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Endodontics and periodontics

Dentistry (Centro Escolar University)

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1. Gutta-percha cones are BEST disinfected by immersing them for 20 mins in

a. Alcohol
b. Quaternary ammonium compounds
c. Eucalyptol
d. Xylol
e. Eugenol
2. The term “odontalgia” means
a. More than the normal complement of teeth
b. Removal of a vital pulp
c. Pulp atrophy
d. Toothache
e. Less than the normal complement of teeth
3. The _____ has emerged as a unique immune cell could be activated by many non-immune processes, including
acute stress and could participate in a variety of inflammatory diseases in the nervous system, skin, joints, as well
as cardiopulmonary, intestinal and urinary systems.
a. Neutrophil
b. Mast cell
c. Epithelioid cell
d. Eosinophil
4. By which of the following routes can microorganisms gain access to the pulp?
a. Exposed dentinal tubules
b. Direct extension between saliva and the pulp chamber
c. Vascular channels
d. Anachoresis
e. All of the above
5. When root canal instruments (files and reamers) are sterilized in a glass bead sterilizer are 450F, they should be
placed in the sterilizer for
a. 30 seconds
b. 10 seconds
c. 2 seconds
d. 20 seconds
e. 5 seconds
6. 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. Irreversible pulpitis
b. Reversible pulpitis
c. Acute apical periodontitis
d. Chronic apical periodontitis
e. Cracked tooth syndrome
7. Which of the following teeth is most likely to exhibit C-shaped morphology?
a. Mandibular first premolar
b. Maxillary first premolar

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c. Mandibular first molar

d. Maxillary first molar
8. A good master cone will have a snug fit at the apical third by:
a. Minimum of 4mm
b. 2mm
c. 5mm
d. No specific length
e. 0.5 to 1mm
9. Sodium hypochlorite may be used effectively as:
1. An antimicrobial agent 2. A tissue solvent
3. A chelating agent 4. An anodyne dressing
a. 1&3
b. 1, 2 & 3
c. 2&3
d. 2, 3 & 4
e. 1&2
10. Based on clinical and radiographic examinations, which of the following teeth has the POOREST long-term
prognosis
a. Maxillary left canine
b. Mandibular left second molar
c. Maxillary right second premolar
d. Maxillary right second molar
e. Mandibular right second premolar
11. When two canals are detected in the same root, the MOST frequent and reliable method for determining the
apical termination of each is by
a. Tactile sensation
b. Varying the horizontal angulation to separate the canals radiographically
c. Varying the horizontal angulation to separate the canals radiographically
d. All of the above
e. None of the above
12. A patient complains of the thermal sensitivity in her front teeth. Pulp test indicate a vital tooth, but the
radiograph shows a radiolucency in the middle of the root of the maxillary left incisor. The MOST probable
diagnosis and treatment are
a. Internal resorption – institute root canal therapy
b. Internal resorption – check vitality and take a radiograph in 6-12 months
c. Questionable diagnosis – observer and take a radiograph in 6-12 months
d. Internal resorption – extract the tooth
e. Questionable diagnosis – place a root canal filling and perform surgery to repair the defect
13. Appropriate time for obturation is:
a. When the canal is free from hemorrhage
b. Before post cementation
c. When the canal has eased to exude tissue fluid
d. When the tooth is symptomatic

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14. EDTA stands for:

a. Ethyldiaminotetracycline acid
b. Ethylaminotetracycline acid
c. Ethyldiaminotetraacetic acid
d. All of the choices
15. On a radiograph, the difference between a healthy pulp and one which is necrotic is that the _____ pulp
appears ____.
a. Healthy; darker
b. Necrotic; lighter
c. Healthy; lighter
d. Necrotic; darker
e. None of the above
16. Which of the following are indications for surgical endodontic intervention?
1. A non-negotiable canal with periapical pathosis
2. A sinus tract that persists after repeated treatment
3. Periapical pathosis in a tooth with a post and core retained crown
a. 1&3
b. 3 only
c. 1&2
d. 1, 2 & 3
e. 2&3
17. The access preparation for root canal treatment should be:
a. Confined to the area where carious destruction occurs
b. Extended to the full periphery of the pulp chamber to remove the overhanging enamel and dentin
c. As small as possible to conserve tooth structure
d. All of these
18. During a stepback enlargement of the canal space, one reason for recapitulation after each increase in
instrument size is to:
a. Create a coronal funnel to facilitate filling with gutta percha
b. Maintain the apical stop for filling with gutta percha
c. Clean the apical segment dentin fillings that are not removed by irrigation
d. Maintain coronal curvature of the canal
19. More than one main canal occurs a significant percent of the time in the
a. Mandibular central incisor
b. Only maxillary first molar distobuccal root and Maxillary first molar lingual root
c. Maxillary first molar lingual root
d. Maxillary first molar distobuccal root
20. direct pulp capping is recommended for primary teeth with which of the following?
a. Calcification in the pulp chamber
b. Carious exposures
c. Mechanical exposures
d. All of these

