Endo MCQ . Endodontic MCQ

Endodontics-Access

Q1

What is the objective of coronal access?

A) To expose and unroof the pulp chamber to gain visibility, icluding removal of pulp horns
B) To locate the canal openings
C) To enable a small file to be placed down the canal openings

Q2

What instrument is NOT ever needed for access preparation?

A) High speed diamond burs
B) RA Steel round burs
C) Gates Glidden Drills
D) Long shank burs
E) Swan neck burs

Q3

How can you identify dentine on the floor of the pulp chamber in a molar?


A) It is smooth
B) It is grey
C) It is knobbly
D) It is dark brown
E) It is hard
Q4

What shape is the access cavity for upper and lower incisors?


A) Triangular
B) Ovoid
C) Round
D) Oblong

Q5

What shape is the access cavity for upper and lower canines?


A) Triangular
B) Ovoid
C) Round
D) Oblong

Q6

What shape is the access cavity for upper and lower premolars?

A) Triangular
B) Ovoid
C) Round
D) Oblong
Q7

What shape is the access cavity for upper and lower molars?

A) Triangular
B) Ovoid
C) Round
D) Oblong

Q8

How many upper incisors have two canals?

A) Hardly any
B) 5%
C) 25%
D) 50%
E) 75%
F) 95%

Q9

How many lower incisors have two canals?

A) Hardly any
B) 5%
C) 25%
D) 50%
E) 75%
F) 95%

Q10

Where is an 'extra' canal often found in upper molars?

A) Mesiobuccal root
B) Distobuccal root
C) Palatal root
D) mesiolingal root

Q11

The opening of the distal canal(s) in molars is usually directly under


A) The distal marginal ridge
B) The centre of the tooth
C) The buccal groove
D) The palatal fissure
E) The cusp of Caribelli

Q12

Upper first premolars usually have

A) One canal
B) Two canals
C) Three canals

Q13

Upper second premolars usually have


A) One canal
B) Two canals
C) Three canals
Q14

If the canal orifice in an upper second premolar appears under the buccal cusp, one might suspect


A) Pulpal sclerosis
B) A palatal canal
C) Internal resorbtion

Q15

When
preparing an access cavity, you find what appears to be the canal
opening much earlier than expected. What might explain this?


A) Incorrect measurement of the pre-op radiograph
B) You have hit a pulp horn
C) Internal resorbtion

Q16

When preparing an access cavity, you come across an orange-yellow slurry inside the pulp chamber. What is it likely to be?

A) Pus
B) Ledermix placed by a previous dentist
C) Necrotic pulp
D) Unset composite resin

Q17

True or false? After entering the pulp chamber, an option is to continue preparation without water spray.


A) True
B) False


Q18

True or false? You should not normally extend the access for anterior teeth under the cingulum.


A) True
B) False

Q19

Why is often advisable to remove an artificial crown from a tooth before preparing an access cavity?


A) Metal shavings may drop into the canal
B) The metal will create false readings when the electronic apex locator is used
C) The tooth may be rotated or tilted under the crown, and the crown just makes it look straight.
D) Dam clamps may loosen the crown



Q20

To find pulp horns, which instrument is most useful?


A) A Briault Probe
B) A file with a curved tip
C) A small round bur
D) A Hedstrom File


Answers

||||||

1a,2c,3b,4a,5b,6d,7a,8a,9d,10a,11b,12b,13a,14b,15b,16b,17a,18b,19c,20a

MCQ Calcium Hydroxide Ca(OH)2

Q1

Which of these is NOT a form of Calcium Hydroxide?


A) Life
B) Dycal
C) Hypocal
D) Coltosol
E) Apexit

Q2

Calcium Hydroxide causes production of tertiary dentine. How?


A) By direct stimulation of odontoblasts
B) By killing bacteria, allowing natural healing processes to occur
C) By sealing dentinal tubules

Q3

True or false? Calcium Hydroxide should be placed into deep cavities prior to acid etching, to protect the pulp from the etchant.


A) True
B) False

Q4

True or false? When Calcium Hydroxide is used as a lining, it should cover the entire cavity floor.

A) True
B) False

Q5

Why is Calcium Hydroxide anti-bacterial?

A) Calcium ions disrupt bacterial metabolism
B) It has a high pH
C) It is acidic

Q6

Approximately how long does the antibacterial effect of a Calcium Hydroxide lining last?

