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Endo > BOOK QUESTIONS > Flashcards

BOOK QUESTIONS Flashcards

1
Q

what does the dental pulp form as a defensive response?

A

Tertiary dentin

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2
Q

what cell in an antigen recognition cell in the dental pulp

A

odontoblasts

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3
Q

what is the most prominent antigen presenting cell in the dental pulp?

A

dendritic cell

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4
Q

what type of collagen most prominent in the dental pulp?

A

type I

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5
Q

What is NOT a type of pulp stone:

free, attached, embedded, or floating?

A

FLOATING

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6
Q

what are free pulp stones?

A

surrounded by pulp

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7
Q

what are attached stones?

A

continuous with the dentin

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8
Q

what are embedded pulp stones?

A

surrounded entirely by DENTIN and mostly of the TERTIARY type

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9
Q

Describe a pulp cap?

A

capping of exposed vital pulp tissue by placing a layer of MTA

this will stimulate reparative dentin and maintain pulp vitality

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10
Q

what is the effect of blood flow to the pulp when anesthtics with vasoconstriction are sued during restorative procedures?

A

blood flow is reduced to less than HALF of its normal rate.

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11
Q

what is dentin blushing?

A

vascular injury (hemorrhage) of pulp tissue often during crown preps. Thought to be due to the frictional heat

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12
Q

why are deeper carious lesions more injurious to the dental pulp?

A

increased dentin permeability in deeper areas, and greater cellular injury to the odontoblasts.

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13
Q

what depth of dentin shield is often sufficent to sheild pulp

A

at least 1 mm

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14
Q

why does a blast of compressed air directed at freshly exposed dentin create a sensation of pain?

A

causes a rapid outward movement of fluid in patent dentinal tubules and this stimulates nociceptors in the dentin pulp

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15
Q

what is the primary reason for the placement of a liner between biocompatible restorative materials and the dentin?

A

eliminate microleakage

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16
Q

what is the most significant determinant of the success of vital pulp therapy?

A

Pulp status before the procedure

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17
Q

what do you place at each visit with step wise evacuation of caries?

A

glas ionomer base

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18
Q

what is apexogenesis?

A

continued physiologic root formation… is a vital pulp therapy procedure performed to encourage continued physiologic development and formation of the root end.

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19
Q

What is Apexification?

A

induction of a calcific barrier across and open apex

you remove the necrotic pulp, depbride the canal, and place an antimicrobial medicament.

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20
Q

why is there greater dentin permeability near the pulp?

A

higher density of the dentinal tubules AND larger diameter

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21
Q

bacterial invasion of the dentinal tubules occurs more rapidly in which teeth?

A

non vital teeth

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22
Q

what is anachoresis?

A

microorganism transport from blood vessels into damaged tissue

PEOPLE are trying to research this topic to see if traumatized teeth with intact crowns are affected this way…

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23
Q

T/F

Root canals can become infected through anachoresis?

A

false

…research says the MAIN pathway of pulpal infection is from dentinal exposure due to enamel cracks

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24
Q

Which is NOT a category of Intraradiuclar infections?

A

tertiary?

Intraradiuclar are primary, secondary, or persistant

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25
Q

most common microorganisms in PRIMARY endo infections are?

A

Gram negative bacteria!

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26
Q

what microorganisms is commonly present in large percentages of root canal treated teeth that present with persistent apical periodontitis, indicaitve of failed treatment?

A

Enterococous Faecalis

It’s faculative anerobic gram pos coccus that has been frequently found in root canal treated teeth.

more restrictive group compared to primary infection

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27
Q

describe gram positive bacteria and endo

A

they have a higher occurence in post instrumentation samples, MORE resitant to antimicrobial treatmetns, adapt ot harsh environmental conditions.

GRAM NEG bacteria are usually eliminated by ENDO treatment!

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28
Q

t/f

A direct pulp exposure of a carious lesion is necessary to have a pulpal response and inflammation?

