates:

A. possible hematoma
B. possible incomplete instrumentation
C. possible incomplete irrigation
D. possible root perforation

32. The smear layer on dentin walls acts to prevent pulpal injury for which of the
following?
A. It reduces diffusion of toxic substances through the tubules.
B. It resists the effects of acid etching of the dentin.
C. It eliminates the need for a cavity liner or base.
D. Its bactericidal activity acts against oral microorganisms.

33. The diagnosis of early necrotizing ulcerative gingivitis is BEST made on the basis of

A. Low grade fever

B. Exfoliative cytology
C. Ulceration of the interdental papilla
D. Bacteriologic examination (smear)
E. Biopsy

34. A barbed broach is most useful for:

A. Coronal-orifice enlargement before establishing the correct working length

B. Removal of cotton, paper points and other objects from the canal
C. Removal of vital tissue from the fine canals
D. Initial planing of the canal walls

35. One objective of root canal obturation is to develop a fluid tight seal. Another
objective is to create a favorable biologic environment for the process of tissue healing.

A. Both statements are TRUE.

B. Both statements are FALSE
C. The first statement is TRUE, the second is FALSE
D. The first statement is FALSE, the second is TRUE

36. The main objective of occlusal equilibration in natural dentition is:

A. Increase shearing action in mastication

B. Prevent myofascial pain syndrome
C. Prevent TMJ pain syndrome
D. Achieve a more favorable distribution of forces to the periodontal ligament

37. In periapical radiographic examination of a person in good general health, a

radiolucent area is found around the apex of a mandibular lateral incisor. There are no
restorations in the tooth, and there is no history of pain. The tooth is vital. Reactions to
hot and cold are normal. The electric pulp tester gives a normal response. The
radiolucent area is PROBABLY a

A. Film artifact
B. Cyst
 C. Periapical osteofibrosis
D. Any of the above
E. Granuloma

38. A periapical lesion was discovered 1 ½ years after RCT on a maxillary central incisor.
Apical curettage and biopsy showed the lesion to be an apical cyst. Two years later, the
lesion is larger than it was before surgery. Which of the following is the most likely cause
of continued failure?

A. Actinomycotic infection
B. Failure to ressect the apex.
C. An unobturated accessory canal
D. Incomplete removal of the apical cyst.
E. Leakage from a poorly debrided and obturated canal.

39. Percolation can cause periapical irritation because of:

A. dead spaces
B. unclean canal
C. excess cement
D. egress of degraded tissue fluid into the periapex
E. all of them

40. Instruments used for pulp canal therapy are sterilized reliably by using

A. Cold sterilization
B. Hot oil
C. An autoclave
D. A glass bead sterilizer
E. Boiling water

41. When is an application of heater-injected gutta-percha potentially beneficial?

A. When there is an open apex

B. The clinician cannot master lateral condensation
C. When the canal is curved and small after preparation.
D. When there are aberrations or irregularities of the canal

42. Prevotella intermedia was formerly known as:

A. Bacteroides melaninogenicus
B. Bacteroides gingivalis
C. Wolinella intermedius
D. Bacteroides intermedius
43. Which of the following perforations has the poorest prognosis?

A. Perforation near the apex

B. Perforation into the furca
C. Perforation through the crown
D. Perforation at the DEJ
E. perforation at the CEJ

44. The mandibular, 2nd molar should be restored with crown after RCT for which of the
following reasons?

A. The pulp chamber is relatively large in comparison to the crown, making the
tooth susceptible to fracture.
B. The tooth is close to the insertion of the muscle of mastication, and the
percentage of preexisting fractures is high.
C. There is a tendency for the buccal cusps to shear off under occlusal loading.
D. Providing a post can be placed in the distal root to strengthen the root.

