AGD 2025-2026 fellowship
42. Where might interference contacts be located during a right working mandibular
movement between right mandibular
first molar and maxillary first molar (teeth #30-#3)?
A. Lingual incline of mandibular buccal cusp
B. Lingual incline of maxillary buccal cusp
C. Buccal incline of maxillary lingual cusp
D. Occlusal stop of the maxillary lingual cusp - answerCorrect Answer: (B) Lingual
incline of maxillary buccal cusp
During a lateral mandibular movement, the right and left mandibular posterior teeth
move across their opposing teeth
in different directions. If the mandible moves to the right, the right mandibular posterior
teeth will move laterally across
their opposing teeth. However, the left mandibular posterior teeth will move medially
across their opposing teeth.
Therefore, in a right working movement, the right posterior teeth can have interferences
in two locations, one
between the lingual incline of the maxillary buccal cusps and the buccal inclines of the
mandibular buccal cusps and
the second between the lingual incline of the maxillary lingual cusps and the buccal
incline of the mandibular lingual
cusps. These are working contacts.
1. A contradiction for the use of N2O/O2 sedation would be:
A. bleomycin sulfate therapy.
B. arteriosclerosis.
C. asthma.
D. Parkinson's disease. - answerA. bleomycin sulfate therapy.
what other conditions contraindicate nitrous oxide? - answerContraindications for the
use of N2O/O2 sedation:
- pneumothorax
-some cases of cystic fibrosis
- some cases of COPD
-recent pneumoencephalography
-suspected/known pernicious anemia or vitamin B12 deficiency
Contraindications for the use of N2O/O2 sedation, what else? - answer-bowel
obstruction
-first trimester of pregnancy
-cancer therapy using bleomycin sulfate
-psychologic impairment
,-current drug use/addiction
Contraindications for the use of N2O/O2 sedation, what else? - answer- patient in
shock, semi-conscious or with serious head injuries
- inability to understand or consent to the procedure
-current upper respiratory tract infection
-middle ear disturbance/surgery
-recent eye surgery
2. The free base form of a local anesthetic is responsible for penetrating the nerve
sheath. The charged base form is
responsible for blocking the sodium channels and blocking the nerve impulse.
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.
Two factors are involved in the action of local anesthetics - diffusion of the drug through
the nerve sheath and binding
at the receptor site in the ion channel. The uncharged, lipid-soluble, free base form of
the anesthetic is responsible
for diffusion through the nerve sheath. After penetration of the nerve sheath and entry
into the axioplasm,
reequilibration occurs inside the nerve because the local anesthetic cannot exist in only
the base form. 75% of the
base molecule within the axioplasm reverts to the cationic or charged form of the drug.
The cationic form enters
sodium channels, binds to the channel receptor site, and ultimately is responsible for
the conduction blockade.
Local anesthetics with a higher pKa will have a faster onset than a local anesthetic with
a lower pKa. The degree of
protein binding of a local anesthetic is related to the duration of action of a local
anesthetic.
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: (D) The
first statement is FALSE; the second is TRUE.
The pKa or dissociation constant is a measure of the affinity of a molecule for hydrogen
ions. When the pH of a
solution has the same value as the pKa of the local anesthetic, exactly 50% of the drug
is the cation form and 50% is
the base form.
A local anesthetic with a high pKa has very few molecules available in the base form.
The onset of anesthesia of this
,drug would be slow because too few base molecules are available to diffuse through the
nerve membrane. The rate
of onset of anesthesia is related to the pKa of the local anesthesia.
what happen After penetration of the nerve sheath? - answerAfter penetration of the
nerve sheath, a reequilibrium occurs between the base and cationic forms of the local
anesthetic. Proteins constitute approximately 10% of the nerve membrane, and local
anesthetics possessing a
greater degree of protein binding (bupivicaine) appear to attach more securely to the
protein receptor sites and to
possess a long duration of clinical activity.
Which of the following anesthetics has the shortest half-life?
A. Lidocaine
B. Mepivicaine
C. Prilocaine
D. Articaine - answerCorrect Answer: (D) Articaine
The elimination half-life of a drug is the time required to decrease its plasma level or
concentration by 50%.
Elimination half-lives of esters are short compared with those of the amides. It is
important to remember that the halflife
of a drug has absolutely no relevance to the clinical duration of action of that drug. A
drug is clinically effective as
long as it remains in its target organ in a concentration high enough to prevent
propagation of a nerve impulse to the
brain. The clinical action of the drug ceases when it diffuses out of its target organ into
capillaries and veins. It is then
that the elimination half-life starts.
