EndoPerio 004

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Centro Escolar University

College of Dentistry
PRE-BOARD THEORETICAL EXAMINATION
0208

ENDODONTICS AND PERIODONTOLOGY

1. The following are requirements of an ideal root canal filling materials:


I. should not be impervious to moisture
II. should not shrink
III. should not stain tooth structure
IV. should be radiopaque
A. I, II & III B. I, III & IV C. II, III & IV D. I, II, III & IV E. I & III only

2. Gutta percha as a root canal sealer:


A. can be condensed and well adapted to the irregularities and contours of the canal
walls
B. is rigid and easily adapted to canals smaller than size 30
C. cannot be displaced by pressure therefore, overfilling is not a hazard
D. relatively insoluble and difficult to remove from the canal when necessary
E. has an adhesive property or quality, therefore, use of sealers is optional

3. Body defenses that facilitates disinfection of root canals:


A. phagocytic cells C. antibiotics
B. antibodies D. both A & B E. both B & C

4. Internal resorption is detected in a vital, asymptomatic tooth. Treatment of choice is to:


A. extract the tooth
B. perform a pulpotomy
C. keep the tooth under observation
D. remove the pulp and proceed with endodontic treatment at this time
E. none of the above

5. The action used for placing a K-type file into a canal should resemble:
A. an up-and-down motion
B. a straight apical pressure
C. complete rotation of the instrument with pressure directed apically
D. a clockwise-counterclockwise motion with pressure directed apically
E. none of the above.

6. Which condition is contraindicated for endodontic treatment?


A. carious exposure with pulpal involvement
B. a non-functional tooth with no future strategic importance
C. necrotic tooth with internal resorption
D. horizontal crown fracture above the gingival margin
E. none of the above.

7. Which of the following may be used to disinfect gutta percha points:


A. boiling C. chemical solutions
B. autoclave D. flame sterilization E. dry heart sterilization

8. Used as an intertreatment dressing material:


A. fermin B. Cavit C. NaoCL D. CMCP E. EDTA

9. In which of the following pathologic conditions would a single-rooted teeth be expected to


respond to heat, cold and electric pulp tester?
A. apical cyst C. chronic apical periodontitis
B. acute apical abscess D. suppurative apical periodontitis
E. Periapical cemental dysplasia (cementoma)
10. Which of the following is characteristic of sensory fibers of the pulp?
A. They can selectively differentiate thermal stimuli
B. They have special neuronal endings that are specific for proprioception
C. They are non-selective to all stimuli indicating only pain when the threshold has
been exceeded.
D. None of the above.

11. Common compacting instrument:


A. file B. spreader C. plugger D. lentulofiller

12. Characterized as the 3-dimensional filling of the entire root canal system is as close to the DCJ
as possible:
A. master cone B. obturation C. mechanical preparation D. apical cone

13. A 3-dimensionally well-filled root canal system:


A. prevents percolation of periapical exudates into the root space
B. maximizes the amount of sealer and minimizes the cone material
C. is independent of the endodontic cavity design
D. is dependent upon the use of intracanal medications to sterilize the canal
E. none of the above

14. Desired periapical tissue responses after endodontic therapy on a tooth with a periapical lesion
include:
I. regeneration of dentin
II. regeneration of alveolar bone
III. deposition of apical cementum
IV. re-establishment of the periodontal ligament
A. I, II & IV B. I & IV only C. II & IV only D. II, III & IV E. III & IV only

15. Which of the following is least likely to cause discoloration of a tooth with a necrotic pulp?
A. decomposition of necrotic tissue
B. hemolysis of unremoved blood cells
C. failure to include pulp horns in a coronal access
D. frequent ingestion of heavy doses of tetracycline
E. use of a root canal sealer that contains precipitated silver

16. Biomechanical preparation of the root canal is necessary to:


A. straighten minor canal curvature
B. prevent post operative discoloration
C. remove areas that can retain bacteria and debris
D. create a space easy to obliterate
E. all of the above

