Endo Don Tics

NURSING*RADTECH*DENTISTRY*CRIMINOLOGY*MIDWIFERY*MEDTECH
LET*PSYCHOMET*RESPIRATORY THERAPY*CIVIL SERVICE*NAPOLCOM

NCLEX*DHA*HAAD* PROMETRIC* UK-CBT

WORKBOOK ENDODONTICS
1. Several of the significant bacteroides species involved in pulpal-periradicular infection have undergone taxonomic
revision. They are now reclassified as:
A. Wolinella and Veillonella species
B. Eubacterium and Fusobacterium
C. Porphyromonas and Prevotella
D. Actinomycetes and Spirochetes
2. Endodontic therapy is contraindicated if the periapical areas associated with a pulpless tooth involves over one-third
of the root because the size of a periapical lesion apparently has no relation to the ability of the body to repair the
lesion:
a. Both the statement and the reason are correct and are related
b. Both the statement and the reason are correct but are not related
c. The statement is incorrect but the reason is correct
d. The statement is correct but the reason is incorrect
3. Which of the following may be used to disinfect gutta-percha points?
a. Dry heat sterilization
b. Flame sterilization
c. Chemical solution
d. Boiling
e. Autoclave
4. Sensory pulpal nerves have which of the following characteristics?
a. Function only as pain mediators
b. May demonstrate selectivity for thermal and chemical stimuli
c. Structurally, they are myelinated fibers that lose their myelin sheath after forming the subodontoblastic
plexus
d. All of the above are correct
e. Only (A) and (C) are correct
5. Ready to fill with the gutta-percha except:
a. At the time of fill, the canal must be dry
b. The tooth responds to thermal tests
c. If a bacteriologic culture test is being used, a negative culture must be obtained
d. The tooth must be asymptomatic
e. The canal must be prepared in a manner that ensures optimum debridement and access to the apical area
so that the filling material can be condensed to obturate the entire preparation
6. A 24-year-old male presents with continuous diffuse pain in the maxillary left canine region. Upon visual
examination the tissue in the mucobuccal vestibule appears inflamed and slightly swollen. Palpation reveals a
tenderness over the apex of the lateral incisor and the canine. Both teeth are slightly percussion sensitive.
Radiographically no pathology is noted. Further evaluation and/or treatment should consist of:
a. Further diagnostic testing, specifically thermal or electric pulp testing
b. A test cavity on each of the two teeth
c. Dismissing the patient until the pain localizes
d. Evaluation of pain of nondental origin
e. Initiating root canal therapy on both teeth because irreversible pulpal disease is present
7. When symptoms and clinical tests show the presence of pulpal pathosis in a posterior tooth and the radiograph
shows no decay or restoration in any proximity to the pulp, this is virtually pathognomonic of:
a. Secondary occlusal trauma
b. A vertical fracture of the tooth
c. Condensing osteitis
d. Periodontal abscess
8. During the excavation of a very deep lesion on tooth #40 on an 8-year-old patient, you initially find large amounts
of mushy, decayed teeth structure over a leathery, demineralized dentin. The tooth is asymptomatic and has given
all signs that it is vital. Treatment contemplated should include:
a. Application of a cavity sealer over the leathery dentin, followed by restoration with amalgam
b. Total excavation; if a pulp exposure is present, do a direct pulp cap
c. Total excavation; if a pulp exposure is present, perform a pulpotomy
d. Application of calcium hydroxide and/or zinc oxide-eugenol over the leathery dentin and
1 TOPRANK REVIEW ACADEMY


restoration with amalgam
e. Total excavation; if no exposure is present, apply a base and restore
9. A 10-year-old boy comes to your office with a coronal fracture of #8. The accident happened about 1 hour ago, and
there is a large pulp exposure. On x-ray you see the apex of a #8 is still not closed. Treatment would consist of:
a. Direct pulp cap with calcium hydroxide
b. Pulpectomy and fill with Ca(OH)2
c. Pulpectomy and later gutta-percha fill
d. Smoothing edges and placing zinc oxide- eugenol over the exposure
e. Pulpotomy with Ca(OH)2
10. The most likely cause of extreme internal calcification to the point of nearly complete obliteration of the pulp cavity
space is:
a. A blow to a tooth in which the injury damaged but did not immediately devitalize the pulp
b. A restoration in which a lining base was not used
c. Natural calcification change taking place after patients reach middle age
d. The presence of a deep carious lesion that has been usually rapid in its advance
