Endodontics Practice Exam Questions 100% ACCURATE GRADE A+ GUARANTEED

D. Calcific healing Calcific healing is ideal and is dependent on expert and prompt intervention. Close proximation (with radiographic verification) of the segments, proper splinting (2-4 weeks) and treatment with a short time interval between injury and treatment are key. Although calcific healing is ideal, two other forms of healing are successful: 1) healing with interproximal connective tissue and 2) healing with interproximal bone and connective tissue. Remarkably, the apical and coronal segments remain vital with prompt treatment. Cohen & Hargreaves, 9th ed., p 626 (2010)The optimal healing for a horizontal root fracture consists of: a. Connective tissue healing b. Granulation tissue healing c. A combination of calcific and connective tissue healing d. Calcific healing C. No treatment is indicated. Re-evaluate on recall The key to this scenario is the fact that there is no mobility or displacement of the fractured segments. The scenario is self- splinting. Pulpal vitality at this stage of the injury is suspect and no treatment is warranted. Unimpeded or uninterrupted healing by the body should be allowed to occur. Torajinebad & Walton, 4th ed., p 172 - 174 A 14-year-old male presents to your dental office. Dental imaging reveals a horizontal root fracture of both of the maxillary central incisors in the middle third of the roots. The apices are closed. There is no evidence of displacement or mobility. Your treatment should be: a. Perform immediate root canal therapy then observe b. Extirpate the pulps and fill the root canal spaces with calcium hydroxide paste c. No treatment is indicated. Re-evaluate on recall d. Treatment plan dental implants as the teeth are hopeless A. Both statements are TRUE A clinician must be methodical, disciplined and knowledgeable in both the art and science of endodontics for proper diagnosis. To rely solely on one piece of evidence is folly. Such a monothematic approach often results in improper diagnosis. Wisdom must be consulted in diagnosis. Sometimes deferral of treatment is wise. The literature and the courts are littered with knee-jerk treatment resulting in unresolved symptoms of patients. Torajinebad & Walton, 4th ed., p 68 - 69 Although diagnosis is a science, it is an imperfect science, and sometimes a detailed, definitive diagnosis is difficult or impossible. Importantly, significant pulpal or periapical pathosis is frequently without marked symptoms at present or in the past. 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 A. Both statements are TRUE As much as an intimate knowledge of dental anatomy is necessary for proper restorative execution, intimate and thorough knowledge of internal pulpal anatomy is needed to access, negotiate and obturate the root canal system. Radiographic evidence is an impression but is often limited by dimensional and resolution limitations. Three-dimensional images of sufficient detail to fully elucidate the complete root canal system currently limit our treatment modalities. Fortunately, research and thermoplastic obturation aid in overcoming, to some degree, these difficulties. Torajinebad & Walton, 4th ed., p 216 - 217 Gaining knowledge of anatomy from textbooks is the most important and most useful method of learning. Common and frequent variations must be memorized for each tooth. 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 A. Both statements are TRUE Each phase of endodontic therapy is dependent on the prior phase. Correct diagnosis leads to proper access, which leads to proper instrumentation, which leads to proper obturation, which leads to proper restoration. Deficiencies in any step compromise the subsequent steps or outcome. The thorough and seasons clinician recognizes this and pays attention to all details. Long-term follow-u is the true test of success. Torajinebad & Walton, 4th ed, p 298 - 299 Most treatment failures related to deficiencies in obturation are long-term failures. A low volume of irritant or slow release of irritant into periapical tissues produces damage that is not apparent in the short-term. 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 B. To the anatomic apex One visit obturation of vital pulps is acceptable in many instances because of the absence of bacterial contamination. The length of obturation is in theory generally agreed to be to the anatomical apex. The location of the anatomical apex and its clinical determination has been a source of much controversy and research. Further, the role of accessory canals in obturation is controversial. Cohen & Hargreaves, 9th ed., p 363 In cases of vital extirpation, endodontically treated teeth are much more comfortable to patient if the root canal is filled: a. To the radiographic apex b. To the anatomic apex c. 1-2mm short of the anatomic apex d. 1-2mm beyond the radiographic apex A. Both statements are TRUE Until recently, the most widely accepted technique has been cleaning and filling the canal with a temporary paste to stimulate the formation of calcified tissue at the apex. The temporary paste is later removed after radiographic evidence of apical closure has been obtained and a permanent filling of gutta percha is placed in the canal. Cohen & Hargreaves, 9th ed., p 869 - 872 Apexification is most often used for the endodontic management of a non- vital permanent tooth have a wide-open blunderbuss apex. The primary purpose of apexification is to stimulate the formation of calcified tissue at the tooth apex. 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 A. Sharp pain on release of biting pressure Radiographically, vertical tooth fractures are rarely detectable in their early stages as the fractured segments most often do not separate. Radiographic evidence is not detectable until much later in the sequence of events. The most reliable and earliest aid in diagnosis is in the dental history. The patient often states, "the tooth only hurts when I bite a certain way," or "it only started hurting after I accidentally bit down on a cherry pit." Vertical root fracture may also be implicated by a recently placed post and core, a cast intracoronal restoration or a recently placed restoration that keeps "falling out." Cohen & Hargreaves, 9th ed. p 23 - 27 Usually the first symptom that best describes a cracked tooth is: a. Sharp pain on release of biting pressure b. Sensitivity to percussion c. Hypersensitivity to vitality tests d. A periodontal defect B. Irreversible pulpitis Irreversible pulpitis may be symptomatic or asymptomatic. With the former, pain may be spontaneous and prolonged even after the source of the pain is removed, especially with cold stimuli. There are minimal to no radiographic changes and deep restorations are often found. Hargreaves & Cohen, 10th ed., p 36 - 37 A patient presents with sharp, shooting pain in a tooth that has a deep amalgam restoration. The pain occurs spontaneously every hour or two, lasting about 5 minutes. The tooth responds to vitality tests, is sensitive to cold, and shows no radiographic periapical changes. These symptoms are suggestive of: a. Pulpal necrosis b. Irreversible pulpitis c. Reversible pulpitis d. Hyperplastic pulpitis B. Maxillary sinusitis When pain is perceived in a patient in maxillary teeth near the sinus area and pulpal/periradicular pathosis is absent, sinus/nasal mucosal disease should be suspected. Throbbing or increased pain sensation can occur when the head is placed lower than the heart. Dental local anesthetic blocks will not abate sinus/nasal mucosal pain. Cohen & Hargreaves, 9th ed., p 66 - 67 A patient complaining of maxillary pain that is more intense when lying down and is relieved when in an upright position is probably suffering from: a. An abscess b. Maxillary sinusitis c. A cyst d. Trigeminal neuralgia C. Chronic apical periodontitis the presence of a well-defined unilocular radiolucency places the lesion in the chronic category of apical periodontitis versus pain that one might see in an acute lesion. Hargreaves & Cohen, 10th ed., p 542 - 545 A patient presents with an onlay on tooth #20. The tooth is asymptomatic but the pulp is necrotic and a periapical radiograph reveals a well-defined unilocular radiolucency at the root apex. The most likely diagnosis would be: a. Chronic pulpitis b. Acute apical periodontitis CONTINUED......