2025 FAGD Fellowship exam
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. - answer 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.
Which of the following statements is true regarding an overdose of local anesthesia?
A. Injecting using a 30 gauge needle should be done to limit the rate of injection.
B. Most overdoses occur when using no vasoconstrictor.
C. Injection of a carpule of anesthetic should be done over a 30 second time frame.
D. Most overdoses occur in elderly patients - answerCorrect Answer: (B) Most
overdoses occur when using no vasoconstrictor.
In most cases where local anesthetic overdose occurred in children being administered
a "plain drug", usually use of epinephrine would delay the absorption of the anesthetic
and decrease the risk of an overdose. The size of the needle and the speed of the
injection would not have an effect on overdosing.
The ability to titrate medication, predictability, and the ability to provide amnesic
properties best describes __________ sedation.
A. intramuscular
B. oral
C. intravenous
D. subcutaneous - answerCorrect Answer: (C) intravenous
Intravenous sedation is the most effective method of ensuring predictable & adequate
sedation in patients. It has a short latent period, it can be titrated, and drugs can be
administered that will have an amnesic period of varying duration. Intramuscular &
subcutaneous both have slow rates of resorption & can't be titrated. Intramuscular and
subcutaneous medication cannot be reversed quickly. Oral sedation can be
unpredictable and not easily titrated in some patients.
,Inhalation of N2O/O2 allows for cognitive recovery with 100% pure oxygen for a
minimum of __________ minutes after termination of the drug.
A. five (5)
B. ten (10)
C. thirty (30)
D. sixty (60 - answerCorrect Answer: (A) five (5)
Inhalation of N2O/O2 allows for cognitive recovery with 100% pure oxygen for a
minimum of 5 minutes after termination of the drug. Depending on patient assessment,
individual recovery time may vary. Post operative oxygenation remains an extremely
important concept of recovery. Generally, emergence (recovery) is a mirror image of
induction. The mirror image includes patients returning to their original emotional state,
as well as recovering from the pharmacologic action of the drug. Physiologically,
recovery occurs the same way for any individual. N2O is principally exhaled unchanged
from the lungs. N2O provides a rapid onset of clinical signs and a correlated rapid
emergence will occur.
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. 4% articaine + epinephrine.
B. 3% mepivicaine.
C. 2% lidocaine + epinephrine.
D. 2% mepivicaine + levonordephrine - answerCorrect Answer: (C) 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 in any one injection. As a rule,
the pediatric dentist administers anesthetic without vasoconstrictor only when treatment
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, where death
resulted, a total of 5, 6 or 7 cartridges of anesthetic without vasoconstrictor had been
administered.
The maximum recommended dose by the FDA of lidocaine with or without epinephrine -
answerThe maximum recommended dose by the FDA of lidocaine with or without
epinephrine is 3.2 mg/lb or 7.0 mg/kg of body weight for the adult and pediatric patient
Diffusion hypoxia can be prevented by:
A. a gradual reduction of the nitrous oxide/oxygen concentration.
B. using a less than 20% nitrous oxide/oxygen concentration.
C. starting induction of sedation with 100% oxygen for 3-5 minutes
. D. administering 100% oxygen for 3-5 minutes after cessation of nitrous oxide. -
answerCorrect Answer: (D) administering 100% oxygen for 3-5 minutes after cessation
of nitrous oxide.
,High concentrations of nitrous oxide may result in a considerable accumulation of
dissolved gas within the body, and when the administration is stopped, large amounts of
nitrous oxide diffuse from the blood into the lung alveoli, diluting oxygen. This "diffusion
The only vasoconstrictor used in local anesthetics that is contraindicated with
concomitant MAO inhibitor therapy is:
A. phenylephrine.
B. norepinephrine.
C. epinephrine.
D. levonordetrin - answerCorrect Answer: (A) phenylephrine.
Despite statements to the contrary in local anesthetic product information approved by
the FDA, local anesthetics containing epinephrine may be used without special
reservation in patients taking monoamine oxidase (MAO) inhibitors.
MAO inibitors - answerAntidepressant agents that work by blocking the action of a
specific enzyme
Exogenous catecholamines are mostly degraded by the enzyme catechol-o-
methyltransferase; inhibition of MAO has little impact on their respective fates or
cardiovascular actions. Of the vasoconstrictors used with local anesthetics, only
phenylephrine is contraindicated with concomitant MAO therapy
All of the following statements about chemically activated (self cure) resins are true
except one. Which is the exception?
A. They have long term storage stability.
B. They can yellow with age.
C. The degree of cure is equal if mixed properly.
D. Marginal stress buildup is much higher than for photocured resins. - answerCorrect
Answer: (D) Marginal stress buildup is much higher than for photocured resins.
Advantages of self-cure resins: - answer1) convenience and simplicity - no equipment
needed, hazard free;
2) long-term storage stability;
3) manipulation of working/setting time by varying proportion; 4) degree of cure equal
throughout material if mixed properly; 5) marginal stress build-up during curing is much
lower than for photocured resins owning to relatively slower rates of cross-link
formation.