17. Ideal root canal medication and dressing:


A. carbolic acid C. oil of cloves E. formocresol
B. penicillin preparation D. Camphorated monochlorophenol

18. Ideal root canal obturant:


A. zinc oxide eugenol cement C. silver points
B. gutta percha D. both A & B E. all of the above

19. In which of the following is one-visit root canal treatment not recommended?
A. The pulp is necrotic and not symptomatic
B. The pulp is necrotic and symptomatic.
C. The pulp is necrotic and there is a draining sinus tract.
D. The pulp is vital and symptomatic.
E. None of the above.

20. The result of RCT in establishing patency is:


A. It prevents procedural errors, such as canal blockage and transportation.
B. It causes irritation of the periodontal attachment apparatus and increased post operative
pain.
C. It enlarges the apical terminus and increases the potential for extrusion of obturating
material.
D. It requires insertion of a file 1.0 to 2.0 mm beyond the canal terminus.

21. The mandibular, 2nd molar should be restored with crown after RCT for which of the following
reasons?
A. The pulp chamber is relatively large in comparison to the crown, making the tooth
susceptible to fracture.
B. The tooth is in close to the insertion of the muscle of mastication, and the
percentage of preexisting fractures is high.
C. There is a tendency for the buccal cusps to shear off under occlusal loading.
D. Providing a post can be placed in the distal root to strengthen the root.

22. A problem with nickel-and-titanium (NiTi) spreaders is which of the following?


A. Tendency to buckle under compaction pressure.
B. Tendency to break during condensation.
C. Creation of greater wedging forces, leading to root fracture.
D. They do not penetrate as deeply as stainless spreaders under equal force.
23. A common gutta percha solvent:
A. alcohol C. beachwood creosote
B. chloroform D. camphorated monochlorophenol E. sodium hypochlorite

24. Moderate extrusion of obturating materials beyond the apex is undesirable because of which of
the following?
A. There is more likelihood of postoperative discomfort.
B. Sealer and gutta-percha cause a severe, inflammatory reaction in periradicular tissue.
C. The prognosis is poorer.
D. All of the above.
E. both A & B only

25. Piezoelectric, ultrasonic devices differs from magneto-strictive devices in which of the
following?
A. The piezoelectric unit transfers more energy to the files.
B. The piezoelectric unit produces heat that requires a coolant.
C. The piezoelectric unit uses a RispiSonic, SharperSonic, and TrioSonic file system
D. The piezoelectric unit vibrates at 2 to 3 kHz.

26. Once the root canal is obturated, what usually happens to the organisms that had previously
entered periapical tissues from the canal?
A. They persist and stimulate formulation of a granuloma.
B. They are eliminated by the natural defenses of the body.
C. They re-enter and reinfect the sterile canal unless periapical surgery is performed.
D. They will have been eliminated by various medicaments that were used in the root
canal.

27. Erratic and inconsistent results from electric pulp testing may be caused by:
1. saliva on the tooth
2. secondary dentin obliterating the pulp chamber
3. multiple canals presenting various stages of pulp pathosis
A. 1 & 2 B. 1 & 3 C. 2 & 3 D. 1 only E. 1,2 & 3

28. 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, 2 & 3 B. 1 & 2 C. 2, 3 & 4 D. 2 & 3 E. 1 & 3
29. The most effective means to reduce root canal microbes is:
A. systemic medication
B. complete debridement of the root canal
C. intracanal medication with a non-specific drug
D. intracanal medication with multiple antibiotic preparations.

30. The primary function of a root canal sealer is to:


A. prevent discoloration
B. seal dentinal tubules
C. stimulate healing in the apical region
D. medicate the canal to eliminate remaining bacteria
E. fill the space between the solid cone material and the pulp canal wall.

