AGD Fellowship 2026 Exam 2-Questions with
Verified Correct Answers
1. Anesthesia of mandibular teeth in adults by the infiltration method would be achieved
best by the use of:
A. 1.8 mL of Prilocaine 4% + epinephrine 1:100,000.
B. 1.8 mL of Bupivacaine 0.5% + epinephrine 1:200,000.
C. 1.8 mL of Mepivacaine 2% + levonordefrin 1:20,000.
D. 1.8 mL of Articaine 4% + epinephrine 1:100,000.
Correct Answer: (D) 1.8 mL of Articaine 4% + epinephrine 1:100,000.
Articaine 4% with 1:100,000 epi was introduced in June 2000. Four well designed studies
showed articaine to be more successful in achieving adequate anesthesia than lidocaine in
mandibular teeth.
One theory is that articaine is more effective due to it's higher concentration. The second theory
is that articaine has a thiophene ring that enables it to diffuse more effectively than the other
local anesthetics that have a benzene ring.
The U.S. Food and Drug Administration has classified articaine, mepivicaine, and
bupivicaine in pregnancy riskcategory of _______.
A. A
B. B
,C. C
D. D
Correct Answer: (C)CLocal anesthetics are generally regarded as safe for use throughout
pregnancy.
The US Food & DrugAdministration has classified lidocaine & prilocaine in pregnancy risk
category B
and articaine, mepivicaine &bupivicaine in category C
C. Category A: adequate & well-controlled studies have failed to show a risk to the fetus
inthe first trimester of pregnancy (and there is no evidence of risk in later trimesters).
Category B: Either (1)adequate & well-controlled studies have failed to show a risk to fetus
in the first trimester of pregnancy, and thereis no evidence of risk in later trimesters, but
animal studies have shown an adverse effect on the fetus; or (2)human studies are lacking,
but animal studies have failed to show a risk to the fetus.
Category C: No adequate &well-controlled studies have been performed in pregnant
women, but animal reproduction studies are lacking orhave shown an adverse effect on the
fetus. Potential benefit may warrant use of the drug in pregnant womendespite potential
risk.
Pain control of the entire primary dentition can be achieved with approximately two
cartridges of local anesthetic.The most recommended drug in this case is:
,A. 3% mepivicaine.
B. 2% lidocaine + epinephrine.
C. 2% mepivicaine + levonordephrine.
D. 4% articaine + epinephrine.
Correct Answer: (B)2% lidocaine + epinephrine.
Pain control for the entire primary dentition can be achieved with approximately two cartridges
of local anesthetic.In the smaller child patient, there is rarely a compelling need to administer a
1.8 ml volume of local anesthetic inany one injection. As a rule, the pediatric dentist administers
anesthetic without vasoconstrictor only whentreatment is limited to one quadrant. If treatment
extends to two or more quadrants in one visit, a vasopressor-containing local anesthetic is
selected. In many instances, death resulted when a total of 5, 6, or 7 cartridges ofanesthetic
without vasoconstrictor had been administered.
The maximum recommended dose by the FDA oflidocaine with or without epinephrine is
3.2 mg/lb or 7.0 mg/kg of body weight for the adult and pediatric patient.
All of the following local anesthetics can be used with a patient taking tricylic
antidepressants except one. Which is the exception?
A. Lidocaine with 1:100,000 epinephrine
B. Mepivicaine with 1:20,000 levonordefrin
C. Bupivicaine with 1:200,000 epinephrine
D. Prilocaine with 1:200,000 epinephrine
, Correct Answer: (B)Mepivicaine with 1:20,000 levonordefrinT
Tricyclic Antidepressants (TCAs) may enhance the cardiovascular actions of exogenously
administeredvasopressors. This enhancement is approximately fivefold to tenfold with
levonordefrin and noreprinephrine, but isonly twofold with epinephrine and phenylephrine.
Administration of noreprinephrine (not available in NorthAmerican local dental anesthetics) and
levonordefrin should be avoided in patients receiving TCAs. Epinephrine-containing local
anesthetics should be administered in the smallest effective doses.
Tricyclic Antidepressants (TCAs)
Antidepressants that increase the action of neurotransimtters by blocking their removal
(reuptake) from the synapses (spaces between nerve cells). (1)
Pediatric considerations for the use of N2O sedation include all of the following except one.
Which is the exception?
