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Challenge
979
I I . The most reliable agent for destroying microorganisms
is which of the following?
a. Chemical sterilizing agents
b. Hot water
c. Ultrasonics
d. X-ray irradiation
e. Heat
1 2. A good, two-stage technique (i. c. , two burs in sequence)
for access through a porcelain fxed-to-metal crown i s
which of the following?
a. Stainless steel (55), round-diamond, coated fssure
b. Diamond-coated, round-carbide, end-cutting fssure
c. SS fssure, carbide. end-cutting fssure
d. carbide, round-diamond, coated, round fssure
e. 55, round-carbide, end-cutting fssure
13. An advantage that nickel titanium (NiTi) has over 5S for
intra canal instruments is which of the following?
a. Lower cost
b. More resistance to breakage
c. Sharper
d. More uniform in shape
e. More fexibility
CHAPTER 7: TOOTH MORPHOLOGY
AND CAVITY PREPARATION
I . Which of the following statements describes dens-en
dente?
. a. It occurs primarily in maxillary, lateral, incisor teeth.
b. It requires the use of a long-shank bur for access
because the pulp chamber is located in the middle
portion of the root.
c. It results in an unrreatable, periodontal pocket.
d. It produces an evagination of dentin and enamel in
mandibular premolars.
2. The incidence of three roots and three canals in maxil
lary frst premolars is which of the following?
a. Less than 1 %
b. 3%
c. 6%
d. 10%
3. Vertucci noted i n maxillary second premolars which of
the following?
. a. \hen two canals were present and join at the apex,
the lingual canal is the straightest.
b. The incidence of t\vo canals at the apex was high,
approaching 75%.
c. The incidence of accessory canals found in the furca
tion was 59%.
d. Histologically, calcifcation correlated with the radio
graphic narrowing of the canal space.
980 CHALLENGE A Se(fAssessmenl Exam
4. In their study of maxillary molars, Kulild and Peters
noted which of the following?
a. Although two canals were ofen present in the mesio
buccal roots, the canals merged apically.
b. The use of magnifcation did not increase the number
of canals found clinically in this tooth group.
c. The orifce to a second canal in the mesiobuccal root
was distal to the main orifce in a line connecting the
mesiobuccal canal to the palatal canal.
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d. A high incidence of two canals with separate foram
ina in the mesiobuccal root (71 %).
5. When treating a mandibular incisor with two canals evi
dent on the preoperative radiograph, which of the fol
lowing statements are true?
a. The internal morphology of the canals will be ribbon
shaped.
, b. A facial-access opening might be considered.
c. The canals ofen remain separate and distinct through
out the root.
d. The access opening should be triangular with the
apex at the cingulum.
6. Which of the following teeth is most likely to exhibit
C-shaped morphology?
a. Maxillary frst premolar
b. Maxillary frst molar
@ c. Mandibular frst premolar
d. Mandibular frst molar
7. In their study of mandibular molars, Skidmore and
Bjorndal noted which of the following?
Q a. The access opening should be rectangular.
b. When there were two canals in the distal root, they
remained distinct with separate apical foramina.
c. The incidence of four canals was over 50%.
d. The mesiobuccal canal was located under the mesio
buccal cusp tip and exhibited the straightest morph
ology.
8. The mandibular, second molar should be restored with a
crown after endodontic treatment for which of the fol
lowing reasons?
a. The pulp chamber is relatively large in comparison to
the crown, making the tooth susceptible to fracture.
b. The tooth is in close to the insertion of the muscles of
mastication, and the percentage of preexisting frac
tures is high.
c. There is a tendency for the buccal CllSpS to shear of
under occlusal loading.
d. Providing a post can be placed in the distal root to
strengthen the rOOL
9. Which of the following statements regarding the
dibular. second molar exhibiting a C-shapcd ro
ogy is correct?
a. The root morphology varies with two separate
distinct roots being a common fnding.
b. Research indicates that the presence of a C-
canal is most common in Caucasians.
c. The C-shaped molar exhibits a ribbon-shaped
with a 180-degree arc beginning in the mesiL-
area and forming an arch extending lingually I
distobuccal.
" d. The mesiolingual canal is often noted to be S
and distinct, exhibiting a separate foramen.
