Endo Quiz 6
Trends (from Dr. Warner's weekly email)
-EPT score >80 (*always necrosis*) -Endo-ice response lingering pain (*irreversible pulpitis*) -Palpation and percussion sensitivity (*symptomatic apical periodontitis*) -Draining exudate (pus) indicates a sinus tract or *chronic apical abscess* -Swelling with erythematous tissue (red) mean *acute apical abscess* -Periapical radiolucency (PARL) -There is always a question about the difference between reversible pulpitis and normal pulp. The main distinguishing aspects are that *reversible pulpitis is usually associated with previous dental work or some type of trauma, including a chief complaint of pain.* -Furthermore, a reversible pulpitis will respond (but not linger) to endo-ice at a much more heightened and sensitive reaction than the adjacent teeth (controls). If the tooth in question respond to endo-ice similar to control teeth, it's considered a normal pulp diagnosis.
E
All of the following statements about amalgam are TRUE except: A. Shrinks on setting resulting in microleakage B. Microleakage decreases as corrosion products seals margins C. Amalgam is being replaced by composites for posterior restorations D. Amalgam is less technique sensitive than composite E. In deep cavities amalgam is associated with more pulpal injury than composites
F
All of the following statements about amalgam are TRUE except: A. Still used to restore posterior teeth B. Shrinking during setting results in micro-leakage C. Micro-leakage decreases as corrosion products accumulate between restoration and cavity wall D. Micro-leakage is reduced by use of a liner E. Micro-leakage reduces with the passage of time F. All are TRUE
B
All of the following statements about cavity/crown preparation is TRUE except: A. Cutting of dentin is not likely to involve the pulp unless the thickness of dentin between pulp and prep is less than 1 mm B. Blushing of dentin during cavity/crown preparation is due to excessive pressure exerted on the dentin C. The bur dentin interface should be constantly wet D. Hand instruments and low speed cutting are safer that high speed with water cooling
E
All of the following statements about direct pulp capping are TRUE EXCEPT: A. Pulpal diagnosis can be normal or reversible pulpitis B. Exposed pulp capped with calcium hydroxide or MTA C. Pulp cap sealed with Glass Ionomer cement and a permanent restoration D. Long-term success rate for capping mechanical pulp exposures is about 80% E. Teeth with carious pulp exposures can be treated with a direct pulp cap F. All are TRUE
F
All of the following statements about indirect pulp capping are TRUE except: A. Caries removed in increments in two or three appointments B. Each time caries is removed, glass ionomer is placed C. Glass ionomer may contribute to mineralization of the dentin D. Tooth is restored with well-sealed temporary restoration E. Case selection is critical; there must be no sign of irreversible pulpitis F. All are TRUE
D
All of the following statements about odontoblast displacement are TRUE except: A. Results from rapid outward fluid movement in the dentinal tubules B. Displaced odontoblasts undergo autolysis and disappear C. Replacement odontoblasts form reparative dentin D. Replacement odontoblasts derived from adjacent odontoblasts undergoing metasis
E
All of the following statements about odontoblast displacement are TRUE except: A. Results from rapid outward fluid movement in the dentinal tubules B. Displaced odontoblasts undergo autolysis and disappear C. Replacement odontoblasts from stem cells in the pulp form tertiary dentin D. Cavity cleansing agent containing acetone or ether can cause odontoblast displacement E. All are TRUE
B
All of the following statements about the Step-Wise excavation of caries is TRUE EXCEPT: A. Caries are removed in two or three appointments over a few months B. Each time the caries are removed, a hard set calcium hydroxide base is placed for dentin remineralization followed by a well-sealed temporary restoration C. Must be no signs of irreversible pulpitis D. Follow-up is critical with pulp-testing and radiographs E. Can also be referred to as an indirect pulp cap F. All are TRUE
B
All the following statements about polycarboxycate cements are TRUE except: A. Does not irritate the pulp B. Expands on setting to limit microleakage C. Does not require a cavity varnish or liner D. Does not require beveling of enamel margins
G