11. Which one of the following is not a requirement of an ideal root canal filling material:
a. It should be inexpensive
b. It should bacteriostatic
c. It should seal the canal laterally as well as apically
d. It should be able to be removed easily
e. It should be easily introduced into a root canal
12. Which of the following statements best applies to diagnostic endodontic procedures?
a. The diagnosis of pulpal disease is always obscure
b. The diagnosis of pulpal disease is generally obscure but is sometimes obvious
c. The diagnosis of pulpal disease is generally obvious but is sometimes obscure
d. The diagnosis of pulpal disease is always obvious
13. During the preparation of tooth #31 to receive a MO amalgam you find that you have inadvertently created a
mechanical exposure of the mesiobuccal pulp horn. The tooth had been properly isolated with a rubber dam and all
the decay has been removed. The patient is 13 years old and has no history of symptoms with this tooth. The
radiograph reveals no apparent pathology although the root apices are not fully formed. Treatment of choice
consists of:
a. An indirect pulp cap with zinc oxide- eugenol followed by an amalgam restoration
b. A direct pulp cap with zinc oxide-eugenol followed by an amalgam restoration
c. A direct pulp cap with calcium hydroxide followed by an amalgam restoration
d. An indirect pulp cap with calcium hydroxide followed by an amalgam restoration
e. A pulpotomy with calcium hydroxide placed over the vital stumps to allow for continued root growth
14. Which structure is not found in a living pulp?
a. Reticulum
b. Haversian canals
c. Nonmedullated nerves
d. Collagen fibers
15. Which of the following is the most commonly used bleaching agent for the endodontically treated teeth?
a. Ether
b. Sodium hypochlorite
c. Superoxol
d. Chloroform
16. Both maxillary central incisors of a nine-year- old patient were fractures. The maxillary left central incisor has a
horizontal crown fracture with badly lacerated pulp. The maxillary right central incisor has an oblique fracture of the
crown with a slight exposure of the pulp. Both incisors have wide open foramina. Treatment of choice is:
a. Pulpectomy of horizontal fracture and pulpotomy on oblique fracture
b. Pulp capping on both incisors
c. Extraction of both incisors
d. Pulpectomy of both incisors
e. Pulpotomy on both incisors
17. If corticosteroids are used as a component of root canal medicaments:
a. Exacerbation of infection may occur
b. Antibacterial action is enhanced
c. Leukocytic infiltration results


d. Microorganisms are destroyed
18. A seven-year-old boy fell off his bicycle one- half hour ago. He fractured his maxillary right central incisor at the
level of the gingiva. The exposed pulp is still vital. What is the treatment of choice for this tooth?
a. Extraction
b. Pulpotomy
c. Pulpectomy
d. Pulp cap
19. Which condition is an apical lesion that develops as an acute exacerbation of a chronic apical abscess (also called a
suppurative apical periodontitis)?
a. Granuloma
b. Cyst
c. Phoenix abscess
d. None of the above
20. The most common cause of persistent positive cultures from a root canal is:
a. Improper drug therapy
b. Poor coronal seal
c. Overcontamination of the root canal
d. Contaminated culture media
21. The greatest root canal diameter in the canine teeth is:
a. Gingivoincisal
b. Mesiodistal
c. Cervicoproximal
d. Labiolingual
22. The term apical collar applies to:
a. The ingrowth of cementum in the apical foramen
b. The condensed bone on the periphery of an apical chronic inflammatory lesion
c. A mechanically prepared portion of the apical section of the canal to aid in the placement of
the root canal filling
d. The atubular translucent dentin formation in the apical three mm of the apical root canal