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

31. A healthy 8-year old child has fractured permanent central incisor. The pulp is widely exposed
and vital. From radiographs, root ends appear incompletely calcified. The recommended
procedure is to:
A. cap the pulp C. perform a pulpotomy
B. extract the tooth D. remove the entire pulp.

32. The action of calcium hydroxide in promoting formation of an apical calcified barrier in a tooth
with an open apex and a necrotic pulp is probably best explained by:
A. creation of a zone of liquefaction necrosis at the apex
B. creation of a zone of coagulation necrosis at the apex
C. creation of an environment that promotes hard tissue deposition
D. calcium ions from the canal dressing precipitating apically to form an apical bridge.

33. The least important factor influencing the pathogenicity of endodontic flora is:
A. Microbial interaction.
B. Endotoxins released after bacterial death.
C. Exotoxins released by living bacteria
D. Enzymes produced by bacteria.

34. Which of the following statements is accurate regarding gutta-percha points?


A. They contain 40% to 50% pure gutta-percha.
B. They adhere to dentin when compacted
C. They can be heat sterilized.
D. They are not compressible.

35. Retreatment has the most favorable prognosis during which of the following?
A. When the cause of failure is identified and is correctable.
B. When the patient is asymptomatic.
C. When gutta-percha was used instead of paste.
D. When a surgical microscope is used.

36. Which of the following teeth is most likely to exhibit C-shaped morphology?
A. Maxillary first premolar C. Mandibular first premolar
B. Maxillary first molar D. Mandibular first molar.

37. 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 & 2 B. 1 & 3 C. 2 & 3 D. 1,2 & 3 E. 3 only

38. Histologically, the normal dental pulp most closely resembles:


A. nervous tissue D. loose connective tissue
B. endothelial tissue E. dense connective tissue
C. granulomatous tissue

39. One objective of root canal obturation is to develop a fluid tight seal. Another objective is to
create a favorable biologic environment for the process of tissue healing.
A. Both statements are TRUE.
B. Both statements are FALSE
C. The first statement is TRUE, the second is FALSE
D. The first statement is FALSE, the second is TRUE.

40. A dentist restored an endodontically treated tooth with a cast post-and-core and a metal
ceramic crown. Tree months later, the patient calls and complains of pain, especially on biting.
Tooth mobility is normal, as are the radiographs. The most probable cause of pain is:
A. a loose crown C. a vertical root fracture
B. psychosomatic D. a premature eccentric contact

41. Which of the following perforations has the poorest prognosis?


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

42. Which of the following is used to bleach a discolored, endodontically treated tooth?
A. Ether C. Sodium bicarbonate
B. Chloroform D. Sodium hypochlorite E. Hydrogen peroxide

43. The most important principle governing the location and outline of the lingual or occlusal
opening into the pulp chamber is:
A. preservation of tooth structure.
B. Direct access along straight lines.
C. Complete removal of the roof of the pulp chamber
D. Removal of all caries and defective restorative material.

44. Endodontic therapy is contraindicated for a single rooted tooth that has:
A. discoloration
B. an acute apical abscess
C. a chronic abscess and a draining sinus tract
D. a horizontal fracture of the apical third of the root.
E. A vertical fracture of the root and an associated deep periodontal defect

45. A negative response to the electric pulp tester immediately after a severe luxation of a tooth
indicates that the:
A. pulp is inflamed
B. electric pulp tester is giving a false reading
C. pulp is necrotic and should be removed
D. blood supply is interrupted, and the negative response may be temporary
E. neural transmission is interrupted ,and the negative response may be
temporary.