Disadvantages of self-cure resins: - answer1) mixing causes air entrapment, leading to
porosity that weakens the material & increases susceptibility to staining. This has been
reduced by the use of mixing syringes;
2) aromatic amine accelerators oxidize and turn yellow with time - i.e., color instability;
3) difficult to mix evenly causing unequal degree of cure & consequently poor
mechanical properties.
, There are extremely sensitive methods for detecting mercury in parts per trillion. There
is no data to show that the mercury released from dental amalgam is harmful to the
general population.
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. - answerCorrect Answer: (A) Both
statements are TRUE. Humans are exposed to mercury from a variety of sources in
addition to dental amalgams. There are extremely sensitive methods for detecting
mercury in parts per trillion; these methods have made it possible to analyze the
sources of mercury exposure to humans. Numerous studies have attempted to
determine whether mercury exposure from dental restorations or other sources
contributes to any documentable health problem. Several studies have estimated the
number of amalgam surfaces needed to expose an individual to mercury concentrations
with a minimum observable effect (slightly impaired psychomotor performance,
detectable tremor and impaired nerve conduction velocity). Estimates are that several
hundred amalgam surfaces would be necessary to achieve these levels. Other studies
have measured renal function in patients whom all of amalgam was removed at the
same time (the worst possible case). Despite markedly elevated blood plasma and urine
levels of mercury, no renal impairment was noted. There is simply no data to show that
mercury released from dental amalgam is harmful to the general population
A dental bonding system has all of the following essential functions except one. Which
is the exception?
A. Provides resistance to separation of a substrate from a restorative material. B.
Distributes stress along bonded interfaces.
C. Provides thermal insulation between materials.
D. Seals the interface - answerCorrect Answer: (C) Provides thermal insulation between
materials.
Bonding and adhesion comprise a complex set of physical, chemical & mechanical
mechanisms that allow the attachment & binding of one substance to another.
3 Essential Functions of a Dental Bonding System: - answer1) Provides resistance to
separation of an adherent substrate (i.e., enamel, dentin, metal composite, ceramic)
from a restorative or cementing material;
2) Distributes stress along bonded interfaces; and
3) Seals the interface via adhesive bonding between dentin and/or enamel and the
bonded material, thus increasing resistance to micro-leakage and decreasing the risk of
postoperative sensitivity, marginal staining, and secondary caries.
The success of endosseous dental implants is based on the biocompatibility of the
implant surface and the ingrowth of new bone into the surface through the process of
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. - answer 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.
Which of the following statements is true regarding an overdose of local anesthesia?
A. Injecting using a 30 gauge needle should be done to limit the rate of injection.
B. Most overdoses occur when using no vasoconstrictor.
C. Injection of a carpule of anesthetic should be done over a 30 second time frame.
D. Most overdoses occur in elderly patients - answerCorrect Answer: (B) Most
overdoses occur when using no vasoconstrictor.
In most cases where local anesthetic overdose occurred in children being administered
a "plain drug", usually use of epinephrine would delay the absorption of the anesthetic
and decrease the risk of an overdose. The size of the needle and the speed of the
injection would not have an effect on overdosing.
The ability to titrate medication, predictability, and the ability to provide amnesic
properties best describes __________ sedation.
A. intramuscular
B. oral
C. intravenous
D. subcutaneous - answerCorrect Answer: (C) intravenous
Intravenous sedation is the most effective method of ensuring predictable & adequate
sedation in patients. It has a short latent period, it can be titrated, and drugs can be
administered that will have an amnesic period of varying duration. Intramuscular &
subcutaneous both have slow rates of resorption & can't be titrated. Intramuscular and
subcutaneous medication cannot be reversed quickly. Oral sedation can be
unpredictable and not easily titrated in some patients.
,Inhalation of N2O/O2 allows for cognitive recovery with 100% pure oxygen for a
minimum of __________ minutes after termination of the drug.
A. five (5)
B. ten (10)
C. thirty (30)
D. sixty (60 - answerCorrect Answer: (A) five (5)
Inhalation of N2O/O2 allows for cognitive recovery with 100% pure oxygen for a
minimum of 5 minutes after termination of the drug. Depending on patient assessment,
individual recovery time may vary. Post operative oxygenation remains an extremely
important concept of recovery. Generally, emergence (recovery) is a mirror image of
induction. The mirror image includes patients returning to their original emotional state,
as well as recovering from the pharmacologic action of the drug. Physiologically,
recovery occurs the same way for any individual. N2O is principally exhaled unchanged
from the lungs. N2O provides a rapid onset of clinical signs and a correlated rapid
emergence will occur.
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. 4% articaine + epinephrine.
B. 3% mepivicaine.
C. 2% lidocaine + epinephrine.
D. 2% mepivicaine + levonordephrine - answerCorrect Answer: (C) 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 in any one injection. As a rule,
the pediatric dentist administers anesthetic without vasoconstrictor only when treatment
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, where death
resulted, a total of 5, 6 or 7 cartridges of anesthetic without vasoconstrictor had been
administered.