I O. A 30-year-old male patient is being treated for a
lary cenrral incisor that he traumatized as a [<1
Radiographically, the canal appears calcifed and <:
evidence of apical pathosis. A fer attempting acces
canal cannot be located despite drilling into the
third of the root. Which of the following stal
regarding further treatment is false?
a. Radiographs may indicate the orientation
access opening within the root.
b. The risk of perforation will be greatest on the
surface. should the clinician continue.
c. The clinician should consider obturating the
segment and performing root end surgery.
d. Because canals become less calcifed as theY
apically, a pathfnder might be used to neg
residual canal space.
CHAPTER 8: CLEANING AND SHAPING
THE ROOT CANAL SYSTEM
1 . \Vhich of the following statements regarding 5:
procedures is false?
a. Shaping is performed after cleaning of the
third of the canal to ensure patency.
b. Shaping facil itates placement of instrur
working length by increasing the coronalm
c. Shaping permits the a more accurate a5''
the apical, cross-sectional canal diameter.
d. Shaping is a necessary procedure becaus
tion occurs from the coronal portion of t
the apex.
,
I
2. Which of the following statements best describes the
Profile Series 29 fles?
a. The Profle Series 29 fles conform to the !Hera
tional Standards Organization (ISO) specifcations
for instrument design.
q b. The instruments exhibit a constant percentage
change between successive instruments.
c. The Profle Series 29 fles were designcd to facilitate
preparation of the coronal portion of the radicular
space.
d. The instruments are most useful in the larger sizes
because there is a smaller change in diameter
between the fles.
3. Each of the following are direct advantages of pre
enlarging the radicular space, excepT for one. Which is
the e.rceplioll?
a. It provides better tactile control of instruments when
negotiating a small, curved canal.
b. It removes the bulk of tissue and contaminants before
apical preparation.
g c. It facil itates obturation.
d. It provides a reservoir for the irrigant.
4. The result of root canal treatment in establishing patency
is which of the following?
Challenge 983
1 6. The dark tooth in the following illustration has a history
of trauma and root canal trcatment. It is likely that the
discoloration is primarily caused by which of the fol
lowing?
a. Remnants of necrotic tissue
b. A leaking restoration
L. Blood pigments in the dentinal tubules
" d. Obturating materials not removed from the chamber
1 7. Of the following, what is the most likely cause offailure
of root canal treatment on the lateral incisor in the illus
tration?
a. The silver point corrodes.
b. The canal is flled too close to the apex.
c. There is coronal leakage.
d. The silver point does not adapt to the prepared space.
984 CHALLENGE A Se/ssessmen Exam
CHAPTER 1 0: RECORDS AND LEGAL
RESPONSIBI LITIES
l . Concering making changes in a patient record, which
oflhe following statements i s accurate?
a. Any changes are forbidden.
h. Deletions are permitted if erased completely as soon
as they occur.
c. Corrections are permitted if dated.
2. Standard of care, as defned by the courts, is which of the
following?
a. Requires absolute perfection
b. Describes what any careful-and-prudent clinician
would do under similar circumstances
c. Does not allow for individual variations of treatment
d. Is equivalent to customary practice
3. The doctrine of informed consent does not require
which of the following?
a. Patients to be advised of reasonably foreseeable risks
of treatment
b. Patients to be advised of reasonable alternatives
c. Patients forfeit their right to do as they see ft with
their body.
d. Patients be advised of the consequences of nontreat
mcnt.
4. Which of the following statements accurately describe a
periodontal examination of a patient referred for endo
dontic treatment?
a. It should performed on the entire dentition.
b. It must be performed at least on the tooth to be treated.
c. It i s necessary only if there is evidence of periodontal
disease.
d. It is necessary only i f requested by the referring
dentist.
5. A dentist may legally do which of the following?
a. Refuse to treat a new patient, despite severe pain and
infection
b. Be bound to see a fonner patient on recall afer treat
ment i s completed
c. Discharge a patient from the practice at any time
d. Refse to treat a patient who has an outstanding
account balance
6. If a patient with human immunodefciency virus (HIV)
requests that the dentist not inform the staf of the con
dition, the dentist should do which of the following?
a. Refuse to treat the patient
b. rell the staffin private, and then treat the patient with
extra precautions
c. Not tell the staf but treat the patient with great cau
tion
d. Not tell the staf and require the patient to assume lia
bility should anyone contract the virus
7. A specialist may be held liable if which of the foil"
occurs?
a. Infomls the patient that the general practitioner p
formed substandard care
b. Fails to disclose to the patient or referring denti
dent pathosis on teeth other than those the sp
-
is treating
c. Fails to locate a small canal that is not evident r
graphically
d. Ilistakenly initiates treatment on the wrong to
a difcult diagnostic situation
8. Of the following, which is the best way for cl inic
avoid legal actions by patients?
a. Tell patients they have no malpractice insurance
b. Anend continuing education courses to
informed of current techniques.
c. Refer all major patient complaints to peer re\;
d. Demonstrate genuine interest in the welfare of
patient.