46. In treating a root canal before obturation, the most important consideration is:
A. general health of the patient
B. cleaning and shaping of the canal
C. efficacy of the irrigating solution
D. amount and concentration of medication used.
E. Sterilization of the canal as evidenced by negative cultures
47. Which of the following root surfaces is the most likely to be strip-perforated during canal
instrumentation of the mesial root of a mandibular first molar?
A. facial B. lingual C. mesial D. distal

48. The success of a pulpotomy for a primary molar depends primarily upon:
A. a vital root pulp C. the amount of root resoprtion
B. the patient’s age D. the absence of internal root resoprtion

49. During a stepback enlargement of the canal space, one reason for recapitulation after each
increase in instrument size is to:
A. maintain coronal curvature of the canal
B. maintain the apical stop for filling with gutta-percha
C. create a coronal funnel to facilitate filling with gutta-percha
clean the apical segment of dentin fillings that are not removed by irrigation

50. The action used for placing K-type file into a canal should resemble:
A. an up-and-down motion
B. a straight apical pressure
C. complete rotation of the instrument with pressure directed apically.
D. a clockwise-counterclockwise motion with pressure directed apically.

51. Radiographically, the level of the normal interproximal alveolar crest is related to the:
A. epithelial attachment. D. Amount of underlying trabecular bone.
B. Anatomy of the alveolar process E. Position of the CEJ of approximal teeth.
C. Location of the gingival attachment

52. Which of the following oral bacteria have been implicated as periodontal pathogens?
A. Porphyromonas gingivalis, Eubacterium sp., and Campylobacter recta
B. Streptococcus gordonii, Streptococcus mutans, and Giamella sp.
C. Lactobacillus casei and Veillonella sp.
D. Streptococcus mitior, Streptococcus gordonii, and Bacteriodes gracillis
E. None of the above

53. Where there are deepened pathologic pockets range from 6-8 mm, gingivectomy is indicated. Will
you do the procedure in:
A. one quadrant at a time C. three quadrant at a time
B. two quadrant at a time D. all at the same time.

54. Histologic examination of the tissues in desquamative gingivitis (gingivosis) reveals:


A. hyperkeratosis D. aggregations of gisnt cells.
B. no inflammatory response E. local loss of the basement membrane
C. elongation of rete pegs

55. Which of the following periodontal diseases causes the most rapid destruction of alveolar bone?
A. Periodontal abscess C. Phenytoin-induced gingival enlargement
B. Chronic periodontitis D. Necrotizing ulcerative gingivitis

56. Subgingival curettage is indicated for:


A. edematous gingival C. periodontitis simplex
B. hyperplastic gingival D. hypertrophied gingival

56. In primary occlusal traumatism, the most diagnostic finding is:


A. Mobility C. bone loss
B. Faceting D. gingival recession E. vertical pocket formation

57. Which of the following is the most appropriate initial treatment for a patient with HIV-associated
necrotizing ulcerative gingivo-periodontitis?
A. Debridement and antimicrobial rinses. C. Gingivectomy and gingivoplasty
B. Definitive root planing and curettage D. administration of antibiotics
58. What is the most important to prevent recurrence of periodontal disease?
A. plaque control C. oral hygiene
B. oral physiotherapy D. all of them.

59. A bacterial enzyme capable of altering the ground substance of the periodontal ligament is:
A. lysozyme C. collagenase
B. peroxidase D. streptokinase E. hyaluronidase

60. Which of the following has been associated with localized juvenile periodontitis?
A. Cyclic eosinophils C. Increased phagocytosis
B. Lysis of neutrophils D. Neutrophil chemotactic defects

61. Pathologic pockets are deepened sulci characterized by:


A. Bone loss and migration of junctional epithelium
B. Bone loss only.
C. Ulceration of lamina propia.
D. Loss of circular epithelium

62. Pronounced bony ledges and interproximal cratering are indicators for performing:
I. gingivectomy IV. flap surgery
II. osseous grafting V. infrabony therapy
III. osseous resection and contouring
A. I & III B. I & V C. II & IV D. III & IV E. IV & V

63. The highest incidence of fibrous gingival enlargement (hyperplasia) is related to:
A. Puberty . C. leukemia D. medication
B. Diabetes D. pregnancy

64. Changes that occurs in edematous gingiva are:


A. Hyperemia in lamina propia.
B. Congestion in the connective tissue bed.
C. Venous stasis in the connective tissue bed.
D. Ulceration of the outer epithelium.