23. In periapical lesions of average size the required time for osteogenesis runs between:
a. 6 and 12 months
b. 1 and 2 months
c. 2 and 6 months
d. 24 and 48 months
24. Which of the following teeth is most likely to have a curved tooth?
a. Maxillary central incisor
b. Mandibular central incisor
c. Maxillary lateral incisor
d. Maxillary canine
25. Most useful in differentiating between an apical abscess and a periodontal abscess would be:
a. Pulp vitality tests
b. Anesthetic test
c. Palpation
d. Percussion test
26. Endodontic procedures involve taking multiple radiographs. How should you protect yourself or your staff while
taking radiographs if there is no barrier available to stand behind?
a. Stand at least 5 feet away exactly opposite the x-ray beam source
b. Stand at least 4 feet away anywhere around the patient
c. Stand at least 6 feet away and in the area that lies between 90 to 135 degrees to x- ray beam
d. Stand at least 7 feet away and in the area that lies between 60 to 90 degrees to x-ray beam
e. Never take an x-ray without a barrier
27. A typical surgical flap for endodontics:
a. Would best be made with an electrosurgery unit
b. Should be of the "split" flap variety
c. Should not extend for more than half of a tooth on either side
d. Should elevate the mucoperiosteum as one tissue
e. Should be replaced with uninterrupted sutures
28. A new patient comes to you for total dental care. During treatment planning you find a


radiolucency associated with the apex of tooth #12. Endodontic therapy was performed on the tooth 1 year ago, an the
patient has had no symptoms or problems with the tooth since then. You are unable to locate previous x-rays. Your
treatment would be to:
a. Retreat the endodontic fill and observe for 6 months
b. Perform endodontic surgery as the persistent radiolucency indicates a failure
c. Wait and observe, checking for clinical signs or symptoms of pathology, or changes in the
radiolucency, at recall visits
d. Adjust the occlusion because trauma to the tooth may cause the lesion to persist
29. Pulp capping in a mature tooth may be followed by:
a. Hypercalcification within the root canals
b. Pulphagia
c. Internal resorption
30. The best treatment of an apical periodontitis resulting during therapy on vital cases it to:
a. Reopen the tooth, irrigate gently, medicate, and close
b. Reinstrument the canals immediately
c. Place on antibiotics
d. Place on analgesic until pain subsides
e. None of the above are correct
31. Microorganisms infect the root canal and periapical tissue by which of the following routes?
a. Direct extension between saliva and periapical region, retrograde infection
b. Direct extension between saliva and pulp chamber
c. Through exposed dentinal tubules to pulp chamber
d. Through the vascular channels
e. All of the above are correct
f. None of the above are correct
32. Which of the following are useful diagnostics aids that can be used to determine if a tooth has a vertical crown-root
fracture?
a. Persistent periodontal defects in an otherwise healthy tooth
b. Wedging the tooth in question and then taking an x-ray
c. Fiberoptic light for transillumination
d. Having a patient bite forcefully on a bite stick
e. All of the above
33. A month ago, a 20 year old patient sustained a traumatic blow to a maxillary central incisor. The tooth is
asymptomatic and gives a normal vital response to heat, horizontal fracture on the apical third of the root with the
segment in close apposition. The tooth is not mobile. Treatment is:
a. Initiate conservative root canal therapy
b. Instrument and fill the root canal and remove the fractured segment surgically
c. Do nothing at present, plan to check the vitality and radiographic appearance periodontically
d. Extract the tooth
34. Endodontic therapy is indicated if the pulp- involved tooth is badly broken down by caries, because in some cases
the carious destruction is so advanced that it would be virtually impossible to restore the tooth to services:
c. The statement is correct but the reason is incorrect
d. The statement is incorrect but the reason is correct
e. Both the statement and the reason are incorrect
35. A 40-year-old female patient presents with vague pain that radiates from the lower right mandible into the right ear
and sometimes is located in the upper right maxillary teeth. The pain is spontaneous, may last for 1-2 hours and
has been present for 3 weeks. The patient relates that she cannot identify any specific stimulus but intact
restorations throughout the mouth. Radiographically #29, #30 and #31 all have deep restorations with bases and
#2 and #3 have full crown coverage. No periapical pathology is present. The next step in the diagnosis and/or
treatment of this patient should consist of:
a. Excavation of the mandibular teeth in an attempt to identify a pulpal exposure
b. Referral to an ear, nose, and throat physician
c. Anesthetic testing when the patient is experiencing pain
d. Dismissal of the patient until the pain localizes
e. Test cavities in the maxillary teeth