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21.Which of he following is characteristic of sensory fibers of pulp?

a. Can selectively differentiate thermal stimuli
b. Have a special neuronal ending that are specific for proprioception
c. Are non-selective to all stimuli indicating only pain when the threshold has been exceeded
d. Both can selectively differentiate thermal stimuli and have special neuronal endings that are specific for
proprioception only
e. None of these
22. A patient has a dull pain in tooth #10 with slight swelling over the area. Pulp testing procedures indicate a
nonvital pulp in #10. A periapical radiograph shows a 3mm radiolucency at the apex of tooth #10 IMMEDIATE
treatment of choice would be to
a. Extract the tooth
b. Prescribe antibiotics for the patient
c. Adjust the occlusion and observe
d. Prescribe an analgesic for the patient
e. Open the tooth and establish drainage
23. The spreader reach is:
a. 2mm short of the working length
b. The depth the spreader has penetrated during compaction
c. Refers to the force exerted by the spreader during compaction
d. All of them
24. With a mechanically exposed pulp, the BEST prognosis is offered by
a. Resection
b. Direct pulp cap
c. Pulpectomy and root canal obturation
d. Indirect pulp cap
e. Pulpotomy
25. Once the root canal in obturated, what usually happened to the organisms that had previously entered
periapical tissues form the canal?
a. They will have been eliminated by various medicaments that were used in the root canal
b. They re-enter and reinfect the sterile canal unless periapical surgery is performed
c. They are eliminated by the natural defenses of the body
d. They persist and stimulate formulation of granuloma
26. The most reliable factor that will help determine if canal is ready for obturation is:
a. No foul odor
b. Negative culture test result
c. Tooth is asymptomatic functional
d. All of the choices
27. Based on clinical and radiographic examination, the MOST appropriate treatment for the mandibular left first
molar is
a. Hemisection of the mesial and subsequent restoration
b. An autogenous bone graft
c. Hemisection of the distal root and subsequent restoration
d. Extraction and subsequent replacement with a suitable prosthesis

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28. In pulps undergoing repair, odontoblasts may be derived from

a. Macrophages
b. Undifferentiated mesenchymal cells
c. Histocytes
d. Plasma cells
e. Any of the above
29. The precursor of the dental pulp during tooth formation is known as the
a. Golgi zone
b. Dental lamina
c. Dental papilla
d. Outer enamel epithelium
e. Hetwig’s sheath
30. The efferent nerves found in the dental pulp are
a. Somatic motor fibers
b. Sympathetic postganglionic fibers
c. Parasympathetic postganglionic fibers
d. Epicritic fiber
e. Both somatic motor and autonomic postganglionic fibers
31. Which of the following is the MOST difficult pulpal or periapical pathosis to diagnose
a. Chronic pulpitis
b. Acute apical abscess
c. Chronic suppurative apical periodontitis
d. Internal resorption
e. Necrotic pulp
32. Blood at the tip of the paper point removed from the root canal indicates:
a. Possible root perforation
b. Possible incomplete instrumentation
c. Possible hematoma
d. Possible incomplete irrigation
33. In the pulp myelinated nerves function to transmit impulses interpreted as:
1. Pain 2. Cold 3. Proprioception
a. 2&3
b. 1&2
c. 1&3
d. 1 only
e. All of them
34. Removal of occlusal prematurities is indicated
a. Immediately after inflammation appears
b. Before the start of instrumentation
c. After tissue healing from surgery
d. Before surgery for gross reduction with fine adjustment after surgery