A) 2 days
B) 2 weeks
C) 2 months
D) 2 years
E) Permanently

Q7

Which of these is NOT a good use for Calcium Hydroxide?

A) Lining under an amalgam restoration
B) Dressing inside a root canal in between visits
C) Promoting apical closure in a young non-vital tooth
D) Pulp capping
E) Lining under a composite restoration

Q8

True or false? Calcium Hydroxide linings have good compressive strength.

A) True
B) False

Q9

True or false? Calcium Hydroxide linings provide a good seal by bonding to dentine.

A) True
B) False

Q10

True or false? Dental preparations of Calcium Hydroxide have a limited shelf life as they turn into Calcium Oxide over time.

A) True
B) False

Q11

True or false? Calcium Hydroxide linings can be placed when the dentine is slightly moist.

A) True
B) False

Q12

True or false? Light cured Calcium Hydroxide formulations have better mechanical properties than self-cured ones.

A) True
B) False

Q13

True or false? When doing an Indirect Pulp Cap, the deep layer of leathery infected dentine is left behind, and covered over with Calcium Hydroxide.

A) True
B) False

Q14

Which of these is NOT essential for a successful direct pulp cap?

A) There should be no spontaneous pain from the tooth
B) When stimulated by hot or cold, the pain should disappear as soon as the stimulus is removed
C) Bleeding from the pulp should be minimal and easily controlled
D) The exposure must be traumatic, I.e. no infected dentine present.
E) Hard leathery infected dentine should be present

Q15

True or false? Calcium Hydroxide is an excellent sealant for root canal therapy.

A) True
B) False

Answers

1d,2b,3b,4b,5b,6c,7a,8b,9b,10a,11b,12a,13a,,14e,15b

Endodontics: Working Length



Q1

How far short of the anatomical apex would one normally prepare the root canal?

A) 0 mm
B) 0.5 mm
C) 1 mm
D) 1.5 mm
E) 2mm
F) 3mm

Q2

When estimating the working length of a tooth -

A) The estimate should be the same as the true working length
B) The estimate should err on the long side
C) The estimate should err on the short side
D) It doesn't matter, because the canal preparation does not start until the true working length is known

Q3

To estimate a working length -

A) An undistorted pre-op radiograph is essential
B) Knowledge of the average lengths of teeth is sometimes enough, if the radiograph is distorted

Q4

True or false: The Parallel radiographic technique provides an undistorted view of a tooth

A) True
B) False

Q5

True or false: The Bisecting-Angle radiographic technique provides an undistorted view of a tooth

A) True
B) False

Q6

When estimating working length using a parallel technique radiograph, how much enlargement of the image is allowed for?

A) None
B) 1 mm
C) 2 mm
D) 3 mm

Q7

If a canal was curved away from the beam on a pre-op radiograph, how would this affect you estimated working length?

A) It would be on the short side
B) It would have no effect
C) It would be on the long side

Q8

When estimating working length from your knowledge of average lengths of teeth and a bisecting-angle radiograph, which of these would you NOT make an allowance for?

A) Apical root resorbtion
B) Incisal wear
C) Incisal fracture
D) Canal calculi (pulp stones)
E) Elongation or foreshortening on the radiograph
F) Hypercementosis

Q9

Which of these is the usual reference point for a molar?

A) Level of access cavity
B) A cusp tip
C) A rubber stop
D) A graduated 'seeker' file

Q10

To obtain the estimated working length from a Parallel technique radiograph, one subtracts how much from the tooth image's length?

A) 0 mm
B) 1 mm
C) 2 mm
D) 3 mm

Q11

For canines, it is usually safe to introduce a file -

A) 16 mm
B) 18 mm
C) 20 mm
D) 22 mm

Q12

For all other teeth (not canines), it is usually safe to introduce a file -

A) 16 mm
B) 18 mm
C) 20 mm
D) 22 mm

3

A tooth has apical root resorbtion. When judging the working length, it will probably be

A) Where it usually is, I.e. 1 mm short of the apex
B) More than this
C) Less than this

Q14

The true working length is determined with an apex locator and a size 8 or 10 file -

A) After access to the canal orifice has been made
B) After the coronal 2/3rds has been shaped
C) After the apical 1/3rd has been shaped

Q15

The true working length is confirmed with a radiograph using a -

A) size 8 file
B) size 10 file
C) size 15 file
D) size 25 file

Q16

The file must be repositioned and a new working length radiograph taken if it is short of the true working length by -

A) 1 mm
B) 2 mm
C) 3 mm
D) 4 mm
E) 5 mm

Q17

A W.L. radiograph has a file inserted 17 mm. It is 2.5 mm short of the anatomical apex. What is the true working length?