36. In treating a tooth with a nonvital pulp and a fistula, the fistula should be treated as follows:
a. Cauterization with phenol
b. No special treatment
c. Use of cautery to eliminate the fistula
d. Curettage of the fistula
37. Which of the following may be considered pulpal irritants when applied to freshly cut dentin?
a. Alcohol
b. Drying cavity prep with air
c. Silver nitrate
d. Phenol
38. The pathognomonic symptoms of acute periapical periodontitis is:
a. Tenderness of tooth to percussion
b. Sensitivity to heat
c. Extraoral swelling
d. Intermittent pain
39. The final access cavity form is determined by:
a. The size and shape of the pulp chamber
b. Curvature of the tooth roots
c. The relationship of the length of tooth file to the cavity walls
d. The location of canal orifices
40. A 12-year-old patient arrives in your office complaining of pain in tooth #7. Yesterday, he was hit in the mouth
during basketball practice. The tooth is slightly mobile but not tender to percussion. Thermal changes do not affect
the tooth, and the electric pulp tester registers a response at 8. Diagnosis and treatment consist of:
a. Necrotic pulp, open and debride
b. An accurate diagnosis cannot be made at this point; treat palliatively and observe157
c. Irreversible pulpal disease; pulpectomy
d. Acute abscess formation; open and drain
e. Reversible pulpal disease; reduce occlusion and place a sedative dressing
41. A 14-year-old patient presents severe pain in tooth #7 and relates a history of trauma in that region. A visual
examination reveals a large carious lesion on the distal surface of #7. Tooth #7 is tender to percussion.
Radiographically a periapical lesion is present at the apex of #8. The initial consideration should be:
a. Thermal and electric pulp tests of #6, #7; #8, and #9
b. Immediate initiation of root canal therapy on tooth #8
c. Excavation and pulpectomy on #7
d. Immediate initiation of root canal therapy on #7 and #8
e. Excavation of tooth #7, placement of an indirect pulp cap, and initiation of root canal therapy on #8
42. The most acceptable method to achieve adequate root canal debridement is:
a. To attain a clean irrigating solution
b. To obtain clean shavings of the canal
c. To achieve glassy smooth walls of the canal
d. All of the above criteria are reliable
e. None of the above criteria is acceptable
43. If an instrument breaks in a canal during treatment, the ethical procedure would be to:
a. Extract the tooth
b. Tell the patient immediately, regardless of consequences
c. Complete treatment and then inform the patient
d. Complete treatment and not tell the patient
44. All the following statements regarding adjuncts to endodontic treatment are true, except:
a. Intentional replantation is a viable alternative to endodontic surgery
b. A major disadvantage of endodontic implants is the lack of an apical seal
c. To stabilize an intentionally replanted tooth, a very effective method is to ask the patient to close in
centric occlusion for the remainder of the day
d. Transplanted teeth with partial root development have a better prognosis than those with developed
roots
e. Orthodontic extrusion is a common indication prior to implant placement
45. Endodontic therapy is contraindicated for patients past middle life because the root canals in the older patients are


very fine, having been filled-in with secondary reparative dentin:
46. The earliest and most common symptom associated with an inflamed pulp is:
a. A dull throbbing pain on mastication
b. Sensitivity to hot, and or, cold stimuli
c. Mild bleeding
d. Pain on percussion
e. A persistent feeling of discomfort
47. Irrigation of the pulp chamber and canals is indicated for which of the following?
a. Prior to instrumentation of a pulp cavity previously opened for drainage
b. During and at completion of access preparation
c. At intervals during and at completion of canal instrumentation
d. At the time the pulp chamber is opened for drainage
48. When would you consider amputating a root of a multirooted tooth:
a. If one root had severe internal or external resorption
b. If one root had extensive nonrestorable root caries
c. If one root lost its alveolar bony support (periodisease)
49. You have completed all the biomechanical preparation of the root canal of tooth #8. The patient returns in 24
hours with severe pain to biting on #8. You open the tooth and upon x- ray you find that your final file size (#55)
is right at the radiographic apex. Treatment of choice is to:
a. Decrease your working length, open, irrigate, and close the tooth, reduce the occlusion, and
prescribe analgesics
b. Trephinate at the apex
c. Enlarge the canal two or three sizes to remove any pulpal remnants
d. Enlarge the canal one or two sizes, irrigate, and close the tooth
e. Open the tooth for drainage and leave open
50. The characteristics of pulpotomy include which of the following?
a. Degree of success is excellent
b. Degree of success is predictable
c. Degree of success is very unpredictable
d. Degree of success is good
51. Common errors in access openings are:
a. Access opening too large
b. Access opening too small
c. Incomplete removal of the pulp chamber roof
52. The primary purpose of the endodontic access opening is to:
a. Remove the coronal pulpal tissue
b. Establish a straight line access to the apical foramen
c. Allow the enlargement of the coronal orifice
d. Allow for the removal of the canal contents
e. Allow for the preparation of the dentinal walls
53. A patient on whom you had performed a vital pulpectomy the previous day complaints that the tooth is sore and
that she cannot bite on the tooth. The most probably diagnosis of the problem is that it is:
a. An apical abscess
b. An acute exacerbation of a granuloma
c. An apical cyst
d. A suppurative periodontitis
54. The most common route for microorganisms and their toxic-by-products to reach the pulp tissue is:
a. From the extension of periapical infection from adjacent, infected teeth
b. Through exposed dentinal tubules following cavity preparation
c. Direct extension through an open cavity or carious lesion


d. Through the pulpal lymphatic system
e. Hematogenious anachoresis
55. A reaming action produces a canal that is relatively:
a. Triangular in shape
b. Square in shape
c. Irregular in shape
d. Round in shape
56. Endodontic therapy is contraindicated for the very ill, for the patient in terminal illness and for the pregnant patient
because extractions are preferred over root canal therapy for these patients.
e. Both the statement and the reason are incorrect
57. While cleaning and shaping the canal, an instrument separates in the canal. Your first attempt to retrieve it results
in a broken instrument passing through the apex. How should you manage this case now?
a. Raise a flap and remove the instrument surgically followed by gutta-percha filling the canal
b. Extract the tooth as irreparable damage has occurred to the apex
c. Use Gates Glidden drills to widen the canal and then try retrieving it
d. Just inform the patient, fill the canal with gutta-percha and monitor
e. Use a smaller H file to bypass it and try retrieving it15
58. An acute apical abscess usually is a result of:
a. An incipient acute pulphagia
b. A moderate acute pulphagia
c. A necrotic pulp
d. Occlusal interference
e. A periodontal pocket
59. You have just completed root canal therapy on a patient whose lower left second molar has a pulpal-periodontal
disease. Prognosis for the endodontic therapy is good, but the periodontal prognosis is guarded. The tooth is
missing the two buccal cusps and the distal marginal ridge due to caries. You want to begin restoration of the tooth
next week. Your treatment of choice is:
a. Full cast crown
b. Amalgam build-up and reevaluation of periodontal status at a later date
c. Post-core with full porcelain to gold crown with margins above the gingival crest
d. Pin amalgam core with full cast crown
e. Reverse three-quarter crown with margins below the gingival crest
60. The most common cause of endodontic- treatment failure is:
a. Overfilling of the root canal
b. Occlusal interference
c. Coexistent periodontal-periapical lesion
d. Incomplete obliteration of the root canal
e. An apical cyst
61. The first consideration in endodontic therapy is:
a. Relief of pain
b. Thorough biomechanical preparation
c. Sterile technique
d. Accurate canal length
e. Complete obliteration of the root canal
62. During access preparation on mandibular molars, two regions tend to be "overcut" which results in the undesirable
over preparation of the tooth. Which are those two most abused areas?