A

FALSE!

cracks in the enamel can attract inflammatory cells to the pulp

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29
Q

what is necessary for pulp and periradicular pathosis to develop?

A

presence of bacteria

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30
Q

T/F
transient changes, such as aspiration of the odontoblasts into the dentinal tubules, are usually reversible in healthy pulps?

A

TRUE

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31
Q

what is NOT a hard tissue change from pulpal inflammation?

A

NOT thickening of periodontal ligamnet

but yes to calcification of pulp tissue space, resoprtion of opulp tissue spaces, formation of pulp stones

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32
Q

T/F

Acute apical abscess is always assoicated with necrotic pulp?

A

true

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33
Q

what is the risk of endo and bisphosphanate therapy

A

greater risk of osteonecrosis if IV bisphosphonate therapy. dont’ damage soft tissue if endo treatment

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34
Q

is selective anesthesia of individual teeth useful in the mandible?

A

no, marginally more effective in the maxilla

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35
Q

A narrow vertical probing defect associated with a tooth exhibiting pulp necrosis but no or mild periodontal disease is most likely a:

A

draining sinus tract

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36
Q
  1. The classification of periodontic-endodontic disease includes which of the following?
A
  1. The classification of periodontic-endodontic disease includes which of the following?
    a. endodontic (pulpal) origin
    b. periodontal origin
    c. endodontic-periodontic origin (true combined lesion)
    d. all of the above

D

37
Q

The common etiologic factor in both periodontal and endodontic disease is the presence and effect of —- on the respective tissues.

A

MICROORGANISMS

38
Q

What is the best means of differentiating endodontic from periodontal pathosis?

A

pulp vitality testing

39
Q
  1. Treatment for primary endodontic disease with concurrent periodontal disease of pulpal origin is treated best by:
    a. scaling and root planning followed by endodontic treatment
    b. endodontic treatment followed by scaling and root planning
    c. endodontic treatment followed by periodontal surgery
    d. endodontic treatment followed by reevaluation of periodontal status in 2 to 3 months
A

d

40
Q
  1. Fractures in cracked teeth most often extend in what direction?
    a. mesiodistal
    b. faciolingual
    c. apical to coronal
    d. horizontal
A

MD

41
Q
  1. Calcifications encountered in the pulp space:
    a. represent additional dentin formation
    b. can always be detected by radiograph
    c. are always attached to the chamber or canal walls
    d. often prevent instruments from negotiating canals
A

a

42
Q
  1. Accessory canals are more common in the apical third; they also are more common in posterior teeth. True or false?
    a. The entire sentence is true.
    b. The first part of the sentence is true, the second part is false.
    c. The first part of the sentence is false, but the second part is true.
    d. The entire sentence is false.
A

TRUE to btoh

43
Q
  1. What is a major objective of the access opening?
    a. to locate the primary or largest canal
    b. to achieve unimpeded straight-line access of the instruments to the first canal curvature or apical one third
    c. to expose the pulp horns
    d. to remove all restorative materials
A

to acheive unimpeded straight line access

44
Q
  1. Which statement best describes the outline form for access?
    a. It mimics the shape of the canal or canals.
    b. It is toward the distal on the occlusal surface in molars.
    c. It is a projection of the internal tooth anatomy onto the external surface.
    d. It is a constant and unchanging shape regardless of age.
A

c

45
Q
  1. What is an advantage of caries removal during access?
    a. It enhances the effectiveness of NaOCl.
    b. It reduces interappointment pain.
    c. It strengthens tooth structure.
    d. It allows assessment of restorability prior to the endodontic treatment.
A

allows assessment of restorability prior

46
Q
  1. Which of the following is not a general principle for endodontic access?
    a. outline form
    b. compensation form
    c. caries removal
    d. toilet of the cavity
A