A) 17 mm
B) 18 mm
C) 18.5 mm
D) 19 mm
E) 19.5 mm
F) 20.5 mm

Q18

With a multi-canal tooth:

A) Each root requires a separate W.L. radiograph
B) All roots should be measured on one radiograph, using their nearest cusp (if possible) as a landmark.
C) All roots should be measured on one radiograph, using the same cusp (if possible) as a landmark.

Q19

Which of these would NOT sometimes give a false reading on an electronic apex locator?

A) Lateral canal
B) Root fracture
C) Contact with metal restoration
D) Fluid in canal
E) Canal calculus (Pulp stone)

Q20

In endodontics, what level of accuracy is reasonably achievable with good technique?

A) ± 0.1 mm
B) ± 0.25 mm
C) ± 0.5 mm
D) ± 1 mm
E) ± 1.5 mm

Sample of Endodontic Examination

1. A patient comes to your clinic on Saturday afternoon complaining of severe sharp pain when eating ice-cream. Your examination revealed a hypersensitive response to thermal test which subside as soon as the stimulus removed. The periapical radiograph shows normal intact PDL. What do you think is your diagnosis?

a) reversible pulpitis

b) irreversible pulpitis

c) pulp necrosis with chronic apical abcess

d) patient has no problem

2. A 20 years old male student reported to the emergency clinic complaining of pain to thermal stimuli of the upper left side. The patient said that he had RCT on tooth #24. The cause of the pain could be:

a) remaining vital tissue at the apical third of the buccal root.

b) over-instrumentation of the palatal canal.

c) debris pushed through the apical foramen of the palatal root.

d) it must be another tooth and not #24.

3. You started RCT on tooth #46 two days ago which was asymptomatic. Patient was given another appointment to finish the RCT. The patient cameback to your clinic complaining of severe pain when chewing on the same tooth. Clinical examination revealed pain on percussion only. Radiograph shows normal apical area. The cause of the pain might be:

a) over-instrumentation.

b) overfilling

c) caries was left in the access opening.

d) all of the above.

4. Leaving the tooth open between appointment during root canal therapy could lead to:

a) healing of the periapical lesion.

b) bacterial contamination of the root canal system.

c) neither (a) nor (b).

5. The pain characteristics of the C-fibers is

a) dull

b) severe and burning

c) sharp and pricking

d) none of the above

6. The fluid movement in dentinal tubules (Hydrodynamic theory) is one of the theories of dentin sensitivity (pain). It was introduced by:

a) Brannstrom 1966

b) Byers 1980

c) Kim 1983

d) none of the above

7. The pain characteristics of A-delta fibers is sharp and pricking.

a) true

b) false

8. The main pathway of communication between Endodontium and Periodontium is via:

a) lateral canals

b) apical foramina

c) secondary canals

d) dentinal tubules

9. Endodontic lesion is often characterized by narrow probing defect.

a) True b) False

10. In true combined Endo-Perio lesions the out come of the treatment depends usually on the Endodontic treatment.

a) True b) False

11. Pulpal disease doesn/t confine to the periapical area.

a) True b) False

12. All root canal treatments are successful.

a) True b) False

13. Case considered successful when the patient is asymptomatic.

a) True b) False

14. The infection of root canal system is related to:

a) mixed aerobic and anaerobic microorganisms

b) single obligate anaerobic species.

c) multiple aerobic species only.

d) none of the above.

15. The followings are factors that might have negative influences on the success/failure (treatment outcomes) of the root canal therapy:

a) Extension of filling (either too long or short)

b) Poor obturation quality

c) Longer observation time

d) Preexisting periradicular pathosise

e) all of the above

f) none of the above

16. The following clinical findings are criteria used for evaluation the success of the root canal therapy:

a) absence of pain and swelling

b) absence of apical lesion

c) healing of the sinus tract

d) the answer is (b)

e) the answer is (a + c)

e) all of the above

17. Which is the best treatment of failed root canal therapy?

a) extraction of the tooth and placement of implant

b) retreatment of the root canal with gutta-percha and sealer cement.