a. The lingual surface under the lingual cusps
b. The buccal surface under the buccal cusps
c. The mesial aspect under the marginal ridge
d. The distal aspect under the marginal ridge
63. In pulps undergoing repair, odontoblasts may be derived from:
a. Histiocytes
b. Plasma cells
c. Macrophages

d. Undifferentiated mesenchymal cells
64. It has been said in endodontics that the lower premolars can be the easiest or the hardest teeth to treat
endodontically because of:
a. The length of the root
b. The possibility of bifurcations in the root canal
c. The size of the canal
d. The position of the tooth in the mouth
65. The most commonly used irrigant in endodontics, Sodium Hypochlorite (NaOCl) is used in the concentration of:
a. 1% c. 2.6%
b. 5.25% d. All of the above
66. Irreversible pulpitis is usually characterized by:
a. Sensitivity to percussion
b. Sensitivity to cold
c. Spontaneous pain
67. All pulpless teeth with periapical lesions should be treated by which of the following:
a. A rubber dam wick should be inserted
b. The tooth should be left open for drainage
c. The case should be managed the same as is one without a periapical lesion (nonvital)
d. An immediate sterilization and root resection should be done
68. In a patient, age 10, with a maxillary central incisor that is nonvital and an incompletely formed apex:
a. You would initiate apexification therapy with Ca(CH)2
b. You would perform surgical endodontics (retrofilling)
c. You would prescribe antibiotic and narcotic medication
d. You would perform nonsurgical endodontic therapy
69. Gutta-percha has an advantage over silver cones as a filling material in that it is more:
a. Easily standardized in size
b. Capable of filling narrow canals
c. Plastic, and thus requires no cement
d. Radiopaque
e. Compatible with dowel post preparations
70. The main benefit of primary incisor replantation is:
a. Maintenance of a normal anterior dentition
b. To maintain child's social acceptance
c. To maintain child's self-esteem
d. To relieve parental guilt
71. When thermal stimuli are applied to teeth, which of the following statements most accurately expresses the
patient's reaction when the threshold has been exceeded:
a. The patient can determine either stimulus accurately
b. The patient's only reaction will be one of pain
c. The patient will be able to distinguish the cold but not the hot stimulus
d. The patient will be able to distinguish the hot but not the cold stimulus E)None of the above are correct
72. While doing vital pulpotomy on a young, immature permanent tooth, the hemorrhage after pulp amputation could
not be controlled with cotton pellets even after several minutes. What is the next step in completing this treatment?
a. Apply formocresol with cotton pellets at the amputation site
b. Stop the procedure and close the tooth with an interim restoration
c. Irrigate the canal with sodium hypochlorite then apply calcium hydroxide
d. Control the hemorrhage with hemostatic agents
e. Perform the amputation at a more apical level
f. All of the above
73. An apical lesion that develops as an acute exacerbation of a chronic or suppurative periodontitis is called:
a. Acute apical abscess
b. Apical cyst
c. Condensing osteitis
d. Chronic apical abscess
e. Phoenix abscess
74. When viewing an x-ray of tooth 8 a large radiolucent area extends both mesially and distally from the walls of the
pulp chamber in the area of the cementoenamel junction (CEJ). The crown of the tooth appears pink near the CEJ.


What condition is most likely represented and what should be used?