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35. Which cells of the immune system possess for the complement component C3q by which they participate in
immediate
a. Monocytes
b. Dermal dendrocytes (histocytes)
c. Peripheral dendritic cells
d. Natural killer (NK) cells
36. Which of the following is characteristic of sensory fibers of pulp?
a. Can selectively differentiate thermal stimuli
b. Are non-selective to all stimuli indicating only pain when the threshold has been exceeded
c. Have special neuronal endings that are specific for proprioception
d. Both can selectively differentiate thermal stimuli and have special neuronal endings that are specific for
proprioception only
e. None of these
37. Defense cells of the pulp include
a. Fibroblasts
b. Histocytes
c. Polycytes
d. Kupfer’s cells
e. All of the above
38. Initially the first group of cells to arrive at the site of injury are neutrophils. Later, _____ becomes more
numerous. In certain parasitic infections, ______ predominate. In viral infection ______ rather than neutrophils
usually predominate.
a. Lymphocytes, macrophages, eosinophils
b. Macrophages, lymphocytes, basophils
c. Macrophages, eosinophils, lymphocytes
d. Plasma cells, basophils eosinophils
39. Most useful in differentiating between an acute apical abscess and an acute periodontal abscess is
a. Radiographs
b. Palpation
c. Pulp vitality test
d. Percussion test
e. Anesthetic test
40. Pulp inflammation is most commonly caused by:
a. Accidental trauma
b. Cavity preparation
c. Traumatic occlusion
d. Bacteria
e. Irritants in dental materials
41. The action used for placing K-type file into a canal should resemble:
a. A straight apical pressure
b. Complete rotation of the instrument with pressure directed apically
c. A clockwise-counterclockwise motion with pressure directed apically
d. An up-and-down motion

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42. Aging of the pulp is evidenced by an increase in:

a. Pulp stones
b. Vascularity
c. Fibrous elements
d. Cellular elements
43. Post operative pain after obturation occur when:
a. There is excess cement
b. Patient failed to take analgesic after treatment
c. There is excessive force applied during lateral condensation
44. A 30-year-old male complains of throbbing pain in the upper right quadrant. The pain is spontaneous and
usually lasts several hours. All test are within normal limits except radiographs, which show a large carious lesion
in the maxillary first premolar. After evacuation of all caries, a 2 mm exposure is produced. The most probable
diagnosis is
a. Necrosis
b. Internal resorption
c. Hyperplastic pulpitis
d. Reversible pulpitis
e. Irreversible pulpitis
45. Which of the following perforations has the poorest prognosis?
a. Perforation at the DEJ
b. Perforation into the furcation
c. Perforation through the crown
d. Perforation at the CEJ
e. Perforation near the apex
46. In cases involving conventional endodontics, the MOST frequent cause of failure is
a. The presence of coexistent periodontal lesion
b. Apical overfilling of the canal
c. In adequate filling of accessory canals
d. Incomplete obliteration of the main canal
e. External root resorption
47. Metallic salts are included in root canal sealers to make sealers:
a. Set hard
b. Radiopaque
c. Antibacterial
d. Set more rapidly
e. Better tolerated by periapical tissues
48. Which of the following should be FIRST in the sequence of treatment?
a. Endodontic therapy on the maxillary left lateral incisor
b. Resolution of the lesions associated with the mandibular left first molar
c. Removal of overhanging restoration on the maxillary first left molar
d. Correction of marginal ridge discrepancy between mandibular right second premolar and first molar

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49. Autoclaving instrument depend on