65. Increasing the zone of attached gingival in the area of mandibular second and third molars is
often complicated by the presence of the:
A. mylohyoid ridge C. internal oblique ridge
B. vestibular fornix D. external oblique ridge E. none of these.

66. Desquamation of the gingival with ulceration of the lamina propia is:
A. Gingivosis C. herpetic gingivostomatitis
B. necrotic ulceration gingivitis D. gingivitis

67. Juvenile Periodontitis is manifested by:


A. Migration or wandering teeth from the upper 1st molars
B. Bone resoprtion
C. 30 mobility
D. retractable gingival

68. Brushing with a hard multi-bristled toothbrush could cause:


I. cervical erosion III. Gingival recession
II. facial clefts IV. cervical abrasion
A. I, II & III B. I, II & IV C. I, III & IV D. II, III & IV E. all of the choices

69. The col is found in which of these?


A. Alveolar mucosa C. Attached gingiva
B. Marginal gingival D. Interdental papilla
70. Which type of periodontitis causes continued attachment loss inspite of apparently appropriate
therapy?
A. Juvenile periodontitis C. Adult periodontits
B. Refractory periodontitis D. Rapidly progressive periodontitis

71. Which of the following cell types contains a biologically active amine which is released in the
inflammatory process and is active in causing vascular permeability?
A. Mast cell C. T lymphocyte
B. Plasma cell D. B lymphocyte E. none of these.

72.Dental plaque is believed to adhere to teeth because


A. Levans are soluble and sticky
B. dextrans are insoluble and sticky
C. the surface tension of plaque is low
D. bacteria secrete a lipoprotein-cementing substance

73. Which of these virulence factors of A.Actinomycetemcomitans is responsible to the killing of


PMN’s resulting in the destruction of the periodontal disease?
A. Leukotoxins C. Endotoxins
B. Enzymes D. Polyclonal B lymphocytes activation

74. ////Soft tissue curettage is most successful in reducing pocker depth in which of the following?
A. infrabony pocket C. hyperplastic fibrotic gingival tissue
B. edematous gingival tissue D. gingival enlargement E. none of these.

75./// Pronounced bony ledges and interproximal cratering are indicative for:
A. Gingivectomy C. Periodontal flap
B. Modified Widmans flap D. Scaling, root planing and curettage

76./// Pockets of biologically active enzymes in the cytoplasm of polymorphonuclear leucocytes which
play an important role in inflammatory periodontal disease are:
A. Cristae C. lysosomes
B. Endoplasmicreticulum D. lysozymes

77. A periodontal pocket can be seen radiographically on which of the following surfaces?
A. lingual B. facial C. mesial D. distal E. none of these

78. The first fiber group destroyed to allow the junctional epithelium to migrate in an apical direction is
the:
A. circular C. dentogingival
B. horizontal D. alveologingival E. none of these.

79. The open flap curettage in periodontal surgical procedures is the:


A. Neumann flap C. Original Widman flap
B. Modified Widman flap D. Nabers flap

80. Although no causal relationship between particular bacteria and periodontal diseases have been
determined, there does appear to be an association between localized juvenile periodontitis and the
presence of:
A. Actnobacillus actinomycetemcomitans C. Treponema denticola
B. Porphyromonas gingivalis D. Actinomyces viscosus

81. Which of the following components or products of plaque bacteria are antigenic in humans?
I. enzymes and other proteins
II. hydrogen sulfide IV. endotoxins
III. polysaccharides V. Ammonia
A. I, II & IV B. I, III & IV C. II, III & V D. III, IV & V E. all of these

82. PMN leucocytes migrate through the blood vessel wall in the early stage of inflammation by
means of:
A. Diapedesis C. chemotaxis
B. Rhexis D. phagocytosis