NOT compensation form

47
Q
  1. What is the outline shape of the access for a maxillary first molar?
    a. round
    b. triangular
    c. trapezoidal
    d. square
A

triangular

48
Q
  1. What is the outline shape of the access for a mandibular first molar with four distinct separate roots?
    a. round
    b. triangular
    c. trapezoidal
    d. square
A

trapezoidal or rectangular

49
Q
  1. What is the preferred method to evaluate whether a canal has been adequately cleaned?
    a. The canal is three files sizes larger than the initial master apical file.
    b. The canal walls are “glassy smooth” when explored with a file.
    c. Dentin shavings obtained are clean and white.
    d. Irrigant runs clear with no visible debris.
A

glassy smooth

50
Q
  1. The degree of canal enlargement during shaping is dictated by which of the following?
    a. method of obturation
    b. anatomy of the root
    c. restorative treatment plan
    d. all of the above
A

all

51
Q
  1. Which of the following is the most widely used irrigating solution?
    a. sodium hypochlorite
    b. ethylenediaminetetraacetic acid (EDTA)
    c. citric acid
    d. QMix
A

sodium hypochlorite

52
Q
  1. What is the primary purpose of an irrigant such as sodium hypochlorite?
    a. to kill bacteria
    b. to dissolve tissue remnants
    c. to flush out debris
    d. to lubricate instruments
A

flush out debris

53
Q
  1. Removal of the smear layer after cleaning and shaping does which of the following?
    a. promotes coronal leakage
    b. reduces dentin permeability
    c. allows better adaptation of obturating materials to canal walls
    d. forces bacteria into dentinal tubules
A

allows for better adaptation of obturating materials

54
Q
  1. EDTA is most effective for which of the following?
    a. decalcifying small canals to allow instruments to negotiate to length
    b. lubricating canals to facilitate instrumentation
    c. eliminating bacteria in the canals
    d. removing the smear layer after cleaning and shaping
A

EDTA removes the smear layer after cleaning and shpaing

55
Q
  1. Recapitulation is defined as:
    a. the removal of accumulated debris using a small file at the corrected working length
    b. confirmation of the working length after completion of cleaning and shaping
    c. the last irrigation before drying of the canal
    d. verification of the master apical file after cleaning and shaping
A

removal of accumulated debris using a small file at the corrected working length

56
Q
  1. Which of the following results in the greatest loss of endodontically treated teeth?
    a. inadequate cleaning and shaping of the canals
    b. inadequate obturation
    c. caries and periodontal disease
    d. vertical root fracture
A

Caries and perio disease

inadequate restorations

57
Q
  1. Dentin becomes more brittle after endodontic treatment due to loss of moisture content.
    a. true
    b. false
A

FALSE

58
Q
  1. The most significant contributing factor to reduced cuspal stiffness (strength) that can predispose to fracture is:
    a. occlusal access opening
    b. loss of one or both marginal ridges
    c. an amalgam restoration placed after root canal treatment
    d. a bonded composite restoration placed after root canal treatment
A

Loss of one or both marginal ridges

59
Q
  1. Which of the following is crucial to a definitive restoration after endodontic treatment?
    a. It should be placed at the time of obturation.
    b. It should allow cuspal flexure to absorb occlusal forces.
    c. It should provide a coronal seal.
    d. It should always be a full-coverage crown on posterior teeth.
A

it should provide a coronal seal. needs to prevent microleakage

60
Q
  1. Which statement is most important with regard to exposure of obturating materials to oral fluids?
    a. It is not a factor if a sealer is used during obturation.
    b. It is a major cause of failure.
    c. It leads to rapid failure.
    d. It many cause pain with thermal changes.
A

major cause of failrue

61
Q
  1. Which statement describes the ideal timing for placement of the definitive restoration?
    a. It should be placed as soon as practical.
    b. It should be placed at the 6-month recall visit to ensure that symptoms do not recur.
    c. It should be placed when radiographic evidence of healing is present.
    d. If should be delayed if there is a questionable prognosis.
A

ASAP

62
Q
  1. The practical principles for function and durability when designing a definitive restoration include all the following except:
    a. conservation of tooth structure
    b. retention
    c. placement of a post
    d. protection of the remaining tooth structure
A

remember, POST IS ONLY FOR RETENTION!!!!