9. Computerized treatment records may not be signe.
tronically.
a. True
b. False
10. Suing to collect fees is a proven route to being "
sued for malpractice.
a. True
b. False
I I . Standard of care for routine endodontics is set
of the following?
a. The state's dental licensing agency
b. Endodontists
c. The community of general dentists
1 2. A patient continues to have pain after a dena
technique of Parafonnaldehyde paste pulpot
tooth with a necrotic pulp and apical pathosis
places a crown. In this situation, which of the f ..
.
"::
statements is true?
a. The dentisr is liable for malpractice b.
ceptable treatment procedures were followe
b. The dentist is not liable if the patient i s no
.
=
to the appropriate specialist who can treat t
\. The dentist is not liable if the dentist perf
tional treatment for no fee.
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a. There is no reaction; the pulp appears normal
b. The odontoblast layer is disrupted, and there
.
infammation.
c. Odontoblasts are aspirated into tubules, ad .
mild infammation.
d. Odontoblasts are absent, and there is extr.,
erythrocytes.
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17. This is an area of pulp close to a carious exposure (see
the following i llustration). Thc infammatory response is
primarily which of the following?
a. Acute
b. Chronic
c. Giant cell
d. Vascular
1 8. The early infammatory cell infltrate response of the
pulp to caries i_volves primarily which of the following?
a. Neutrophils
b. Macrophages
c. Neutrophils, plasma cells, and lymphocytes
d. Macrophages and lymphocytes
e. Lymphocytes, plasma cells, and macrophagcs
1 9. Hypersensitivity of the pulp after restoration placement
indicates which of the following?
a. Acute infammation in the pulp
b. Chronic infammation in the pulp
c. MicroJeakage at the restoration and tooth interface
d. Stimulation of sensory nerves by hydrodynamics
e. Tubules are blocked by restorative material or smear
layer or both
CHAPTER 1 6: TRAUMATIC INJURIES
1. If several teeth are out of alignment after trauma, the
most reasonable explanation is which of the following?
. Luxation
b. Subluxation
. c. Alveolar fracture
d. Root fracture
Challenge
993
2. Initial vitality testing oftraumatized teeth is most useful
to which of the following?
. . a. It establishes a baseline for comparison with future
testing.
b. It detennines whether root canal treatment is indi
cated.
c. It determines if the blood supply to the pulp is com
promised.
d. It predicts the prognosis.
3. A nonnal periapical radiograph ora traumatized tooth is
useful for which of the following?
a. It visualizes most root fractures.
b. It visualizes concussion injuries.
* L. It gathers baseline information.
d. It locates foreign objects.
4. Which of the following statements regarding crown
infraction is accurate?
5.
a. It may indicate luxation injuries.
b. It is rarely seen on transillumination.
c. It seldom requires a follow-up examination.
d. It describes the process of coronal pulp necrosis.
Which of the following statements regarding uncompli
cated crown fracture is accurate?
a. It is an indication for a dentin-bonded restoration.
b. It requires baseline pulp testing.
c. It involves root canal treatment if the exposed dentin
is sensitive to cold stimulus.
d. It has a questionable long-term prognosis.
e. It is managed differently in young versus older
patients.
6. Which of the fol l owing statements regarding compli
cated crown factures is accurate?
. Exposure to the oral cavity permits rapid bacterial
penetration through the pulp.
b. Infammation is limited to the coronal 2 mm of the
exposed pulp for the frst 24 hours.
c. The tooth is nonnally managed by root canal treat
ment and restoration.
7. Which of the following statements regarding replace
ment resorption is accurate?
+
a. It results from direct contact between root, dentin,
and bone.
b. It is managed by surgical exposure and repair with a
biocompatible material.
c. It results when at least 75% of the root surface is
damaged.
d. It can be avoided by timely endodontic intervention.
994 CHALLENGE A SelAssessmen Exam
8. Pulp necrosis is most likely to occur after which of the
following?
a. Midroot fracture
b. Intrusive luxation
c. Concussion
d. Compl icated crown fracture
9. Which of the following statements regarding cervical
root resorption is accurate?
a. It is a common. self-limiting result ofluxation injury.
b. It causes signifcant pulpal symptoms.
c. It can be arrested by root canal treatment.
' d. It may extend coronally to present as a pink spot on
the crown.