45. In recurrent necrotizing ulcerative gingivitis, exacerbations and remissions which

occur are based to a significant extent upon

A. Excessive smoking
B. Stressful episodes
C. The amount of suppuration present excessive smoking
D. An increase in the types of causative organisms

46. Gutta-percha cones are BEST disinfected by immersing them for 20 minutes in

A. Eugenol
B. Alcohol
C. Xylol
D. Eucalyptol
E. Quaternary ammonium compounds

47. Which of the following may be used to disinfect gutta-percha points?

A. Dry heat sterilization

B. Flame sterilization
C. Boiling
D. Chemical solutions
E. Autoclave
48. Perforation on the mesial in the cervical third of the root of a maxillary first premolar
is a common error in performing an endodontic procedure because:
 A. the crown tipped distally.
B. The root tends to curve distally
C. The entire tooth tends to tip distally
D. The bur tends to be directed mesially
E. concavity on the mesial root frequently exists.

49. The rationale for placing a ZOE cement base over the gutta-percha filling before
bleaching is that

A. All of the above

B. The whitish color of ZOE will act synergistically with the bleaching agent
to restore the cervical portion of the crown to its original shade
C. Chloroform may soften the gutta-percha and affect the integrity of the root
canal filling
D. Superoxol may penetrate the periapex and cause excruciating pain

50. Alveolar bone loss may be a feature of the following conditions, except:

A. Hyperparathyroidism
B. eosinophilic granuloma
C. Hypophosphatasia
D. erosive lichen planus

51. Which of the following terms refers to reshaping the bone without removing tooth-
supporting bone?

A. Osteoplasty
B. Negative architecture
C. Positive architecture
D. Ostectomy

52. A variation of the laterally positioned flap is called:

A. A free gingival flap

B. A coronally positioned flap
C. A modified Widman flap
D. A double papilla flap

53. All corners of a periodontal flap should be:

A. No answer text provided

B. It doesn’t matter whether the corners of a periodontal flap are sharp or
 rounded
C. rounded
D. Sharp

54. After gingival curettage, the expected result would be:

A. Increase tooth mobility

B. Deeper gingival sulcus
C. Increased edema
D. Shallower gingival sulcus

55. What instrument will you use in debridement of an edematous gingival:

A. subgingival curette
B. hoe
C. scaler
D. ultrasonic scaler

56. Host factors influence the pathogenesis and progression of disease:

A. Localized Aggressive Periodontitis

B. Generalized Aggressive Periodontitis
C. Chronic periodontitis
D. Necrotizing Ulcerative Gingivitis
E. Necrotizing Ulcerative Periodontitis

57. Frequent brushing helps to prevent calculus formation by:

A.Neutralizing local acidity

B. Removing Ca/P ions that attach to tooth surfaces
C. Breaking up the matrix of plaque
D. Removing food particles on teeth and interproximal areas
E. All of the above

58. Which of the following root surfaces is the most likely to be strip-perforated during
canal instrumentation of the mesial root of a mandibular first molar?

A. facial
B. lingual
C. mesial
D. distal

59. In gingivectomy, the incision must follow the bleeding points because they refer to
the bottom of the pockets.
 A. The statement and reason is related.
B. The statement and reason is correct but is not related.
C. The statement is correct but the reason is incorrect.
D. The statement is incorrect but the reason is correct

60. Prevotella intermedia was formerly known as:

A. Bacteroides melaninogenicus
B. Bacteroides intermedius
C. Wolinella intermedius
D. Bacteroides gingivalis

61. How should a periodontal probe be adapted in an interproximal area?

A. it should be parallel to the long axis of the tooth at the point angle
B. it should be parallel to the long axis of the tooth at the contact area
C. it should touch the contact area and the tip should angle slightly beneath and
beyond the contact area
D. it should be perpendicular to the long axis of the tooth in front of the contact
area

62. Although the exact mechanism of formation of calculus is not understood, it is known
that the organic matrix of calculus in humans includes:

A. no living microorganisms
B. an abundance of microorganisms
C. a fusospirochetal complex
D. only by-products of bacterial metabolism