Half-Life
Articaine 27 min
Prilocaine 90 min
Lidocaine 90 min
Mepivicaine 116 min
The maximum daily dose for Tylenol® extra strength tablets is _________mg.
A. 2500
B. 3000
C. 3500
D. 4000 - answerCorrect Answer: (D) 4000
Max dose according to Lexicomp 2019 is 4000 mg
6. Which of the following is a contraindication to using a benzodiazepine as a sedative
agent?
A. An epileptic patient
B. A patient who is on coumadin
C. A hyperthyroid patient
, D. A patient with narrow angle glaucoma - answerCorrect Answer: (D) A patient with
narrow angle glaucoma
Benzodiazepines are contraindicated in patients with narrow-angle closure glaucoma or
untreated open-angle
glaucoma. These agents do not possess anticholinergic activity but have rarely been
associated with increased
intraocular pressure. These medications can cause further narrowing and can lead to
blockage of the eye's drainage
system. Allergy, psychoses, and acute narrow-angle glaucoma represent
contraindications for the administration of
benzodiazepines. Benzodiazepines may be administered to patients with open-angle
glaucoma who are receiving
appropriate therapy.
7. Following administration of an inferior alveolar nerve block (IANB), the clinician
should routinely administer a buccal
nerve block. The buccal nerve provides sensory innervation to the buccal soft tissues
adjacent to the mandibular
molars only.
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: (D) The
first statement is FALSE; the second is TRUE.
"The buccal nerve is a branch of the anterior division of V3 and consequently is not
anesthetized during IANB. Nor is
anesthesia of the buccal nerve necessary for most restorative dental procedures. The
buccal nerve provides sensory
innervation to the buccal soft tissues adjacent to the mandibular molars only. The sole
indication for administration of
a buccal nerve block therefore is when manipulation of these tissues is contemplated...."
Thus, the first statement is
False as anesthesia of the buccal nerve should not be routine combined with IANB
anesthesia
8. Which impression material consistently shows the least amount of dimensional
change at 24 hours?
A. Polysulfides
B. Polyethers
C. Condensation silicones
D. Addition silicones - answerCorrect Answer: (D) Addition silicones
Dimensional stability refers to the lack of dimensional change of the impression over
time.
There are 6 major sources
of dimensional change: - answer1) polymerization shrinkage
42. Where might interference contacts be located during a right working mandibular
movement between right mandibular
first molar and maxillary first molar (teeth #30-#3)?
A. Lingual incline of mandibular buccal cusp
B. Lingual incline of maxillary buccal cusp
C. Buccal incline of maxillary lingual cusp
D. Occlusal stop of the maxillary lingual cusp - answerCorrect Answer: (B) Lingual
incline of maxillary buccal cusp
During a lateral mandibular movement, the right and left mandibular posterior teeth
move across their opposing teeth
in different directions. If the mandible moves to the right, the right mandibular posterior
teeth will move laterally across
their opposing teeth. However, the left mandibular posterior teeth will move medially
across their opposing teeth.
Therefore, in a right working movement, the right posterior teeth can have interferences
in two locations, one
between the lingual incline of the maxillary buccal cusps and the buccal inclines of the
mandibular buccal cusps and
the second between the lingual incline of the maxillary lingual cusps and the buccal
incline of the mandibular lingual
cusps. These are working contacts.
1. A contradiction for the use of N2O/O2 sedation would be:
A. bleomycin sulfate therapy.
B. arteriosclerosis.
C. asthma.
D. Parkinson's disease. - answerA. bleomycin sulfate therapy.
what other conditions contraindicate nitrous oxide? - answerContraindications for the
use of N2O/O2 sedation:
- pneumothorax
-some cases of cystic fibrosis
- some cases of COPD
-recent pneumoencephalography
-suspected/known pernicious anemia or vitamin B12 deficiency
Contraindications for the use of N2O/O2 sedation, what else? - answer-bowel
obstruction
-first trimester of pregnancy
-cancer therapy using bleomycin sulfate
-psychologic impairment
,-current drug use/addiction
Contraindications for the use of N2O/O2 sedation, what else? - answer- patient in
shock, semi-conscious or with serious head injuries
- inability to understand or consent to the procedure
-current upper respiratory tract infection
-middle ear disturbance/surgery
-recent eye surgery
2. The free base form of a local anesthetic is responsible for penetrating the nerve
sheath. The charged base form is
responsible for blocking the sodium channels and blocking the nerve impulse.
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.