10. Which of the following statements regarding internal
root resorption is accurate?
a. It is more common in permanent than deciduous
teeth.
b. It is simple to differentiate fom other types of
resorption.
, c. It is characterized histologically by infammatory
tissue with multinucleated giant cells.
d. It is ruled out when there is no response to pulp
testing.
I I . A luxated 100th should be splinted in which of the fol
lowing sinttions?
*
a. If the tooth is mobile after spl inting
b. Until the root canal treannent is completed
c. With the composite as close to the gingiva as possible
d. All orthe above
12. Which medium of storage for an avulsed tooth is best for
prolonged extraoral periods?
a. Hanks balanced salt solution
b. Milk
c. Disrilled water
d. Saliva
1 3. The most important factor for managing avulsions is
which of the following?
a. Extraoral time
b. Decontamination of the root surface
c. Prompt initiation ofroat canal treatment
d. Proper preparation of the socket
1 4. Tooth mobility after trauma may be because of which of
the following"
a. Displacement
b. Alveolar fracture
c. Root fracture
d. Crown fracture
e. All of the above
1 5 . Which of the following is true about thermal and
trical tests after trauma?
a. Sensitivity tests evaluate the nerve and eire
condition of the tooth.
b. False-positive tests are more likely than false-
live tests.
"" c. It may take up to 9 months for normal blood f
renlfll.
d. None of the above statements are accurate.
1 6. \Vhich of the following statements regarding i
root resorption is accurate?
a. It is rare in deciduous teeth.
b. It is initiated by odontoblasts.
c. It is seldom confused with exteral resorption.
d. It is usually asymptomatic.
1 7. Which of the following statements regarding av
teeth is accurate?
a. They can be treated endodontically outside the
in limited circumstances.
b. They should be rigidly spl inted for 3 to 4 wek
allow periodontal support to mature.
c. They generally do not require antibiotic treatm=
the time of replantation.
d. They should have apexifcation attempted when
apex is not closed.
CHAPTER 1 7: ENDODONTIC AND PERIODONTIC
INTERRELATIONSHIPS
I . According to Gutmann, molar teeth are most like
have accessory and lateral canals:
a. Branching from the main canal to form an apical d
b. In the apical one third of the root
c. On the lateral surface of the root
d. In the fllrcation
2. Which of the following statements regarding palat
gival grooves is false?
a. The incidence of palata gingival grooves ranges f
1 0% to 20% of the population.
b. The maxillary lateral incisor is afected more that t
central incisor.
c. The grooves extend apically in varying distance
with less than 1 % reaching the apex.
d. Pulp necrosis frequently occurs in teeth with pal2
gingival grooves because of the lack of cemenn=
covering the dentin.
3. The prognosis for a tooth with a perforation is affected
by all of the following factors, except Jor ole. Which i s
the exception?
a. Location of the perforation
b. The time of repair
c. The ability to seal the defect
d. The ability to perform root canal treatment on the
remaining canals
e. The placement ofa poSt to retain the core afer perfo
ration repair
4. Which of the following statements best describes retro
grade periodontitis?
a. Inflammation from the periodontal sulcus migrates
apically, causing pulp infammation and eventually
pulp necrosis.
b. Pulp necrosis occurs, and the toxic irritants cause
infammation that migrates to the gingival margin,
creating a periodontal pocket.
c. Irritants gain access to the periodontal tissues at the
site of a vertical-root fracture, producing tissue
destruction that mimics periodontitis.
d. Pulp necrosis results in the formation of an apical,
radiolucent lesion characterized by the loss of the
apical lamina dura.
5 . Which of the following statements best describes the
efect periodontal disease has on the dental pulp?
a. There i s a direct correlation between the severity of
the periodontal disease and the percentage of pulps
that become necrotic.
b. When periodontal disease or the treatment of the dis
ease exposes a lateral or accessory canal. complete
pulp necrosis will result.
c. Although periodontitis can cause pulp infammation
and necrosis, treatment procedures have little efect
on the pulp.
d. Periodontal disease that does not expose the apical
foramen is unlikely to produce signifcant damage to
the pulp.
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Challenge
995
6. Which of the following statements regarding the pri
mary endodontic lesion with secondary periodontic
involvement is correct?
