1. Which of the following periodontal conditions is consistent with a tooth whose pulp became necrotic three weeks ago? a. a narrow periodontal pocket without calculus and a tooth that responds rapidly and painfully to a thermal stimulus b. a narrow periodontal pocket without calculus and a tooth that does not respond to thermal stimulus c. a broad periodontal pocket with considerable calculus present 2. TRUE or FALSE (Circle one) With regard to the electric pulp test, if a tooth does not feel the electrical stimulus and false negatives can be ruled out, the pulp more than likely has some degree of necrosis. 3. TRUE or FALSE (Circle one) Pulp stones are often seen in a healthy pulp. 4. Match column A to column B ___ AAP (acute apical abscess)A. percussion sensitivity must be present ___ CAPB. usually accompanied by several acute symptoms ___ AAAC. denser bone ___ condensing osteitisD. radiolucency 5. You have decided to perform an apicoectomy on a maxillary lateral incisor because of an unretrievable separated instrument in the apical three millimeters. The patient has a well-done porcelain-fused-to- metal crown on this tooth that was placed four months ago. The patient's periodontal status is excellent with minimal pocketing. The flap design most suited for this situation would most likely be a. a semi-lunar flap b. a Luebke-Ochsenbein flap with vertical incisions as necessary c. an intrasulcular flap design with vertical incisions as necessary 6. Which nerve fiber is most susceptible to oxygen deprivation? a. A - delta b. C 7. TRUE or FALSE (Circle one) A tooth suffering from pulpal necrosis may be extremely painful or not painful at all. 8. Circle ALL of the pathologic entities that must have a distinct radiolucency associated with the tooth (more than a widening of the periodontal ligament space). a. condensing osteitis b. CAP (chronic apical periodontitis) c. Phoenix abscess d. AAA (acute apical abscess) 9. Which one of the following four chemicals is not known to be a solvent of gutta-percha? a. chloroform b. eucalyptol c. xylol d. eugenol 10. The principal advantage in using sodium hypochlorite is that it a. is a good chelating agent b. acts as a local anesthetic agent c. is a good solvent for necrotic tissue d. all of the above 11. Name the three purposes of a root canal sealer: a. b. c. 12. TRUE or FALSE (Circle one) As taught here at SIU/SDM all endodontically treated posterior teeth require full cuspal protection. 13. You are looking at a full-mouth xray series of a patient and notice that there is a large periapical radiolucency on tooth #3, a tooth that is seen to have a huge well-placed amalgam. Checking old radiographs you note that this tooth had a small developing periapical lesion as long as three years ago. There is no caries in this particular tooth. Pulp testing shows the tooth to be non-vital. If both aerobic and anaerobic cultures were taken of this periapical lesion, the predominant organism would most likely be a. aerobic b. anaerobic 14. Match column A to column B ___ dry heat sterilizationA. 1 hour at 160 degrees Celsius ___ gas sterilizationB. 20 minutes at 132 degrees Celsius at 20 psi ___ steam sterilizationC. 20 minutes at 132 degrees Celsius at 10 psi D. 20 minutes at 121 degrees Celsius at 15 psi E. 2 hours at 160 degrees Celsius 15. TRUE or FALSE (Circle one) According to the American Heart Association, antibiotic prophylaxis is always necessary whenever endodontic treatment is provided for a patient in either medium- or high-risk categories. 15. Which one of the following periapical pathologies is least likely to cause moderate to severe pain? a . phoenix abscess b. chronic apical abscess c. acute apical abscess 16. Which one of the four tissues below typically will not change in the course of a periapical radiolucency healing after conventional endodontics is done on a tooth? a. cementum b. dentin c. bone d. periodontal ligament 17. In the diagram to the right, which perforation site has the poorest prognosis (all other things being equal) ? a. site A b. site BA c. site C B C 18. Circle all the correct descriptive phrases that apply to affected dentin. a. infected b. unremineralized c. non-vital d. reversibly denatured 19. TRUE or FALSE (Circle one) Dentinal sclerosis involves increased mineralization of the peritubular dentin surrounding the dentinal tubule. 20. Dead tracts are __________________________________________ . 21. In general, which one of the following is considered most damaging to the pulp? a. heating while polishing a restoration b. desiccation c. microleakage d. chemical irritation e. large differences in the coefficient of thermal expansion of different materials 22. Circle the one item in each pair that favors doing a direct pulp cap procedure (all other things being equal). reversible pulpitis - irreversible pulpitis younger tooth with open apex - older tooth with closed apex hemorrhage can be controlled - non-stop hemorrhage recent traumatic pulp exposure - carious pulp exposure carious exposure tooth #8 in a eight year old - carious exposure tooth #8 in a forty year old Name _________________ December 15 , 1998 Final Exam DAEN 741 Choose the one most appropriate (correct) answer, unless directed otherwise. 