A. Health evaluation including allergies, current medications, previous sedation
experiences
B. Anatomic factors such as enlarged tonsils and adenoids
C. Middle ear disturbances
D. Weigh
Correct Answer: (D)Weight
Nitrous oxide also enters natural, artificial, pathologic, orsurgery-related gas-filled spaces (e.g.,
Verified Correct Answers
1. Anesthesia of mandibular teeth in adults by the infiltration method would be achieved
best by the use of:
A. 1.8 mL of Prilocaine 4% + epinephrine 1:100,000.
B. 1.8 mL of Bupivacaine 0.5% + epinephrine 1:200,000.
C. 1.8 mL of Mepivacaine 2% + levonordefrin 1:20,000.
D. 1.8 mL of Articaine 4% + epinephrine 1:100,000.
Correct Answer: (D) 1.8 mL of Articaine 4% + epinephrine 1:100,000.
Articaine 4% with 1:100,000 epi was introduced in June 2000. Four well designed studies
showed articaine to be more successful in achieving adequate anesthesia than lidocaine in
mandibular teeth.
One theory is that articaine is more effective due to it's higher concentration. The second theory
is that articaine has a thiophene ring that enables it to diffuse more effectively than the other
local anesthetics that have a benzene ring.
The U.S. Food and Drug Administration has classified articaine, mepivicaine, and
bupivicaine in pregnancy riskcategory of _______.
A. A
B. B
,C. C
D. D
Correct Answer: (C)CLocal anesthetics are generally regarded as safe for use throughout
pregnancy.
The US Food & DrugAdministration has classified lidocaine & prilocaine in pregnancy risk
category B
and articaine, mepivicaine &bupivicaine in category C
C. Category A: adequate & well-controlled studies have failed to show a risk to the fetus
inthe first trimester of pregnancy (and there is no evidence of risk in later trimesters).
Category B: Either (1)adequate & well-controlled studies have failed to show a risk to fetus
in the first trimester of pregnancy, and thereis no evidence of risk in later trimesters, but
animal studies have shown an adverse effect on the fetus; or (2)human studies are lacking,
but animal studies have failed to show a risk to the fetus.
Category C: No adequate &well-controlled studies have been performed in pregnant
women, but animal reproduction studies are lacking orhave shown an adverse effect on the
fetus. Potential benefit may warrant use of the drug in pregnant womendespite potential
risk.
Pain control of the entire primary dentition can be achieved with approximately two
cartridges of local anesthetic.The most recommended drug in this case is:
,A. 3% mepivicaine.
B. 2% lidocaine + epinephrine.
C. 2% mepivicaine + levonordephrine.
D. 4% articaine + epinephrine.
Correct Answer: (B)2% lidocaine + epinephrine.
Pain control for the entire primary dentition can be achieved with approximately two cartridges
of local anesthetic.In the smaller child patient, there is rarely a compelling need to administer a
1.8 ml volume of local anesthetic inany one injection. As a rule, the pediatric dentist administers
anesthetic without vasoconstrictor only whentreatment is limited to one quadrant. If treatment
extends to two or more quadrants in one visit, a vasopressor-containing local anesthetic is
selected. In many instances, death resulted when a total of 5, 6, or 7 cartridges ofanesthetic
without vasoconstrictor had been administered.
The maximum recommended dose by the FDA oflidocaine with or without epinephrine is
3.2 mg/lb or 7.0 mg/kg of body weight for the adult and pediatric patient.
All of the following local anesthetics can be used with a patient taking tricylic
antidepressants except one. Which is the exception?
A. Lidocaine with 1:100,000 epinephrine
B. Mepivicaine with 1:20,000 levonordefrin
C. Bupivicaine with 1:200,000 epinephrine
D. Prilocaine with 1:200,000 epinephrine
, Correct Answer: (B)Mepivicaine with 1:20,000 levonordefrinT
Tricyclic Antidepressants (TCAs) may enhance the cardiovascular actions of exogenously
administeredvasopressors. This enhancement is approximately fivefold to tenfold with
levonordefrin and noreprinephrine, but isonly twofold with epinephrine and phenylephrine.
Administration of noreprinephrine (not available in NorthAmerican local dental anesthetics) and
levonordefrin should be avoided in patients receiving TCAs. Epinephrine-containing local
anesthetics should be administered in the smallest effective doses.
Tricyclic Antidepressants (TCAs)
Antidepressants that increase the action of neurotransimtters by blocking their removal
(reuptake) from the synapses (spaces between nerve cells). (1)
Pediatric considerations for the use of N2O sedation include all of the following except one.
Which is the exception?
A. Health evaluation including allergies, current medications, previous sedation
experiences
B. Anatomic factors such as enlarged tonsils and adenoids
C. Middle ear disturbances
D. Weigh
Correct Answer: (D)Weight
Nitrous oxide also enters natural, artificial, pathologic, orsurgery-related gas-filled spaces (e.g.,