Apexification is the treatment of an immature tooth with an open apex that has the following characteristics: A. CaOH can be used to induce apical barrier. B. More current methodologies utilize MTA compacted into the apical area. C. First step is to access and remove hemorrhagic vital pulp. D. Long-term use of CaOH may weaken the root. E. a, b, and c F. b, c, and d G. a, b, and d H. All of the above
D
Apical actinomyces: A. Is handled by the host defenses B. Is dependent on a intraradicular infection C. Is usually symptomatic D. Will require periradicular surgery
D
Cavity preparations should be dried with: A. Acetone B. Ether C. Alcohol D. Cotton pellets E. Long blasts of air
D
Cavity varnish (all are *false* EXCEPT): *which one is true*: A. Is a suspension of materials in a volatile organic liquid or aqueous solution B. Is a thick cement that lines the cavity prep C. Reduces dentin permeability more than bases D. When applied to dentin it does not form an impervious coating E. All are FALSE
E
Choose the pulpal and periapical diagnoses: A. normal - normal B. normal - symptomatic apical periodontitis (SAP) C. irreversible pulpitis - normal D. reversible pulpitis - asymptomatic apical periodontitis (AAP) E. reversible pulpitis - normal
B
Choose the pulpal and periapical diagnoses: Pain #9 that wakes patient up at night Not tender to percussion and palpation Distal carious lesion Quick response to cold pulp testing which persists as lingering pain Radiograph reveals normal pulpal space and is negative for apical pathology A. Necrosis - Normal B. Symptomatic irreversible pulpitis - Normal C. Reversible pulpitis - Normal D. Symptomatic irreversible pulpitis - Symptomatic Apical Periodontitis (SAP) E. Normal - Normal
D
Choose the pulpal and periapical diagnoses: Pain #9 that wakes patient up at night Tender to percussion and palpation Distal carious lesion Quick response to ice which persists as lingering pain Radiograph reveals normal pulpal space and is negative for apical pathology A. Necrosis - Normal B. Symptomatic irreversible pulpitis - Normal C. Reversible pulpitis - Normal D. Symptomatic irreversible pulpitis - Symptomatic Apical Periodontitis (SAP) E. Normal - Normal
B
Choose the pulpal and periapical diagnoses: -Discolored #9 -Mucobuccal fold swelling -No response to pulp tests -Radiograph reveals normal pulpal space and an apical radiolucency -Negative to Percussion A. Acute irreversible pulpitis- Asymptomatic apical Periodontitis (AAP) B. Necrosis - Acute Apical Abscess (AAA) C. Necrosis - Chronic Apical Abscess (CAA) D. Symptomatic irreversible pulpitis - Normal E. Symptomatic irreversible pulpitis - Symptomatic Apical Periodontitis (SAP)
E
Choose the pulpal and periapical diagnosis A. necrosis - asymptomatic apical periodontitis (AAP) B. previously started - chronic apical abscess (CAA) C. previously treated - symptomatic apical periodontitis (SAP) D. necrosis - asymptomatic apical periodontitis (AAP) E. previously treated - asymptomatic apical periodontitis (AAP)
D
Choose the pulpal and periapical diagnosis A. normal - chronic apical abscess (CAA) B. irreversible pulpitis - acute apical abscess (AAA) C. necrosis - asymptomatic apical periodontits (AAP) D. necrosis - chronic apical abscess (CAA) E. necrosis - acute apical abscess (AAA)
D
Choose the pulpal and periapical diagnosis A. normal - normal B. normal - symptomatic apical periodontitis (SAP) C. reversible pulpitis - asymptomatic apical periodontitis (AAP) D. irreversible pulpitis - symptomatic apical periodontitis (SAP) E. irreversible pulpitis - normal
D
Choose the pulpal and periapical diagnosis A. normal - symptomatic apical periodontitis (SAP) B. necrosis - chronic apical abscess (CAA) C. necrosis - symptomatic apical periodontitis (SAP) D. necrosis - acute apical abscess (AAA) E. irreversible pulpitis - acute apical abscess (AAA)
D
Choose the pulpal and periapical diagnosis. Asymptomatic #9 Negative to percussion and palpation No response to pulp tests Radiograph reveals widen pulpal space , and is negative for apical pathology A. Necrosis- Asymptomatic apical Periodontitis (AAP) B. Necrosis - Acute Apical Abscess (AAA) C. Necrosis - Chronic Apical Abscess (CAA) D. Necrosis - Normal E. Acute irreversible pulpitis - Symptomatic Apical Periodontitis (SAP)
C
Choose the pulpal and periapical diagnosis: Tooth #9 is very sensitive to cold Negative to percussion and palpation Distal carious lesion No spontaneous pain Quick response to cold pulp testing which does not linger Radiograph reveals calcified pulpal space and is negative for apical pathology A. Necrosis - Normal B. Symptomatic irreversible pulpitis - Normal C. Reversible pulpitis - Normal D. Symptomatic irreversible pulpitis - Symptomatic Apical Periodontitis (SAP) E. Normal - Normal