O Pulp necrosis occurs initially and an apical lesion
forms. Apical migration of periodontal disease
results in communication between the two lesions.
b. Treatment consists of pClforming endodontic treat
ment, which is followed by a 6-month recall exami
nation. If the periodontal component is still present,
periodontal therapy is initiated.
c. The primary endodontic lesion with secondary peri
odontic involvement exhibits a poorer prognosis
when compared with the primary periodontal lesion
with secondary endodontic involvement.
d. Pulp necrosis occurs and forms a sinus tract through
the periodontal ligament that, over time, permits the
accumulation of plaque and calculus on the root.
7. Which of the following statements regarding root resec
tion is false?
a. Success depends primarily on treatment planning and
case selection.
b. Failures occur primarily because of continued peri
odontal breakdown.
c. The long-term prognosis for the pulp in teeth with
vital-root resection is poor.
d. Endodontic treatment should precede resection of a
root.
8. Which of the following statements regarding guided
tissue regeneration (GTR) is false?
a. GTR is an effective adjunct to treatment of peri
odomal disease but has limited value in treating
endodontic pathosis.
b. The combined endodontic periodontic lesion has the
least favorable prognosis for GTR because of the
relationship of the lesion to the gingival margin.
c. Bioresorbable membranes exhibit results similar to
nonresorbable membranes.
d. Evidence suggest that GTR enhances bone formation
by preventing contact of connective tissue with the
bone.
Challenge
1001
2. Which of the following statements is correct regarding
the incidence of cervical resorption afer internal
bleaching?
a. Cervical resorption can be as high 25% when Super
oxyl and heat are used.
b. Lesions develop rapidly and can be detected I to 2
months after bleaching.
c. The incidence of cervical resorption increases
patients who are 25 years old and older.
d. Although cervical resorption is often attributed to
bleaching, it is more l ikely caused by a previous trau
matic injury to the involved tooth.
3. Each of the following is an intrinsic form of tooth dis
coloration, excepf Jar one. Which is the exception?
a. Endemic fuorosis
b. Hereditary opalescent dentin
c. Tetracycline staining
d. Peridex staining
4. Which of the following statements regarding microabra
sion is correct?
a. The agent used in the technique is 30% hydrogen per
oxide, which can be obtained in proprietary products,
such > Prem3.
b. The technique is useful in treating white-and-brown
spot surface lesions.
c. Microabrasion should not be used before placement
of bonded restorations.
d. Requires a local anesthetic and frequently produces
postoperative thermal sensitivity.
5. When performing a walking bleach procedure, which of
the following statements is accurate?
a. The dentin should be etched before placement of the
bleaching agent to increase permeability of the
tubules and enJ3nce the bleaching action.
b. The sodium perborate paste should be covered by a
minimum of2 ofCavit or IR.
c. A barrier over the obturating material is not required.
d. The defnitive bonded restoration should be placed at
the visit in which the sodium perborate paste is
removed.
6. Which of the following statements regarding power
bleaching is false?
a. Power bleaching ofen uses a liquid rubber dam com
posed of a light cured resin gel.
b. Vitamin E can be used to neutralize the oxidizing
effects of hydrogen peroxide that comes in contact
with sof tissues.
c. Power bleaching can often be performed by trained
dental auxiliary personnel.
d. After fabrication of custom trays with appropriate
reservoirs, patients apply a bleaching gel every 2
hours during their waking hours.
a. Gram-positive aerobes
b. Gramnegatie anaerobes
c. Mixed flora
d. l one
I I . What is the likely cause of the patient's pain?
a. Infamed pulp
b. Apical abscess
c. Cracked tooth
d. Periodontal abscess
12. What additional tests are indicated?
a. Cold test
b. Heat test
c. Test cavity
d. Transillumination
1 3. \hat type of permanent restoration is indicated?
a. Occlusal amalgam
b. Occlusal bonded composite
c. Pin-retained amalgam
d. Full-cast crown
Questions 1 4 to 20 relate to the following photograph and
radiograph.
The patient reports "a bad toothache for 2 days. I can't bite
on these lower, right, front teeth." There is pain on pressure
and palpation in the region of the lateral incisor and canine.
The premolar (small amalgam) is asymptomatic. The lateral
and premolar respond to pulp testing; the canine does not
respond. There is no swelling. There is an aphthous ulcer on
the facial attached gingiva of the lateral. All probings are
normal. The lateral and canine have moderate mobility.