63
Q
  1. Which of the following is an indication for placing only a direct restoration (amalgam or composite)?
    a. Excessive loss of tooth structure is a factor.
    b. The opposing arch has been restored with full-coverage crowns.
    c. Esthetics is not a concern.
    d. The marginal ridges are intact.
A

marginal ridges are intact

64
Q
  1. What is a possible outcome with overfill of obturation materials?
    a. decreased periapical inflammation
    b. improved and rapid healing of periapical tissues
    c. inadequate apical seal
    d. decreased postobturation discomfort
A

Inadequate apical seal

65
Q
  1. Which statement best describes lateral canals?
    a. They connect adjacent canals within the same root.
    b. They may allow bacterial and necrotic debris access to the periodontium.
    c. They are débrided with copious irrigation.
    d. They are significant determinants of the prognosis in endodontic outcomes.
A

B

overall remember that they have minimal impact on the prognosis

66
Q
  1. What pulp/periapical diagnosis may result in completed treatment in a single visit?
    a. symptomatic apical periodontitis
    b. asymptomatic apical periodontitis
    c. acute apical abscess
    d. painful irreversible pulpitis
A

painful irreversible pulpitis

67
Q
  1. Which of the following is a disadvantage of gutta-percha?
    a. poor adaptation to irregularities of the canal with compaction
    b. shrinkage if altered by heat or solvents
    c. not easily managed and manipulated
    d. difficult to partially remove from a canal
A

shrinkage if altered by heat or solvents

68
Q
  1. Which of the following is an advantage of gutta-percha?
    a. adhesiveness to dentin
    b. slight elasticity and rebound effect
    c. expansion on cooling when warmed
    d. adaptation to canal irregularities with compaction
A

adaptation to canal irregularities with compaction

69
Q
  1. What have recent studies shown regarding synthetic polyester resin–based polymers?
    a. They are adhesive to canal walls throughout their length.
    b. They are inflammatory to periapical tissues.
    c. They are mutagenic.
    d. There is no difference in resistance to leakage compared to gutta-percha.
A

no difference in resistance to leakage compared to gutta percha

70
Q
  1. Which of the following describes lateral compaction of gutta-percha?
    a. It is the technique of choice in cases involving internal resorption.
    b. It involves multiple steps and an extensive armamentarium.
    c. It provides good length control.
    d. It is difficult to retreat.
A

LENGTH control!

71
Q
  1. Which of the following would not be an early sign or indication of a perforation?
    a. pain during access preparation
    b. sudden appearance of hemorrhage
    c. burning pain and a bad taste during irrigation with NaOCl
    d. a malpositioned file as viewed on a radiograph
A

NOT pain

72
Q
  1. What are the ideal time and material for nonsurgical repair of a furcation perforation?
    a. immediate repair with amalgam
    b. immediate repair with MTA
    c. delayed repair with amalgam
    d. delayed repair with MTA
A

REPAIR with MTA

73
Q
  1. What is a common cause of ledge formation during cleaning and shaping?
    a. straight-line access into the canal
    b. excess irrigating solution
    c. overenlargement of a curved canal using files
    d. constant recapitulation and irrigation into the apical portion of the canal
A

overenlargement of a curved canal using files

74
Q
  1. What is a possible etiology for an apical root perforation?
    a. inability to negotiate canals with ledges
    b. working length determination with radiographs only
    c. trying to locate canals in a small chamber
    d. failure to adjust the working length after curved canals have been straightened during cleaning and shaping
A

failure to adjust the working legnth after cruved canals have been straightened during cleaning and shaping

75
Q
  1. Which type of perforation has the poorest long-term prognosis?
    a. apical root perforation
    b. stripping perforation in the apical third of the root
    c. stripping perforation in the coronal third of the root below the crest of bone
    d. direct floor to furcation perforation in a multirooted tooth
A

strippin gperofration inthe CORNAL third of the root below the crest. this can lead to serious attachment loss