a. Internal resorption; surgical curettage
b. External resorption; Ca(OH)2 or gutta- percha
c. External resorption; surgical curettage
d. Internal resorption; Ca(OH)2 or gutta- percha
75. Which of the following is not an indication to use solvent-softened custom cones?
a. Tugback" within 1 mm of working length
b. Lack of an apical stop
c. An irregular apical portion of the canal
d. An abnormally large apical portion of the canal
e. After an apexification procedure
76. Factors in the prognosis of the replantation of a traumatically avulsed tooth include:
a. Length of time out of the socket
b. Degree of root dehydration
c. Degree of alveolar destruction
77. Instrumentation well short of the apical foramen can result in:
a. Shelfing or ledging the canal
b. Forcing necrotic material into the periapical region
c. Traumatizing the periapical tissues
d. Grossly enlarging the apical region
78. Discoloration of an endodontically treated tooth is usually caused by:
a. Leaving sealer paste in the pulp chamber
b. Trauma with resulting pulpal hemorrhage
c. Failure to debride the pulp chamber completely during endodontic therapy
d. Only (A) and (C) are correct
e. (A), (B) and (C) are correct
79. What control tooth or teeth should you use when testing a suspected pulpally involved tooth?
a. You need test only the suspected teeth
b. The adjacent teeth and contralateral tooth
c. Contralateral tooth and opposing tooth161
d. Opposing teeth and adjacent teeth E)All of the above are correct
80. Which of the following are acceptable methods to clean and shape a canal using Nickel titanium instruments?
a. Reaming motion
b. Engine-driven rotary motion
c. Push and pull stroke
d. All of the above
81. The location of the narrowest constriction of the "normal" pulp canal is located at the:
a. Dentinoenamel junction
b. Cementoenamel junction
c. Cementodentinal junction
d. Radiographic apex
82. If hot gutta-percha is placed on the occlusal surface of an intact premolar tooth for 10 seconds what changes
would occur in the pulp?
a. None
b. Rapid increase of intrapulpal pressure followed by a decrease to slightly below normal
c. Slow increase of intrapulpal pressure followed by a slow decrease to near normal
d. Rapid increase of intrapulpal pressure followed by a decrease to near normal
e. Rapid increase of intrapulpal pressure followed by a decrease to slightly above normal
83. In treating a nonvital central incisor in a young child, what is the most vital important factor in insuring continued
development or closure of the apex?
a. Obtaining a negative culture
b. Irrigating with sodium hypochlorite
c. Placing a thick mix of calcium hydroxide and CMCP at the apex
d. Irrigating with saline solution
e. Completely instrumenting and debriding the canal of all necrotic tissue
84. A 13-year-old female presents with intermittent pain in tooth #31 that began 2 weeks ago. The pain comes and
goes, sometimes is severe, and lasts more than 2 hours. The tooth hurts slightly on biting, and she has notices a


tenderness in the vestibule next to the tooth. A radiograph shows a large
restoration with a deep base and the presence of immature root development. Your diagnosis and treatment consists
of:
a. Irreversible pulpal disease; pulpotomy and apexification
b. Reversible pulpal disease; occlusal adjustment and observation
c. Irreversible pulpal disease; pulp extirpation and initiation of root canal therapy
d. Reversible pulpal disease; excavation and placement of a sedative dressing
e. Irreversible pulpal disease; open for drainage
85. How can you improve the appearance of your patient's endodontically treated maxillary left central that is badly
discolored?
a. Gold crown with porcelain facing
b. Porcelain jacket crown
c. By bleaching
86. A root canal is ready for filling when:
a. The culture is negative
b. The patient is asymptomatic
c. The canal is dry
d. The canal has been accurately measured, cleansed, and shaped
87. The result of pulp testing in multirooted teeth is sometimes questionable because:
a. The pulp may be used in one or two canals and necrotic in another
b. Of the presence of large restorations
c. The dentin is thick
d. The maxillary sinus is involved
88. A 21-year-old female presents with slight discomfort on tooth #7. She complains that is is tender to biting and
occasionally gives her an ache near the apex. A radiograph reveals a previous root canal filling (silver cone) which
extends 1 mm past the apex. Around the silver cone is a 3 x 5 mm periapical lesion. The crown of the tooth is
partially broken down, and you can see the coronal end of the silver cone. Treatment of choice is:
a. Trephination of the lesion and prescription of antibiotics
b. Periapical curretage and simple cutting off of the extended silver point
c. Retreatment, removing the silver point, and preparation of the tooth for a post- core
restoration
d. Extraction of the tooth and replacement with a three unit fixed partial denture
e. Periapical surgery, retrofilling and restoration of the tooth with a synthetic material
89. A patient comes into your office with a draining fistula (sinus) associated with the maxillary right central incisor.