Challenge 1009
14. Which tooth and tissue are the probable source of pain?
a. Lateral incisor and pulp
b. Canine and pulp
c. Canine and periapical tissue
d. Lateral incisor, canine, and periapical tissue
1 5. What is the likely pulpal and periapical diagnosis for the
lateral incisor?
a. Irreversible; phoenix abscess
b. Normal; chronic apical periodontitis
c. Necrosis; phoenix abscess
d. Reversible; normal
1 6. What is the likely pulpal and periapical diagnosis for the
canine?
a. lrreversible pulpitis; phoenix abscess
b. Normal; chronic apical periodontitis
c. Necrosis; phoenix abscess
d. Necrosis; suppurative apical periodontitis
1 7. Which teeth (tooth) require(s) endodontic treatment?
a. Lateral incisor only
b. Canine only
c. Both the lateral incisor and canine
d. Neither at present
1 8. Which bacteria have been related to this pathosis?
a. Gram-negative rods; anaerobic
b. Gram-positive rods; anaerobic
c. Gram-negative cocci; aerobic
d. Gram-positive cocci; aerobic
1 9. Of the following infammatory cells, which would likely
predominate periapically?
a. Lymphocytes
b. Polymorphonuclear neutrophilic leukocytes
c. Plasma cells
d. Macrophages
20. Looking at the radiograph and clinical photograph, what
is the likely cause of the pulpal and periapical pathosis?
a. Incisal attrition
b. Cervical erosion
c. Caries
d. Impact trauma
1010 CHALLENGE A SelAssessment Exam
Questions 21 to 25 relate to the following radiograph.
The patient reports severe, continuous pain in the mandibu
lar, right quadrant. She states that the pain began when she
was drinking iced tea last evening and the pain has not sub
sided. She slept poorly last night. Medical history is noncon
tributory.
Amalgams were placed a few months earlier afer removal
of deep caries on both molars. She has increased pain on
lying down. The pain is not relieved with analgesics. She
cannot localize the pain to an individual tooth. Pulp testing
shows response on the premolar and second molar. The frst
molar does not respond. Cold-water application causes
intense, difse pain in the region. Percussion and palpation
are not painful. Probings are normal.
2 1 . Which tooth (teeth) is (are) the most likely cause of her
pain?
a. Premolar
b. First molar
c. Second molar
d. First and second molars
22. What is the pulpal and periapical diagnosis for the frst
molar?
a. Necrosis; chronic apical periodontitis
b. Necrosis; phoenix abscess
c. Irreversible pulpitis; chronic apical periodontitis
d. Irreversible pulpitis; acute apical periodontitis
23. What is the pulpal and periapical diagnosis for the sec
ond molar?
a. Irreversible pulpitis; normal
b. Irreversible pulpitis; acute apical periodontitis
c. Irreversible pulpitis; acute apical abscess
d. Nonnal; normal
24. What should be the minimal emergency treatment on te
ofending tooth (teeth)?
a. Remove the amalgam and place a sedative dressin_
Prescribe analgesics and antibiotics.
b. Do a complete canal preparation. Place a conn
pellet of formocresol.
c. Reduce the occlusion and prescribe antibiotics.
d. Perform pulpotomy and place a dry-cotton peUeL
25. Inferior alveolar injection is indicated. If the ofending
tooth (teeth) i s (are) not anesthetized, what is the likely
reason?
a. There is a decreased pH in the region favoring for
mation of cations.
b. The anesthetic solution is diluted by the inf -
tory fuids.
c. There may be morphologic changes i n the nerves t
originate in the infamed areas; these nerves becomes
more excitable.
d. Because of infammation, there is increased circula
tion in the area; this carries away the anesthetic n
rapidly.
Questions 26 to 28 relate to the following radiograph.
The patient has no adverse signs or symptoms. Surgery
several years ago. There are no probing defects. The canin
responds to pulp testing.
26. What diagnosis is likely?
a. Chronic apical periodontitis
b. Foreign-body reaction
c. Apical radicular cyst
d. Scar tissue
27. What is the likely cause?
a. Continued irritation from an undebrided, unsealed
canal
b. Adverse reaction to corrosion of the amalgam
c. Coronal leakage
d. Perforation of both cortical plates.
28. What should the treatment plan be?
a. Replace the crown; retreat the canal.
b. Perform another surgery and place another root end
material.
c. Place the patient on antibiotics to resolve the lesion.
d. No treatment is needed.
Questions 29 to 35 relate to the following clinical photo
graph and radiograph.
Challenge
1 01 1
A 58-year-old woman has swelling i n the maxillary anterior
area that has steadily increased for 2 days. She denies thermal
sensitivity and tenderness to biting pressure. The swelling is
between teeth nos. 9 (cenlral incisor) and 1 0 (l ateral incisor).