a. Direct contact between saturated steam and items to be sterilized
b. A temperature of 248F (120C) for 15 minutes
c. A temperature of 160F (71C) for 15 minutes
d. Lubricating instruments
50. A radicular cyst is always associated with
a. Pericoronal infection
b. Non-vital tooth or teeth
c. Deep cavity
d. Vital tooth or teeth
e. None of the above
51. Which of the following is MOST likely to occur on the facial aspect of mandibular right premolars subsequent
to a periodontal flap procedure that includes these teeth?
a. Increase in probing depths from the cementoenamel junctions
b. Decrease in probing depths from the cementoenamel junctions
c. Improvement in crown-root ratios
d. Gain of attachment
e. Loss of attachment
52. Which of the following terms refers to reshaping the bone without removing tooth-supporting bone?
a. Positive architecture
b. Negative architecture
c. Osteoplasty
d. Ostectomy
53. Which cells of the immune system possess receptors for the complement component C3q by which they
participate in immediate inflammation?
a. Monocytes
b. Peripheral dendritic cells
c. Dermal dendrocytes (histocytes)
d. Natural killer (NK) cells
54. In a clinically healthy periodontium, the microbial flora is largely composed of:
a. Gram-positive facultative
b. Gram-negative facultative
c. Gram-positive obligate microorganisms
d. Gram-negative obligate microorganisms
55. Risk factors for gingivitis except:
a. Occlusal trauma
b. Drugs
c. Hormones
d. Plaque
56. The purposes of periodontal dressings (packs) include all of the following except:
a. Maintain the sutured position of the flaps
b. Stop persistent bleeding

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c. Prevent mechanical injury to healing tissues

d. Improve patient comfort
57. Apical migration of the epithelial attachment with corresponding recession of the marginal gingiva results in
a. Periodontal pocket depth
b. A shallow sulcus
c. Reduction of periodontal pocket depth
d. Gingival pocket formation
e. Infrabony pocket formation
58. Which of the following is/are necessary for osseointegration to be successful:
a. Minimization of surgical trauma
b. Uncontaminated implant surfaces
c. Limited micromotion during healing
d. Primary stability of the implant
e. All of the above
59. The ____ has emerged as a unique immune cell that could be activated by many non-immune processes,
including acute stress and could participate in a variety of inflammatory diseases in the nervous system, skin,
joints, as well as cardiopulmonary, intestinal and urinary systems.
a. Neutrophil
b. Epithelioid cell
c. Mast cell
d. Eosinophil
60. Localized aggressive periodontitis is confined in
a. First molar and incisors
b. Molar area
c. Premolars
d. Incisor and canine area
61. If a patient is able to prevent plaque accumulation on his teeth, how often is a prophylaxis required?
a. Every 3 months
b. Every 12 months
c. Every 2 years
d. Every 6 months
e. Never
62. Which of the following regarding chronic, apical periodontitis is/are accurate?
a. It may contain epithelial arcades or rings
b. It has a predominance of B-cells over T-cells
c. It represents a continuous, slow process that is asymptomatic
d. It is a neutrophil-dominated lesion encapsulated in a collagenous connective tissue
63. Osseointegration can fail due to:
a. Bacterial plaque
b. Micromotion during healing
c. Occlusal overload
d. Excessive cantilevering of the prosthesis
e. All of the above

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64. Radiopaque irregularities associated with the roots of mandibular central incisors MOST likely represent
a. Hyperplastic cementum
b. A cementoma (periapical cemental dysplasia)
c. Subgingival pellicle
d. Root caries
e. Subgingival calculus
65. Which of the following is/are necessary for osseointegration to be successful:
a. Minimization of surgical trauma
b. Uncontaminated implant surfaces
c. Limited micromotion during healing
d. Primary stability of the implant
e. All of the above
66. Tobacco smoking is thought to be a predisposing or a contributing factor in which of the following conditions?
a. Cyclic neutropenia
b. Juvenile periodontitis
c. Chediak-Higashi syndrome
d. Necrotizing ulcerative gingivitis
e. Gingivitis-periodontitis
67. The bacterial flora in periodontal pockets associated with aggressive periodontitis is predominantly
a. Negative anaerobic rods
b. Positive anaerobic cocci
c. Positive aerobic cocci
d. Negative aerobic cocci
e. Negative anaerobic cocci
68. The main cells involved in chronic infection are lymphocytes and:
a. Natural killer (NK) cells
b. Monocytes
c. Peripheral dendritic cells
d. Dermal dendrocytes (histocytes)
69. Which of the following would you consider in the treatment plan of a patient with NUG (necrotizing Ulcerative
Gingivitis)?
a. Radiograph
b. Case history and clinical experiences
c. Oral prophylaxis & sublingual curettage and root planning
d. All of the above
70. Inadequate margins of restorations should be corrected PRIMARILY because they
a. Retain food debris
b. Cause mechanical irritation
c. Interfere with mastication
d. Interfere with plaque removal
e. Cause occlusal disharmony