23. In a successful pulp cap and in successful apexogenesis, medicaments, tissue, cells, and other items are laid down in a sequential pattern. Indicate the order in which 1. dentin-like tissue (dentinal bridge) 2. necrotic tissue 3. odontoblasts are seen in either successful pulp cap or apexogenesis starting with calcium hydroxide on the left and pulp on the right. CALCIUM HYDROXIDE _____________ ______________ ______________ PULP\ 24. If apexogenesis and apexification are successful, conventional endodontic treatment always follows a. apexogenesis b. apexification c. both apexogenesis and apexification d. neither apexogenesis or apexification 25. The apex of a tooth generally matures most rapidly in a a. bucco-lingual direction b. mesio-distal direction 26. Which of the following are indications for surgical endodontic intervention? (a) a non-negotiable canal with periapical pathosis (b) a sinus tract that persists after repeated treatment (c) periapical pathosis in a tooth with a post and core retained crown a. a and b b. a and c c. b and c d. all of the above 27. Circle all correct answers. After trauma to an eight year old's maxillary central incisor vitality testing is invalid because a. trauma can interrupt the nerve supply to the tooth b. an eight year old's maxillary incisor is not yet fully formed and consequently the nerve supply hasn't reached maturity yet c. the eight year old is too young emotionally to be trusted in her responses to vitality testing 28. Circle all factors listed in your notes that help to maintain pulp vitality in a horizontal root fracture. a. adequate stabilization b. adequate reduction (repositioning tooth in its proper alignment) c. adequate occlusal reduction d. adequate antibiotic coverage 29. Which of the following may be used to disinfect gutta-percha points? a. boiling b. autoclave c. chemical solutions d. flame sterilization e. dry heat sterilization 30. What is the one factor which determines whether or not conventional root canal therapy may or may not be done on an avulsed tooth assuming it can be saved at all? a. its maturity at the time of avulsion b. whether or not its been soaked in fluoride c. whether or not its been treated with calcium hydroxide or not d. whether or not replacement resorption is seen to occur. 31. Circle all items that may result from trauma and subsequently lead to discoloration of a tooth. a. fluorosis b. tetracycline staining c. iron sulfide formation from hemoglobin d. necrotic pulp e. sclerotic dentin 32. Which one of the following is an active bleaching agent? a. phosphoric acid b. hydrogen peroxide c. urea 33. When bleaching vital teeth the agent placed in a tray fitted to the patient's mouth is a. phosphoric acid b. hydrogen peroxide c. carbamide peroxide d. zinc oxide 34. The powder used in the "walking" bleach technique is ____________________. 35. You completed conventional endodontic therapy on a maxillary first molar, and after several attempts were unable to adequately clean, shape, and obturate the last three millimeters of the mesial buccal root. It is now a year later and a recall radiograph shows a new periapical radiolucency around the apex of this root. The surgical procedure most likely to be used in correcting this situation would be a. an apicoectomy with retrofilling b. a root amputation c. a hemisection d. an incision-and-drainage procedure 36. Which one of the following items is not considered an example of a stressed pulp (a pulp seen to have fewer cells, more collagen, more calcifications) a. a tooth with extensive periodontal problems b. an old tooth c. calcific metamorphosis d. a tooth in the latter stages of apexogenesis e. irreversible pulpitis 37. Which one of the following materials is the least preferred material for retrofilling after apicoectomy? a. IRM b. Super-EBA c. MTA (mineral trioxide aggregate) d. amalgam (zinc- free) 38. What's the primary difference between a hemisection and a bicuspidization procedure? 39. Circle all items below that allow communication between pulp and periodontal ligament. a. apical foramen b. lateral canals c. mental foramen d. dentinal tubules not covered by cementum e. lingual groove f. infraorbital foramen 40. A female patient, age forty-two, comes to you complaining of pain in the area of tooth number three. She is caries free. You note that the tooth is slightly sensitive to both percussion and palpation. Slight inflammation of the attached gingiva is noted with only very minimal swelling.