76
Q
  1. Which solvent has been shown to be the most efficient in softening gutta-percha?
    a. chloroform
    b. halothane
    c. methylchloroform
    d. xylene
A

chloroform

77
Q
  1. What is the purpose of incision for drainage?
    a. to evacuate inflammatory exudates from a soft tissue swelling
    b. to obtain a biopsy specimen
    c. to prevent a postoperative swelling
    d. to avoid emergency cleaning and shaping of the root canals
A

evacuate inflammatory exudates from a soft tissue swelling

78
Q

. What is the primary determinant of successful endodontic treatment?

a. selection of the proper obturation technique
b. effective elimination of microorganisms from the pulp space
c. use of rotary instruments to shape the canals
d. use of an effective irrigation regimen

A

elimination of microorgaisms from the pulp space

79
Q

What are the major indicators of successful endodontic treatment?

a. lack of discoloration and absence of tenderness on biting
b. absence of swelling and redness of the gingiva
c. absence of symptoms and of apical radiolucency
d. a happy patient who has paid the bill

A

absence of symptoms and of apical radiolucency

80
Q
  1. Which of the following is not a clinical criterion for evaluating treatment outcomes?
    a. absence of a radiolucency
    b. no evidence of a sinus tract
    c. no swelling present
    d. no response to percussion or palpation
A

absence of radiolucency

81
Q
  1. Which of the following is not considered a predictor of success or failure?
    a. the patient’s medical history
    b. apical pathosis
    c. the quality of the coronal restoration
    d. the extent and quality of obturation
A

NOT patient’s medical history

82
Q
  1. The most common postoperative cause of endodontic treatment failure is:
    a. overextension of obturating material
    b. a separated instrument
    c. coronal leakage
    d. placement of a post unnecessarily
A

CORONAL LEAKAGE

83
Q

ich of the agents recommended for internal bleaching is preferred?

a. carbamide peroxide
b. sodium perborate
c. hydrogen peroxide
d. sodium peroxyborate monohydrate

A

sodium perborate

84
Q
  1. Which statement is not true regarding calcifications in the pulp space?
    a. Pulp stones are usually found in the coronal pulp.
    b. Pulp stones can increase the incidence of odontogenic pain.
    c. Calcifications increase with both age and irritation.
    d. Diffuse calcifications are most commonly found in the radicular pulp.
A

pulp stones can increase the incidence of odontogenic pain. NOT TRUE

85
Q

another name for a denticle?

A

pulp stone

86
Q

pulp stones are found in ___ and diffuse in ___

A

pulp stones in the coronal area, and linear diffuse calficiations in the radicular pulp

87
Q
  1. Which of the following occurs in the pulp chamber in molars with age?
    a. decreases primarily in a mesiodistal dimension
    b. decreases primarily in an occlusal-apical dimension
    c. remains the same in volume
    d. increases in size in response to irritation
A

decreases in an occlusal apical dimension

88
Q
  1. The healing capacity of older patients is significantly less than that of younger patients because of a decrease in periapical vascularity. The vascularity of the periapical tissues is a critical determinant in healing.
    a. The first statement is false; the second statement is true.
    b. The first statement is true; the second statement is false.
    c. Both statements are true.
    d. Both statements are false.
A

first false, second true

PERIAPICAL blodo flow is NOT impaired with AGE

89
Q

various types of pulp calcificaitons?

A
  • Free—surrounded by pulp tissue

  • Attached–continuous with dentin

  • Embedded–surrounded by dentin (tertiary usually)

  • Diffuse or linear deposits with neurovascular bundles.—usually seen in aged, traumatized or chronically inflamed pulps 
Are they pathologic? NO 
Do they cause symptoms? NO regardless of size
  • Many people contain pulp stones and occur in normal, and chronically inflamed pulps. Not responsible for any symptoms reguardless of size. Large ones may block access to the canal or root apex during tx.

Endo (14 decks)

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