1. Pulpal and periradicular pathosis results primarily from which of the following? a. Traumatic injury caused by heat during cavity preparation
b. Bacterial invasion
c. Toxicity of dental materials d. Immunologic reactions
2. Which of the following statements regarding the organism producing pulpal pathosis is correct?
a. The organisms are primarily facultative streptococci.
b. Single isolates (i.e., monoinfection) produce the most severe reactions c. Isolates tend to be polymicrobial and anaerobic.
d. Organisms infecting the pulp tend to be aerobic, compared to organisms infecting the periapex.
3. Which of the following best describes anachoresis?
a. The attraction of bloodborne microorganisms to inflamed tissue during a bacteremia
b. The process of carious invasion, cavitation, and exposure of the pulp from bacteria
c. Bacteria located in dentinal tubules, and the pulp that are seeded to the systemic circulation, inducing disease in other areas of the body
4. Which of the following statements regarding strict anaerobes is accurate? a. They are missing enzymes, catalase, and superoxide dismutase.
b. They function best at high oxidation-reduction potentials. c. They can grow in the presence of oxygen.
d. All of the above statements are accurate.
5. The most common black-pigmented bacteria cultivated from endodontic infections is which of the following?
a. Bacteroides melaninogaster b. Fusobacterium nucleatum c. Prevotella nigrescens d. Porphyromonas intermedia
6. Treatment of actinomycosis israelii may include which of the following? a. Root canal treatment
b. Root end surgery c. Antibiotics d. All of the above
7. Which is true regarding microbial virulence factors? a. Fimbriae assist in bacterial aggregation.
b. Pili break off and form extracellular vesicles filled with enzymes.
c. Lipopolysaccharides is found in the liposomes of gram-positive bacteria. d. All of the above.
8. Which of the following statements regarding polyamines is accurate? a. They are produced by bacteria and host cells.
b. They may be found in infected root canals.
c. They are more concentrated in teeth with spontaneous pain. d. All of the above statements are accurate.
9. Which of the following statements regarding fascial space infections is accurate? a. They are associated with radiographically visible periradicular lesions.
b. They occur in potential spaces between fascia and underlying tissue. c. They occur when a tooth apex is located coronal to a muscle attachment.
d. All of the above statements are accurate.
10. Which of the following statements regarding Ludwig's angina is accurate?
a. It involves the submental, sublingual, and submental space of the right or left side. b. It can progress into the canine and infraorbital space.
c. It can result in airway obstruction. d. All of the above statements are accurate.
11. Antibiotics are recommended for which of the following? a. Sinus tracts
b. Acute, apical periodontitis c. After root end surgery d. None of the above
12. Incision and drainage is indicated which of the following? a. For sinus tracts
b. When the swelling is diffuse and indurated c. For acute, apical periodontitis
d. All of the above
13. Incision and drainage of cellulitis is effective because of which of the following? a. It provides a pathway of drainage to prevent spread of infection.
b. It relieves increased tissue pressure. c. It provides relief of pain.
d. It increases circulation to the area and improves delivery of antibiotics. e. All of the above statements are accurate.
a. It has a broader spectrum than amoxicillin.
b. It may be dosed at 4-hour intervals for severe infection. c. It will select for resistant organisms, especially in the GI tract. d. It has up to a 25% allergy rate.
15. Which of the following statements regarding metronidazole is accurate? a. It is effective against facultative and anaerobic bacteria.
b. It cannot be given with penicillin because of disulfuram reaction. c. It cannot be taken with lithium or alcohol.
d. All of the above statements are accurate.
16. Which of the following statements regarding clindamycin is accurate? a. It is an alternative to potassium penicillin V in allergic individuals. b. It is effective against facultative and anaerobic bacteria.
c. It is rarely associated with pseudomembranous colitis in doses recommended for endodontic infections.
d. All of the above statements are accurate.
17. Which of the following statements regarding the American Heart Association (AHA) guidelines for prophylactic antibiotic coverage is accurate?
a. They are the standard of care for clinicians. b. They are based on controlled clinical studies. c. They are not a substitute for clinical judgment.
18. The AHA recommends antibiotic prophylaxis for which of the following? a. Surgery
b. Instrumentation beyond the apex c. Periodontal-ligament injection
d. All of the above
19. Which of the following statements regarding he theory of focal infection is accurate?
a. It was propounded by Dr. William Hunter in 1910.
b. It was referred to infections found around poorly made restorations. c. It was used to explain diseases for which there was no cure.
d. It results in needles tooth extraction. e. All of the above statements are accurate.
20. Which of the following is correct in relation to the periradicular lesion formed in response to dental caries and subsequent pulp necrosis?
a. Bacteria are commonly found in the granuloma. b. T-helper cells predominate over T-suppressor cells.
c. Formation of the granuloma is mediated through a specific immunologic response.
d. The release of interleukins can mediate bone resorption.
CHAPTER 14:
INSTRUMENTS, MATERIALS, AND DEVICES
1. Which of the following statements regarding pulp stimulation with cold is accurate?
a. It is best accomplished with carbon dioxide snow (i.e., dry ice). b. It is an accurate assessment of pulp vitality.
c. It directly stimulates the pain fibers in the pulp. d. It is best determined with a blast of air.