There is normal mobility, and probing depths are 4 to 5 m
with the distofacial surface of tooth no. 9 probing 8 mm.
There is no tenderess to percLission, but there is tenderess
to palpation. Pulp tests reveal Ihat teeth nos. 8, 9, 1 0, and I I
are responsive to electrical-pulp testing and to thermal stim
ulation with carbon dioxide snow (i . e. , dry ice).
29. Based on this information, the clinical photograph, and
the radiograph, what is the pulpal diagnosis for tooth no
.
9?
a. Normal
b. Reversible pulpitis
c. Irreversible pulpitis
d. Necrotic
30. Based on this information, the clinical photograph, and
the radiograph, what is the pulpal diagnosis for tooth no.
1 0'>
a. Normal
b. Reversible pUlpit is
c. Irreversible pulpitis
d. Necrotic
3 1 . What is the periradicular diagnosis for tooth no. 9?
a. Normal
b. Chronic apical periodontitis
c. Chronic suppurative, apical periodontitis
d. Acute apical periodontitis
e. Acute periodontal abscess
1012 CHALLENGE A Se/Assessmen Exam
32. Which of the following is the most likely the cause of
swelling associated with teeth nos. 9 and 1 0?
a. Pulp necrosis
b. Periodontal disease
c. A developmental groove defect
d. Vertical-root fracture
e. Peripheral giant-cell granuloma
33. Which of the following is most important in determining
if this lesion is of periodontal origin or of pulpal origin?
a. Percussion
b. A periapical radiograph
c. Periodontal mobility and mobility assessment
d. Pulp testing
e. Periodontal probing
34. Treatment of this case requires which of the following?
a. Periodontal scaling, root planing of the area. and
drainage
b. Root canal debridement of tooth no. 9, followed by
incision and drainage
c. Analgesic treatment and antibiotic treatment until the
involved tooth can be localized
d. Flap refection to inspect the root for a vertical root
fracture or lateral canal
e. Surgical excision and biopsy
35. Which of the following statements is 'rue regarding the
effects of periodontal treatment procedures on the dental
pulp?
a. Scaling and root-planing procedures remove cemen
tum, expose dentinal tubules, which are invaded and
result in pulp infammation.
b. Citric acid application appears to produce pulpal
infammation when used i n conjunction with reat
tachment procedures.
c. Hypersensitivity may result from scaling but is a sign
of pulpal pathosis or infammation or both.
d. Scaling and root-planing procedures may produce
deposition of tertiary dentin.
ANSWER KEY
Chapter 1
I . b; 2. d; 3. b; 4. b; 5. b; 6. d; 7. a; 8. c; 9. c; 1 0. c; I I . e; 1 2.
d; 1 3. b; 1 4. a; 1 5 . c; 1 6. d; 1 7. d; 1 8. c; 1 9. d: 20. b.
Chapter 2
I . d; 2. e; 3. c: 4. a; 5 . b; 6. b; 7. b: 8. b; 9. b; 1 0. c; I I . b; 1 2.
b; 1 3. a; 1 4. b; 1 5 . c; 1 6. b; 1 7. a; 1 8. a; 1 9. b; 20. d: 2 I . c; 22.
a; 23. b; 24. c.
Chapter 3
I . d; 2. b; 3. b; 4. d; 5 . c; 6. c; 7. c; 8. a; 9. a; 1 0. e; I I . b.
Chapter 4
I . d; 2. c; 3. b; 4. c; 5. d; 6. c; 7. d; 8. c; 9. c; 1 0. a; I I . L. 1:"
d.
Chapter 5
I . b; 2. c; 3. d; 4. b; 5. a; 6. c; 7. d; 8. a; 9. c; 1 0. c; I I . L. 1 2
d; 1 3. c; 1 4. a; 1 5. c; 1 6. a; 1 7. a; 1 8. d; 1 9. c; 20. b; 21 .
Chapter 6
I . a; 2. c; 3. b; 4. a; 5. b; 6. d; 7. b; 8. c; 9. a; 1 0. b; I I . C. t:
b; 1 3. c.
Chapter 7
1 . a; 2. c; 3. a; 4. d; 5. b; 6. c; 7. a; 8. b; 9. d; 1 0. b.
Chapter 8
I . a; 2. b; 3. c; 4. a; 5. c; 6. d; 7. b; 8. d; 9. b; 1 0. d; I I . < L
a.
Chapter 9
I . c; 2. d; 3. a: 4. c; 5. e; 6. d; 7. a; 8. d; 9. c; 1 0. b; I I . b:
a; 1 3 . a; 1 4. a; 1 5. a; 1 6. d; 1 7. d.