Two factors are involved in the action of local anesthetics - diffusion of the drug through
the nerve sheath and binding
at the receptor site in the ion channel. The uncharged, lipid-soluble, free base form of
the anesthetic is responsible
for diffusion through the nerve sheath. After penetration of the nerve sheath and entry
into the axioplasm,
reequilibration occurs inside the nerve because the local anesthetic cannot exist in only
the base form. 75% of the
base molecule within the axioplasm reverts to the cationic or charged form of the drug.
The cationic form enters
sodium channels, binds to the channel receptor site, and ultimately is responsible for
the conduction blockade.
Local anesthetics with a higher pKa will have a faster onset than a local anesthetic with
a lower pKa. The degree of
protein binding of a local anesthetic is related to the duration of action of a local
anesthetic.
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: (D) The
first statement is FALSE; the second is TRUE.
The pKa or dissociation constant is a measure of the affinity of a molecule for hydrogen
ions. When the pH of a
solution has the same value as the pKa of the local anesthetic, exactly 50% of the drug
is the cation form and 50% is
the base form.
A local anesthetic with a high pKa has very few molecules available in the base form.
The onset of anesthesia of this
,drug would be slow because too few base molecules are available to diffuse through the
nerve membrane. The rate
of onset of anesthesia is related to the pKa of the local anesthesia.
what happen After penetration of the nerve sheath? - answerAfter penetration of the
nerve sheath, a reequilibrium occurs between the base and cationic forms of the local
anesthetic. Proteins constitute approximately 10% of the nerve membrane, and local
anesthetics possessing a
greater degree of protein binding (bupivicaine) appear to attach more securely to the
protein receptor sites and to
possess a long duration of clinical activity.
Which of the following anesthetics has the shortest half-life?
A. Lidocaine
B. Mepivicaine
C. Prilocaine
D. Articaine - answerCorrect Answer: (D) Articaine
The elimination half-life of a drug is the time required to decrease its plasma level or
concentration by 50%.
Elimination half-lives of esters are short compared with those of the amides. It is
important to remember that the halflife
of a drug has absolutely no relevance to the clinical duration of action of that drug. A
drug is clinically effective as
long as it remains in its target organ in a concentration high enough to prevent
propagation of a nerve impulse to the
brain. The clinical action of the drug ceases when it diffuses out of its target organ into
capillaries and veins. It is then
that the elimination half-life starts.
Half-Life
Articaine 27 min
Prilocaine 90 min
Lidocaine 90 min
Mepivicaine 116 min
The maximum daily dose for Tylenol® extra strength tablets is _________mg.
A. 2500
B. 3000
C. 3500
D. 4000 - answerCorrect Answer: (D) 4000
Max dose according to Lexicomp 2019 is 4000 mg
6. Which of the following is a contraindication to using a benzodiazepine as a sedative
agent?
A. An epileptic patient
B. A patient who is on coumadin
C. A hyperthyroid patient
, D. A patient with narrow angle glaucoma - answerCorrect Answer: (D) A patient with
narrow angle glaucoma
Benzodiazepines are contraindicated in patients with narrow-angle closure glaucoma or
untreated open-angle
glaucoma. These agents do not possess anticholinergic activity but have rarely been
associated with increased
intraocular pressure. These medications can cause further narrowing and can lead to
blockage of the eye's drainage
system. Allergy, psychoses, and acute narrow-angle glaucoma represent
contraindications for the administration of
benzodiazepines. Benzodiazepines may be administered to patients with open-angle
glaucoma who are receiving
appropriate therapy.
7. Following administration of an inferior alveolar nerve block (IANB), the clinician
should routinely administer a buccal
nerve block. The buccal nerve provides sensory innervation to the buccal soft tissues
adjacent to the mandibular
molars only.
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: (D) The
first statement is FALSE; the second is TRUE.
"The buccal nerve is a branch of the anterior division of V3 and consequently is not
anesthetized during IANB. Nor is
anesthesia of the buccal nerve necessary for most restorative dental procedures. The
buccal nerve provides sensory
innervation to the buccal soft tissues adjacent to the mandibular molars only. The sole
indication for administration of
a buccal nerve block therefore is when manipulation of these tissues is contemplated...."
Thus, the first statement is
False as anesthesia of the buccal nerve should not be routine combined with IANB
anesthesia
8. Which impression material consistently shows the least amount of dimensional
change at 24 hours?
A. Polysulfides
B. Polyethers
C. Condensation silicones
D. Addition silicones - answerCorrect Answer: (D) Addition silicones
Dimensional stability refers to the lack of dimensional change of the impression over
time.
There are 6 major sources
of dimensional change: - answer1) polymerization shrinkage