The maximum recommended dose by the FDA of lidocaine with or without epinephrine -
answerThe maximum recommended dose by the FDA of lidocaine with or without
epinephrine is 3.2 mg/lb or 7.0 mg/kg of body weight for the adult and pediatric patient
Diffusion hypoxia can be prevented by:
A. a gradual reduction of the nitrous oxide/oxygen concentration.
B. using a less than 20% nitrous oxide/oxygen concentration.
C. starting induction of sedation with 100% oxygen for 3-5 minutes
. D. administering 100% oxygen for 3-5 minutes after cessation of nitrous oxide. -
answerCorrect Answer: (D) administering 100% oxygen for 3-5 minutes after cessation
of nitrous oxide.
,High concentrations of nitrous oxide may result in a considerable accumulation of
dissolved gas within the body, and when the administration is stopped, large amounts of
nitrous oxide diffuse from the blood into the lung alveoli, diluting oxygen. This "diffusion
The only vasoconstrictor used in local anesthetics that is contraindicated with
concomitant MAO inhibitor therapy is:
A. phenylephrine.
B. norepinephrine.
C. epinephrine.
D. levonordetrin - answerCorrect Answer: (A) phenylephrine.
Despite statements to the contrary in local anesthetic product information approved by
the FDA, local anesthetics containing epinephrine may be used without special
reservation in patients taking monoamine oxidase (MAO) inhibitors.
MAO inibitors - answerAntidepressant agents that work by blocking the action of a
specific enzyme
Exogenous catecholamines are mostly degraded by the enzyme catechol-o-
methyltransferase; inhibition of MAO has little impact on their respective fates or
cardiovascular actions. Of the vasoconstrictors used with local anesthetics, only
phenylephrine is contraindicated with concomitant MAO therapy
All of the following statements about chemically activated (self cure) resins are true
except one. Which is the exception?
A. They have long term storage stability.
B. They can yellow with age.
C. The degree of cure is equal if mixed properly.
D. Marginal stress buildup is much higher than for photocured resins. - answerCorrect
Answer: (D) Marginal stress buildup is much higher than for photocured resins.
Advantages of self-cure resins: - answer1) convenience and simplicity - no equipment
needed, hazard free;
2) long-term storage stability;
3) manipulation of working/setting time by varying proportion; 4) degree of cure equal
throughout material if mixed properly; 5) marginal stress build-up during curing is much
lower than for photocured resins owning to relatively slower rates of cross-link
formation.
Disadvantages of self-cure resins: - answer1) mixing causes air entrapment, leading to
porosity that weakens the material & increases susceptibility to staining. This has been
reduced by the use of mixing syringes;
2) aromatic amine accelerators oxidize and turn yellow with time - i.e., color instability;
3) difficult to mix evenly causing unequal degree of cure & consequently poor
mechanical properties.
, There are extremely sensitive methods for detecting mercury in parts per trillion. There
is no data to show that the mercury released from dental amalgam is harmful to the
general population.
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. - answerCorrect Answer: (A) Both
statements are TRUE. Humans are exposed to mercury from a variety of sources in
addition to dental amalgams. There are extremely sensitive methods for detecting
mercury in parts per trillion; these methods have made it possible to analyze the
sources of mercury exposure to humans. Numerous studies have attempted to
determine whether mercury exposure from dental restorations or other sources
contributes to any documentable health problem. Several studies have estimated the
number of amalgam surfaces needed to expose an individual to mercury concentrations
with a minimum observable effect (slightly impaired psychomotor performance,
detectable tremor and impaired nerve conduction velocity). Estimates are that several
hundred amalgam surfaces would be necessary to achieve these levels. Other studies
have measured renal function in patients whom all of amalgam was removed at the
same time (the worst possible case). Despite markedly elevated blood plasma and urine
levels of mercury, no renal impairment was noted. There is simply no data to show that
mercury released from dental amalgam is harmful to the general population
A dental bonding system has all of the following essential functions except one. Which
is the exception?
A. Provides resistance to separation of a substrate from a restorative material. B.
Distributes stress along bonded interfaces.
C. Provides thermal insulation between materials.
D. Seals the interface - answerCorrect Answer: (C) Provides thermal insulation between
materials.
Bonding and adhesion comprise a complex set of physical, chemical & mechanical
mechanisms that allow the attachment & binding of one substance to another.
3 Essential Functions of a Dental Bonding System: - answer1) Provides resistance to
separation of an adherent substrate (i.e., enamel, dentin, metal composite, ceramic)
from a restorative or cementing material;
2) Distributes stress along bonded interfaces; and
3) Seals the interface via adhesive bonding between dentin and/or enamel and the
bonded material, thus increasing resistance to micro-leakage and decreasing the risk of
postoperative sensitivity, marginal staining, and secondary caries.
The success of endosseous dental implants is based on the biocompatibility of the
implant surface and the ingrowth of new bone into the surface through the process of