83. Which of the following is the most appropriate initial treatment for a patient with HIV-associated
necrotizing ulcerative gingivo-periodontitis?
A. Debridement and antimicrobial rinses. C. Gingivectomy and gingivoplasty
B. Definitive root planing and curettage D. administration of antibiotics

84.Loss of periodontal attachment is determined by measuring the distance between the:


A. gingival margin and the CEJ
B. gingival margin and the bottom of the periodontal pocket
C. CEJ and the bottom of the periodontal pocket
D. Gingival margin and the most coronal portion of the connective tissue attachment

85. Alveolar bone loss may be a feature of the following conditions, except:
A. Hyperparathyroidism C. eosinophilic granuloma
B. Hypophosphatasia D. erosive lichen planus

86. Barriers are used in the management of infrabony defects, except:


A. prevent proliferation of gingival connective tissue and epithelium to the root
surface
B. allow long junctional epithelium attachment
C. permit regeneration of periodontal tissues to form a fibrillar attachment from bone to
cementum
D. regenerate periodontal collagen fibers

87. Which of the following factors is most critical in determining whether or not to extract a tooth
involved with periodontal disease?
A. depth of pockets C. amount of attachment loss
B. mobility of the tooth D. relationship to adjacent teeth

88. Which of these gingival connective tissue component acts as a molecular filter and regulates cell
migration:
A. Glucoronic acid C. Glycoproteins
B. Proteoglycans D. Heparatan
89. Unilateral mastication will tend to result in:
A. Greater accumulation of plaque in the unused side
B. Heavier and denser bone support in the unused side
C. Greater accumulation of plaque in the used side
D. Greater degree of periodontal disease in the used side

90. Apical migration of the epithelial attachment with corresponding recession of the marginal
gingival results in
A. a shallow sulcus C. infrabony pocket formation
B. gingival pocket formation D. periodontal pocket formation

91. The index used for assessment of average severity of periodontal disease in large population
groups is:
A. Loe and Silness index C. Greene and Vermillon index
B. Russel index D. Ramfjord index

92.. Which of the following periodontal diseases show a strong genetic etiologic relationship?
A. Adult periodontitis C. Juvenile periodontitis
B. Acute necrotizing ulcerative gingivitis D. Gingivitis

93.Apical migration of the epithelial attachment with corresponding recession of the marginal gingival
results in
A. a shallow sulcus C. infrabony pocket formation
B. gingival pocket formation D. periodontal pocket formation
94. The periodontal ligament is vital to the tooth, except:
A. contains nerves and vascular elements
B. provides the cellular elements of bone and cementum
C. furnishes an elastic sling for holding the tooth
D. allows for physiologic movement of the teeth

95. Pocket where gingival sulcus is deepened because of the increased bulk of the gingiva:
A. gingival pocket B. periodontal pocket C. suprabony pocket D. infrabony pocket

96. The most common clinical sign of occlusal trauma is the presence of:
A. wear facets C. tooth mobility
B. enamel cracks D. cuspal fracture E. tooth sensitivity

97. Which of these inhibit collagenase formation in the management of periodontal disease:
A. Amoxycillin C. Metronidazole
B. Erythromycin D. Minocycline

98 Pocket where the bottom of the pocket is apical to the level of the adjacent alveolar bone. :
A. gingival pocket B. periodontal pocket C. suprabony pocket D. infrabony pocket.

99. Which of the following is the current method-of-choice for removing or disrupting bacterial masses
in the mouth?
A. Biologic C. Mechanical (brush and floss)
B. Chemical (mouthwashes) D. Antibiotic (penicillin, tetracycline)

100. During calculus removal, the surface of the root feels smoothest following scaling with:
A. a hoe D. an unltrasonic instrument
B. periodontal files E. a rotary driven metal scaler
C. a periodontal curet

/dent
11-26-2008

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