Chapter 1 0
I . c; 2. b; 3 . c; 4. b; 5 . a; 6 . a; 7 . b; 8 . d; 9. b; 10. a; I I . b:
a.
Chapter 1 1
I . c; 2. a; 3. b; 4. a; 5. b; 6. b; 7. a; 8. d; 9. b; 1 0. d; I I . M. C
d; 1 3. c; 1 4. b; 1 5 . b; 1 6. a.
Chapter 1 2
I . c ; 2 . a; 3 . b; 4. b; 5 . c; 6 . a; 7 . c ; 8 . a; 9. d; 1 0. a; I I . r:
-
b; 1 3 . b; 1 4. c; 1 5. a.
Chapter 1 3
I . d 2. c 3 . a 4. a 5 . c 6 . d 7 . b; 8 . d 9. b; 1 0. e l l . d 1 2. b: :3
e 1 4. b; 1 5. c; 1 6. c; 1 7. c; 1 8. d; 1 9. e; 20. b.
Chapter 1 4
1 . a; 2 . c; 3 . a; 4. b; 5 . a; 6 . a; 7 . c; 8 . a; 9. c; 1 0. e; 1 1 . I':
c; 1 3. a; 14. b; 1 5 . b; 1 6. d; 1 7. b; 1 8. c; 1 9. a; 20. d.
Chapter 1 5
I . d; 2 . d; 3. a; 4 d; 5 . a; 6. a; 7 . a; 8 . b; 9. d; 1 0. c; I I . I r:.
d; 1 3 . b; 14. d; 1 5. b; 1 6. b; 1 7. a; 1 8. e; 1 9. d.
Chapter 1 6
1 . c; 2. a; 3. c ; 4. a; 5 . b; 6. b; 7. a; 8. b; 9. d; 1 O. c; 1 1 . ! 2
a; 1 3. a; 1 4. e; 1 5. c; 1 6. d; 1 7. b.
Chapter 1 7
I . b; 2. a; 3. e; 4. b; 5. d; 6. d; 7. b; 8. a; 9. b; 10. a.
..
Chapter 1 8
I . a ; 2 . a ; 3 . a ; 4. a; 5. a ; 6. a; 7 . a; 8 . a ; 9. b; 1 0. d; I I . a; 1 2.
b; 1 3. a; 1 4. a; I S. b; 1 6. e; 1 7. b; 1 8. a; 1 9. a.
Chapter 19
I . e; 2. e; 3. a; 4. d; 5. a; 6. d; 7. c; 8. a; 9. b; 1 0. d; I I . b; 1 2.
e ; 1 3 . b; 1 4. a ; I S. d.
Chapter 20
I . a; 2. d; 3. d; 4. b; S. c; 6. c; 7. b; 8. a; 9. d; 1 0. a; I I . a; 12.
a; 1 3. c; 1 4. d; I S. a; 1 6. b; 1 7. c; 1 8. b; 1 9. d.
Chapter 21
I. a; 2. a; 3. d; 4. b; S. b; 6. d.
Chapter 22
l . d; 2. a; 3. b; 4. d; S. e; a; 7. d; 8. b; 9. d; 1 0. d.
Chapter 23
I . d; 2. e; 3. d; 4. d; S. b; 6. d; 7. e; 8. b; 9. a; 1 0. e; I I . a; 1 2.
b; 1 3. b; 14. d.
Chapter 24
Challenge
1013
I . e; 2. d; 3. a; 4. e; 5. a; 6. d; 7. e; 8. e; 9. e; 1 0. a; I I . d; 1 2.
b; 1 3. e; 1 4. c; 1 5. b; 1 6. a; 1 7. d.
Chapter 25
I . d; 2. b; 3. d; 4. c; 5. e; 6. a; 7. a; 8. d; 9. a; 1 0. d; I I . c; 1 2.
d.
Chapter 26
I . c; 2. a; 3. c; 4. a; 5. d
Test Your Knowled
g
e
I . d; 2. d; 3. c; 4. b; S. a; 6. b; 7. a; 8. d; 9. d; 1 0. e; I I . e;
1 2. d; 1 3. d; 14. e; 1 5 . d; 1 6. e; 1 7. b; 1 8. a; 1 9. b; 20. a; 2 1 .
e; 22. a; 23. a; 24. d; 25. e. 26. d; 27. d; 28. d; 29. a; 30. a;
3 1 . e; 32. b; 33. d: 34. a; 35. d.