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71. The main cells involved in chronic infection are lymphocytes and:
a. Plasma cells
b. Mast cells
c. Neutrophils
d. Macrophages
72. Deep periodontal pockets are often treated by access flap. Successful cases result in reduction of pocket
depth, even if there is no change in the position of gingival margin. In these cases, the reduced pocket depth most
likely results from
a. Adequate dosage of the appropriate antibiotic
b. Formulation of a long, junctional epithelium
c. Formation of new bone, cementum, and periodontal ligament
d. Formation of new collagen fibers that attach the gingiva to root surfaces
e. Rekeratinization of pocket epithelium
73. Which of the following is NOT a clinical sign of bruxism?
a. Cracked teeth or fillings
b. TMJ symptoms
c. Periodontal pocket formation
d. Muscle soreness
e. Wear facets on teeth
74. Which of the following organisms is least likely to be found among normal anaerobic flora of the gingival
sulcus?
a. Mycobacteria
b. Bacteroides
c. Treponema
d. Actinobacillus
e. Fusobacterium
75. The normal alveolar crest on bite-wing radiographs is USUALLY
a. 1-2 mmm apical to the cementoenamel junction
b. 3-4 mm apical to the cementoenamel junction
c. At the cementoenamel junction
d. Not visible
e. 5-6 mm apical to the cementoenamel junction
76. In recurrent necrotizing ulcerative gingivitis, exacerbations and remissions which occur are based to a
significant extent upon
a. Excessive smoking
b. The amount of suppuration present
c. Stressful episodes
d. An increase in the types of causative organisms
77. The calcified bodies sometimes found in the periodontal ligament are best described as which of the
following?
a. Bone
b. Denticles
c. Cementicles

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d. Mineralized interstitial tissue

e. Enamel pearls
78. Prevotella intermedia was formerly known as:
a. Wolinella intermedius
b. Bacteroides gingivalis
c. Bacteroides intermedius
d. Bacteroides melaninogenicus
79. Circumpubertal onset:
a. Localized aggressive periodontitis
b. Necrotizing ulcerative gingivitis
c. Necrotizing ulcerative periodontitis
d. Generalized aggressive periodontitis
e. Chronic periodontitis
80. Microorganisms that colonize periodontal abscess have been reported to be primarily:
a. Gram-negative aerobic robs
b. Gram-negative anaerobic rods
c. Gram-positive anaerobic cocci
d. Gram-positive aerobic cocci
81. A soft tissue graft that is rotated or otherwise repositioned to correct an adjacent defect is called a:
a. Frenectomy
b. Free gingival graft
c. Pedicle graft
d. Connective tissue graft
82. In assessing the severity or extent of periodontitis in epidemiologic studies of a large population one would
MOST likely use the _____ index
a. Plaque (P.I.)
b. PMA
c. Gingival (GI)
d. Sulcus bleeding (SBI)
e. Periodontal (PI)
83. Acts as messenger molecules transmitting signals to other cells
a. Matrix Metallo Proteinases
b. Interleukins
c. Cytokines
d. Lipo Poly Saccharide
e. Lipo Teichoic Acid
84. The most common osseous defects are:
a. Through-and-through furcation defects
b. One-wall intrabony defects
c. Three-wall intrabony defects
d. Two-wall intrabony defects (osseous craters)
85. The main cells involved in chronic infection are lymphocytes and:

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a. Neutrophils
b. Plasma cells
c. Mast cells
d. Macrophages
86. Which of the following species of streptococci is usually not found in human dental plaque?
a. S. mitior (S. mitis)
b. S. sanguis
c. S. pyogenes
d. S. mutans
e. S. salivarius
87. A variation of the laterally positioned flap is called:
a. A modified Widman flap
b. A free gingival flap
c. A double papilla flap
d. A coronally positioned flap
88. Frequent brushing helps to precent calculus formation by
a. Removing Ca/P ions that attach to tooth surfaces
b. Removing food particles on teeth and interproximal areas
c. Breaking up the matrix of plaque
d. Neutralizing local acidity
89. The purposes of periodontal dressings (packs) include all of the following except:
a. Maintain the sutured position of the flaps
b. Prevent mechanical injury to healing tissues
c. Improve patient comfort
d. Stop persistent bleeding
90. Initially the first group of cells to arrive at the site of injury are neutrophils. Later, _______ becomes more
numerous. In certain parasitic infections, _______ predominate. In viral infection _______ rather than neutrophils
usually predominate.
a. Macrophages, lymphocytes, basophils
b. Lymphocytes, macrophages, eosinophils
c. Plasma cells, basophils, eosinophils
d. Macrophages, eosinophils, lymphocytes
91. Daily cleaning of a root surface by the patient has been shown to
a. Corrode the enamel
b. Allow remineralization of the root surface
c. Cause root resorption
d. Cause root sensitivity
e. Stimulate the epithelial attachment
92. Which of the following statements best describe retrograde periodontitis?
a. Irritants gain access to the periodontal tissues at the site of a vertical-root-fracture producing tissue
destruction that mimics periodontitis.
b. Pulp necrosis results in the formation of an apical, radioluscent lesion characterized by the loss of the
apical lamina dura.

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c. Pulp necrosis occurs, and the toxic irritant cause inflammation that migrates to the gingival margin,
creating a periodontal pocket
d. Inflammation from the periodontal sulcus migrates apically, causing pulp inflammation and eventually
pulp necrosis
93. Loss of periodontal attachment is determined by measuring the distance between the
a. Gingival margin and the cementoenamel junction
b. Gingival margin and the bottom of the periodontal pocket
c. Gingival margin and the most coronal portion of the connective tissue attachment
d. Cementoenamel junction and the most coronal portion of the connective tissue attachment
e. Cementoenamel junction and the bottom of the periodontal pocket
94. Correction of a marked prematurity on a periodontally involved tooth results in a clinically observable
reduction in
a. Gingival inflammation
b. Mobility
c. Periodontal pocket depth
d. Facial clefts
e. All of the above
95. Curettage refers to
a. Removal of dental plaque from the coronal surfaces of teeth
b. Soft tissue debridement of the gingival wall of a periodontal socket
c. Scaling and/or planning of the root surface
d. Removal of calcified deposits from the gingival sulcus and/or periodontal pocket
96. Blood vessels in interdental papillae anastomose freely with:
a. Periodontal vessels only
b. Interalveolar vessels only
c. Both periodontal and interalveolar vessels
d. None of these
97. Leukotoxin is a product of which bacteria
a. P. intermedia
b. B. forsythus
c. A. actinomycetemcomitans
d. P. gingivalis
98. The role of microbial plaque is MOST obscure in which of the following diseases
a. Desquamative gingivitis
b. Necrotizing ulcerative gingivitis
c. Gingivitis
d. Juvenile gingivitis
e. Periodontitis
99. *Site development* for implants includes all of the following techniques except:
a. Orthodontic tooth movement
b. Guided tissue regeneration
c. Bisphosphonate supplementation for bone densit
d. Bone grafting with cow bone

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e. Socket grafting
100. Premature contacts of the dentition are MOST harmful if the patient
a. Clenches and grinds his teeth
b. Has maligned teeth
c. Consumes a high nondetergent diet
d. Wears a partial denture
ANSWERS 26. d. 52. 78. c.

1. a. 27. 53. 79. a.

2. d 28. 54. a. 80. b.

3. 29. b. 55. a. 81. c.

4. e. 30. 56. 82.

5. 31. 57. 83.

6. 32. a. 58. e. 84. d.

7. a. 33. 59. 85. d.

8. 34. 60. a. 86. c.

9. e. 35. 61. d 87. c.

10. 36. 62. 88.

11. 37. b. 63. e. 89.

12. 38. 64. 90.

13. a. 39. c. 65. e. 91. b.

14. c 40. 66. 92. d.

15. 41. 67. a. 93. a.

16. 42. c. 68. 94. b.

17. 43. 69. 95. c.

18. c. 44. 70. d. 96.

19. a. 45. b. 71. d. 97. c.

20. 46. c. 72. b. 98. a.

21. 47. b. 73. c. 99.

22. 48. 74. 100.

23. 49. b. 75. a.

24. b 50. b. 76.

25. a. 51. 77. c.

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