C
Choose the pulpal and periapical diagnosis: Discolored #9 Tender to touch and percussion No response to pulp tests Radiograph reveals normal pulpal space and an apical radiolucency A. Irreversible pulpitis - Normal B. Necrosis - Asymptomatic Apical Periodontitis (AAP) C. Necrosis - Symptomatic Apical Periodontitis (SAP) D. Necrosis - Chronic Apical Abscess (CAA) E. Necrosis - Normal
A
Dentin is an effective insulator. The least mount of thickness that will not cause damage to the pulp is: A. 1.0 mm B. 1.5 mm C. 2.0 mm D. 2.5 mm
B
Dr. Hill indicated that all of the following statements about calcific metamorphosis are TRUE except: A. Pulpal space is still present B. Histologic obliteration of the pulpal space C. Is a hard tissue change D. Crown will have a yellow color E. Does not require immediate treatment unless symptoms develop or an x-ray reveals apical pathology
B
Dr. Newton indicated that the primary objective of the first appointment in the treatment of a tooth with diagnosis of necrosis is: A. Complete canal preparation B. Maximum instrumentation with the first file size that binds at the apex or the crown down technique C. Instrumentation at least two file sizes beyond the first instrument that binds snugly at the apex
E
Glass Ionomer cements (one is FALSE): A. Used as liners, and luting agents B. Were originally used as esthetic restorations C. Also used as a pulp capping agent in conjunction with calcium hydroxide D. When used as a liner over dentin thickness of .5 to .25 it will produce tertiary dentin E. All are TRUE
B
Indirect pulp capping: A. Only requires one appointment B. Indicated if no history of pulpal pain C. XNOP placed in prep to suppress bacteria D. Is highly recommended by Walton
E -rapid outward fluid mvmt in the dentinal tubule *can result in aspiration of odontoblastic nuclei* (another question)
Rapid outward fluid movement in the dentinal tubule: A. Can result from slow advancing caries B. Will never produce pain C. Can result from cavity washing with warm water D. Can result from cavity preparation drying with cotton pellets E. Can result from cavity preparation drying with prolonged air blasts
True
T/F: Amalgam is the only restorative material in which the marginal seal improves with time.
D
The marginal seal of which restorative material improves with time: A. Zinc phosphate materials B. Composite C. Glass Ionomer cements D. Amalgam E. Polycarboxylate cement
C
The material that demonstrates the most favorable long-term prognosis with direct pulp capping procedures is: A. ZnOE paste B. CaOH C. MTA (mineral trioxide aggregate) D. Dycal
B
The minimal amount of dentin remaining between cavity prep and the pulp should be: A. 0.5 mm B. 1.0 mm C. 1.5 mm D. 2.0 mm
C
Torebinejad et al., indicates that all of the following are TRUE about the smear layer except. What is the EXCEPTION? A. Composed of organic and inorganic debris lining the canal wall. B. May block dentinal tubules thereby decreasing permeability. C. Is a barrier to bacteria and bacterial products. D. Can be removed by irrigating with chelating agents (EDTA, QMIX). E. There are no exceptions, all statements are true.
E
Walton indicates that all of the following statements about the smear layer are TRUE except: A. Smear layer consists of mineral crystal fragments and organic matrix fragments produced when tooth structure is cut B. Removal of smear layer opens the dentinal tubules C. Smear layer can block the dentinal tubules D. The smear layer is permeable to bacterial products E. Smear layer can be removed with sodium hypochlorite F. All are TRUE
F
Walton indicates that all of the following statements about the smear layer are true EXCEPT: A. Smear layer consists of mineral crystal fragments and organic matrix fragments produced when tooth structure is cut B. Removal of smear layer opens the dentinal tubules C. Smear layer can block the dentinal tubules D. The smear layer is permeable to bacterial products E. Acid etching opens up the dentinal tubules F. All are TRUE
C
Walton indicates that the purpose of a base under metallic restorations is to: A. Improve retention B. Strengthen restoration C. Reduce dentin permeability D. Line the cavity preparation E. Act as an insulator
C
Zinc-oxide - eugenol: A. Is a permanent filling material B. Active ingredient is zinc-oxide C. Has antimicrobial properties D. Provides a poor biologic seal E. Is recommended for direct pulp capping F. Nontoxic when placed in contact with tissue