63. Gingival changes evident during pregnancy probably result from the effect of:

A. Estrogen
B. Progesterone
C. Histamine
D. Vit. Deficiency

64. In recurrent necrotizing ulcerative gingivitis, exacerbations and remissions which

occur are based to a significant extent upon

A. An increase in the types of causative organisms

B. Stressful episodes
C. Excessive smoking
D. The amount of suppuration present
65. In a clinically healthy periodontium, the microbial flora is largely composed of:

A. Gram-positive obligate microorganisms

B. Gram-positive facultative
C. Gram-negative obligate microorganisms
D. Gram-negative facultative

66. The key etiologic agent in the initiation of gingivitis and PD is:

A. calculus
B. plaque
C. toothbrush abrasion
D. saliva

67. Tobacco smoking is thought to be a predisposing or a contributing factor in which of

the following conditions?

A. Cyclic neutropenia
B. Gingivitis-periodontitis
C. Chediak-Higashi syndrome
D. Juvenile periodontitis
E. Necrotizing ulcerative gingivitis

68. Responsible for remodeling and degradation of matrix components:

A. proteinases
B. Matrix Metalloproteinases
C. cytokines
D. LipoTeichoicAcid
E.LipoPolySaccharide

69. The main cells involved in chronic infection are lymphocytes and:

A. Macrophages
B. Plasma cells
C. Mast cells
D. Neutrophils

70. A postoperative problem that has been reported to occur with use of fresh hip
marrow bone autografts is:

A. Inflammation in the periodontium

B. Root resorption
 C. Bone overgrowth to the extent that esthetic problems result
D. Loss of graft and involved teeth due to a massive immune rejection
response
E. Severe infection, resulting in loss of the entire alveolus

71. Curettage refers to:

A. Scaling and/or planning of the root surface

B. Removal of dental plaque from the coronal surfaces of teeth
C. Soft tissue debridement of the gingival wall of a periodontal socket
D. Removal of calcified deposits from the gingival sulcus and/or periodontal
pocket

72. Which of the following is/are necessary for osseointegration to be successful:

A. Limited micromotion during healing

B. Minimization of surgical trauma
C. Primary stability of the implant
D. All of the above
E. Uncontaminated implant surfaces

73. Generalized interproximal attachment loss affecting at least 3 permanent teeth other
than first molars and incisors :

A. Localized Aggressive Periodontitis

B. Generalized Aggressive Periodontitis
C. Chronic periodontitis
D. Necrotizing Ulcerative Gingivitis
E.Necrotizing Ulcerative Periodontitis

74. The periodontal ligament is vital to the tooth, except:

A. contains nerves and vascular elements

B. provides the cellular elements of bone and cementum
C. furnishes an elastic sling for holding the tooth
D. allows for physiologic movement of the teeth

75. The most important plaque retentive factor is:

A. overhanging margins of restorations

B. calculus
C. crowded teeth
D. furcations
76. Chronic apical periodontitis is best differentiated from acute apical periodontitis by
which of the following?

A. Pulp testing and radiographic appearance.

B. Pulp testing and nature of symptoms
C. Radiographic appearance and nature of symptoms.
D. Pulp testing, radiographic appearance and nature of symptoms

77. Which cells of the immune system possess receptors for the complement component
C3q by which they participate in immediate inflammation?

A. Dermal dendrocytes (histiocytes)

B. Natural killer (NK) cells
C. Monocytes
D. Peripheral dendritic cells

78. Osseointegration can fail due to:

A. Micromotion during healing

B. All of the above
C. Excessive cantilevering of the prosthesis
D. Occlusal overload
E. Bacterial plaque

79. . Products of subgingival microorganisms that activate chemical mediators of

inflammation:

A. proteinases
B. Matrix Metalloproteinases
C. cytokines
D. LipoTeichoicAcid
E. LipoPolySaccharide

80. When using the periodontal probe to measure pocket depth, the measurement is
taken from the :

A. Base of the pocket to the CEJ

B. free gingival margin to the CEJ
C. Junctional epithelium to the margin of the free gingiva
D. base of the pocket to the mucogingival junction