2. With regard to electrical pulp testing, which of the following is true? a. Positive responses can be used for differential diagnosis of pulp pathosis.
b. The device uses a pulsating, alternating current with a duration of 1 to 15 ms. c. The device uses a low current with a high-potential difference in voltage. d. Gingival and periodontal tissues are more sensitive to testing than the pulp. 3. Which of the following statements regarding digital radiographs is accurate?
a. They are produced by a charged coupled device and do not require x-rays. b. They have the advantage of being manipulatable, which facilitates interpretation. c. They have greater resolution than traditional film.
d. They are captured by a sensor that has a greater surface area than traditional film. 4. Which of the following statements regarding nickel and titanium (NiTi)
instruments is accurate?
a. They exhibit a high elastic modulus, which provides flexibility.
b. When stressed, they exhibit transformation from the austenitic crystalline phase to a martensitic structure.
c. They cannot be strained to the same level as stainless steel (SS) without permanent deformation.
d. They are easier to prebend before placement in the canal than SS. 5. A barbed broach is most useful for which of the following?
a. Removal of cotton, paper points, and other objects from the canal b. Removal of vital tissue from fine canals
c. Initial planing of the canal walls
d. Coronal-orifice enlargement before establishing the correct working length 6. In comparing K-type files with reamers, which of the following statements regarding K-type files is accurate?
a. They have more flutes per millimeter, which increase flexibility.
c. They are more effective in removing debris.
d. They are the least flexible when comparing instruments of the same size.
7. Based on instrument design and method of manufacturing, which of the following is most susceptible to fracture?
a. K-type file fabricated from tapered, square SS blank b. K-flex file fabricated from rhomboidal SS blank c. Hedström file fabricated from round SS blank d. Reamer fabricated from triangular SS blank
8. Which of the following statements regarding Hedström files are accurate? a. They are manufactured by machining a round cross-sectional wire.
b. They are effective when used in a reaming action.
c. They are safer than K-type files, because external signs of stress are more visible as changes in flute design.
d. They are aggressive because of a negative-rake angle that is parallel to the shaft. 9. Which of the following statements regarding the Profile rotary instruments is accurate?
a. They are used at a range of 1500 to 2000 rpm.
b. They are NiTi instruments manufactured in half sizes. c. They exhibit sizes that are ISO and ANSI standardized. d. They incorporate radial lands in the flute design.
10. Which of the following statements regarding the best apex locators is accurate? a. They require training with the instrument to become proficient.
b. They are sensitive to canal contents.
d. On average, they are accurate to within 0.5 mm of the apex. e. All of the above statements are accurate.
11. Piezoelectric, ultrasonic devices differ 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, ShaperSonic, and TrioSonic file system. d. The piezoelectric unit vibrates at 2 to 3 kHz.
12. Which of the following statements regarding ultrasonic root canal instrumentation is accurate?
a. It should be performed in a dry environment. b. It poses little risk of file breakage.
c. It is not very useful for dentin removal.
d. It is most useful in small canals where file contact with the wall is maximized. 13. Which of the following statements regarding sodium hypochlorite used as a root canal irrigating solution is accurate?
a. It is buffered to a pH of 12 to 13, which increases toxicity. b. It exhibits a chelating action on dentin.
c. It should be used in higher concentrations because of the increased free chlorine available.
d. It is a good wetting agent that permits the solution to flow into canal irregularities. 14. When ethylenediaminetetraacetic acid (EDTA) is used as an endodontic irrigant, which of the following statements is accurate?
a. It must be completely removed after use to prevent continued action and destruction of dentin.
c. It acts on organic-and-inorganic components of the smear layer. d. It penetrates deep into dentin and enhances root canal preparation.
15. Calcium hydroxide is advocated as an interappointment medication primarily because of which of the following
a. Its ability to dissolve necrotic tissue b. Its antimicrobial activity
c. Its ability to stimulate hard-tissue formation d. Its ability to temporarily seal the canal
16. Which of the following statements is accurate regarding gutta-percha points is accurate?
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.
17. An advantage to AH26 as an endodontic sealer is which of the following? a. The release of formaldehyde on setting
b. Low toxicity
c. Long working time, but quick setting (i.e., 1 to 2 hours) at body temperature d. It can be distinguished from gutta-percha radiographically
18. N2, Endomethasone, and Reibler's paste are sealers that do which of the following?
a. Produce liquefaction necrosis in the periradicular tissues
b. Induce healing in the apical pulp wound after vital pulp extirpation c. Can cause periapical inflammation
d. Do not produce a seal when used in combination with a core material 19. Which of the following statements is accurate regarding TERM is accurate?
a. It seals as well as Cavit.
b. It is the material of choice when strength is a requirement. c. It is a zinc oxide-reinforced material that can be light cured. d. It has a eugenol component that is antibacterial.
20. The root end is ultrasonically prepared during endodontic surgery for which of the following reasons?
a. It results in apical cracks at low settings. b. It results in larger, but cleaner, cavity walls.
c. It can make a deeper cavity more safely than a bur. d. It does not require as acute an angle of root resection.