The tooth restored with an acceptable crown (full coverage) and the radiograph reveals a post extending to
midroot level. In addition, an old root canal filling, (five years old) is evident; however, it is well short of the root
end (about 4 mm). A large radiolucent area appears circumscribed at the root apex. You would:
a. Remove the crown and attempt to remove the post prior to nonsurgical endodontics
b. Prescribe antibiotic and narcotic medication
c. Extract the tooth
d. Perform a surgical endodontic procedure (retrofilling)
90. The cold-response for an inflamed pulp is:
a. The worsening of a toothache by the application of cold
b. Pain that lasts as long as the cold is applied but is of more intense character than on normal adjacent
teeth
c. Pain that is brought on by cold that continues after the cold stimulus has been removed
91. A 34-year-old black female presents for a routine oral examination. She only has the six mandibular anterior teeth
remaining in her mouth. There is no evidence of decay or tooth destruction. Although slight periodontal disease is
present. She is totally asymptomatic. Radiographically there are no periapical radiolucencies present in the two
lower central incisors. Electric pulp testing indicates all teeth are responsive in a similar fashion. Treatment of
choice is:
a. Transillumination to identify dark, potentially necrotic, pulp chambers
b. Test cavities on the lower central incisors
c. Initiate root canal therapy on two teeth


d. Extract and replace these teeth when fabricating a lower partial denture
e. No treatment is necessary
92. Which procedure is probably not considered essential for the success of intentional replantation?
a. Curettage of the socket to remove periapical pathosis
b. Repair of any perforation or resorptive defect before replantation
c. Minimum out-of-socket time
d. A skillful extraction
e. Minimum damage
93. An 8-year-old patient presents with mild discomfort in teeth #9 and #10. The teeth were traumatized the day
before in a fall from a bicycle. Both teeth are slightly percussion sensitive and the crowns are intact. Electric pulp
tests indicate that neither tooth is responsive to electric stimulation. Treatment of choice is:
a. Pulpectomy on both #9 and #10
b. Referral to a pedodontist
c. Pulpotomy on #9 and #10
d. Thermal testing
e. Observation of the patient over the next few weeks
94. The dental pulp is an organ that responds to a variety of stimuli and contains nerve endings or receptors for:
a. Pain d. Kinesthesia
b. Pressure e. Temperature
c. Proprioception
95. Which of the following canals in a maxillary first molar is usually the most difficult to locate?
a. Mesiobuccal
b. Distobuccal
c. Palatal
d. All of the canals are relatively easy to find
96. Canals are not prepared to a certain size to be filled with a given material. The size to which canals are prepared is
determined by:
a. Original size of the canal63
b. Shape of the canal
c. Curvature of the canal
97. One of the most important principles of cleansing and shaping a canal is:
a. Do not shape or enlarge the canal until the exact working length has been established
b. Do not curve instruments before entering canal
c. Use films in a dry canal
d. Use instruments in sequence while advancing from a large instrument to a smaller instrument
98. A patient reports to your office for routine restorative therapy. After usual examination, radiographic and so on, you
see a maxillary lateral incisor overfilled (about 1 mm) with gutta-percha. There is a radiolucent area at the apex:
however, the endodontic therapy was completed only one month ago. You would:
a. Prescribe antibiotics
b. Redo the tooth with a nonsurgical endodontic approach
c. Perform surgical endodontic therapy (retrofilling)
d. Take recall radiographs every three to six months to observe healing
99. The desired periapical tissue response following endodontic therapy on a tooth with a periapical lesion is:
a. Reestablishment of the periodontal ligament
b. Deposition of apical cementum
c. Regeneration of alveolar bone
100. Which one of the following is not a valid indication for apicoectomy?
a. Curve within apical third of root that cannot be negotiated
b. Broken instrument in the apical third of the canal
c. Periapically involved teeth in patients with insufficient time for conventional endodontic treatment
d. Perforation in apical third
e. Presence of the fistula

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