81. Gingival changes evident during pregnancy probably result from the effect of:
A. Estrogen
B. Progesterone
 C. Histamine
D Vit. Deficiency

82. Pathologic pockets are deepened sulci characterized by:

A. Bone loss and migration of junctional epithelium

B. Bone loss only.
C. Ulceration of lamina propria.
D. Loss of circular epithelium

83. Which of the following cells participate in the early phase of inflammation (early
lesion of gingivitis)?

A. Eosinophils
B. kupffer’s cells
C. Mast cells
D. Epithelioid

84. The bacterial flora in periodontal pockets associated with aggressive periodontitis is
predominantly

A. Negative aerobic cocci

B. Positive aerobic cocci
C. Negative anaerobic rods
D. Positive anaerobic cocci
E. Negative anaerobic cocci

85. Stimulates bone resorption

A. cytokines
B. interleukins
C. LipoPolySaccharide
D. LipoTeichoicAcid
E. Matrix Metalloproteinases

86. Pseudopockets are most likely to be seen in a patient with:

A. acute gingivitis
B. advanced periodontitis
C. inflammatory gingival enlargement
D. NUG

87.The cribriform plate (alveolar bone proper) reveals minute openings which represent:
 A. areas of osteoclastic activity.
B. Regions of hematopoietic activity.
C. Resorption sites of the spongiosa.
D. Attachment sites of Sharpey’s fibers.
E. Regions for passage of vascular and nerve elements.

88. Inadequate margins of restorations should be corrected PRIMARILY because they

A. Interfere with plaque removal

B. Cause mechanical irritation
C. Interfere with mastication
D. Retain food debris
E. Cause occlusal disharmony

89. The collagen found in the gingival:

A. Type 1
B. biochemically similar to the collagen found elsewhere
C. accounts for 90% of the gingival protein
D. has turn over rate as rapid as in the PDL

90. The purposes of periodontal dressings (packs) include all of the following Except:

A.improve patient comfort

B. prevent mechanical injury to healing tissues
C. Maintain the sutured position of the flaps
D. Stop persistent bleeding

91. In assessing the severity or extent of periodontitis in epidemiologic studies of a large

population one would MOST likely use the _____ index.

A. Periodontal (PI)
B. PMA
C. Gingival (GI)
D. Plaque (PL I)
E. Sulcus bleeding (SBI)

92. Products of Subgingival microorganisms that activate chemical mediators of

inflammation:

a. proteinases
b. Matrix Metalloproteinases
c. cytokines
d. LipoTeichoicAcid
 e. LipoPolySaccharide

93. A tissue graft between individuals of the same species but with non-identical genes:

A. graft
B. allograft
C. Alloplast

94. The alveolar bone proper usually consist of:

A. woven bone
B. lamellar bone only
C. bundle bone only
D. bundle bone and lamellar bone.

95. . Which of the following regarding acute apical periodontitis is/are accurate?

A. It is limited to the periodontal ligament (histologically).

B. It is detectable radiographically.
C. It may heal if induced by an infectious agent.
D. All of the above statements are accurate.

96. Gingiva which is free from significant accumulation of inflammatory cells:

A. Normal
B. clinically healthy
C. pristine
D. free gingival

97. Which of these virulence factors of A.Actinomycetemcomitans is responsible for the

killing of PMNs resulting in the destruction of the periodontal disease?

A. Leukotoxins
B. Endotoxins
C. Enzymes
D. Polyclonal
E. lymphocytes activation

98. Which of the following is/are necessary for osseointegration to be successful:

A. Minimization of surgical trauma

B. Primary stability of the implant
C. Limited micromotion during healing
D. All of the above
 E. Uncontaminated implant surfaces

99. Which of these is not a diagnostic feature of occlusal trauma?

A. Widening of periodontal surface

B. Loss of alveolar bone
C. Periodontal pocket formation
D. Increased in tooth mobility

100. Which of the following is not a “principal” collagenous fiber group of the periodontal
ligament?

A. Apical
B. horizontal
C. Oblique
D. Gingivodental
E. none