b) periapical surgery with retrograde filling

c) prescription of antibiotic and strong analgesic

18. The success/failure rate of root canal therapy among dental interns at the College of Dentistry, King Saud University is:

a) 50.9%

b) 100%

c) 44.7%

d) 20.1%

19. Contra-indication of Endodontic surgery includes:

a) inability to eliminate pathology by conventional RCT.

b) inability to clean and fill the entire Root Canal by conventional method .

c) iatrogenic problems e.g : broken instrument , perforation.

d) none of the above

e) all of the above

20. The advantages of the submarginal (Ochsenbein-Luebke) flap are:

a) it does involve marginal or interdental gingiva nor expose crestal bone

b) it does not involve marginal or interdental gingiva nor expose crestal bone

c) seldom used when patient care about his esthetic.

d) all of the above



Answer keys

1. a

2. d

3. a

4. b

5. a

6. a

7. a

8. b

9. a

10. b

11. a

12. b

13. b

14. a

15. e

16. e

17. b

18. a

19. d

20. b

Select the most appropriate answer:



Electrical pulp tester is:

device used to determine the presence or absence of sensory inerrvation.
device used to determine the direct pulpal circulation.
device used to measure the temperature of the pulp
a and b



According to ISO, the number of each instrument refers to the diameter of

D1 in mm
D2 in mm
D1 in mmX100
D2 in mm x100.



Gutta-percha endodontic filling material contains:-

more ZO than GP
more GP than ZO.
equal amount of GP+ZO.
GP + coloring agents only.



The intrapulpal injection produces profound anesthesia if the anesthetic solution deposit passively into the pulp chamber.

True ( ) False ( )



Bacterial invasion of the dead DT is slow possibly due to the presence of natural resistance factors in dentin and pulp tissue.Therefore DT of pulpless teeth cannot be infected by bacteria after pulpal necrosis.

a- First statement is true, and the second statement is false.

b- First statement is false, and the second statement is true.

c- Both statements are true.

d- Both statements are false

1. Electronic apex locator may be useful when:

a. the patient is physically impaired.

b. anatomic structures overlay the root apex.

c. a pregnant patient wishes to avoid x-ray exposure.

d. all of the above.

2. External root resorptions:

a. are untreatable.

b. can only be distinguished surgically from internal resorptions.

c. appear to be superimposed over the root canal.

d. all of the above.

3. Prognosis for root canal treatment is worse when the patient:

a. has pain as a presenting symptom.

b. has an interappointment flare-up.

c. has class III mobility and loss of bone support (probing defects).

d. has a small periradicular radiolucent lesion.

4. Referral of difficult cases is indicated when the dentist:

a. does not have the indicated equipment.

b. does not have the indicated training and experience.

c. is not sure what procedures are indicated.

d. all of the above.

5. Which of the following is most responsible for short underfilled

a. severe curvatures.

b. packing debris.

c. canal ledging.

d. calcification of the canal.

6. In a standardized K-file the diameter D is always greater that D by:

a. 0.02 mm.

b. 0.032 mm.

c. 0.32 mm.

d. 0.16 mm.

7. The following medicaments have poort antimicrobial effect except:

a. alcohol.

b. crestain.

c. monochlorophenol.

d. cationic detergents.

8. Chloroform -

a. is the most effective intra-canal medicament.

b. evaporates rapidly.

c. has antibacterial effect.

d. none of the above.

9. Calcium hydroxide can be used as:

a. an intracanal medicament.

b. a temporary root canal filling.

c. an apexification agent.

d. all of the above.

11. The functions of the irrigation solution are the following, except:

a. lubrication.

b. debridement.

c. sterilization.

d. disinfection.

12. Preparing curved canal in multiple planes –

a. permits preservation of the natural curvature.

b. increase risk for furcal perforation.

c. requires Gates-Glidden drill.

d. a and c.

13. Most of the rotary instruments prepare canal using –

a. crown-down technique.

b. step-back technique.

c. anti-curvature technique.

d. balance-force technique.

1. Cavity test:



a. Is a common diagnostic procedure.

b. Considered a non-aggressive method of testing.

c. Is the last resort to identify a necrotic tooth.

d. Used to diagnose the condition of periradicular tissues.

e. Can be the first line of vitality testing.


f. None of the above.



2. A
22 years old male patient came to your office early in the morning
complaining of pain that awakened him at 2:00 AM last night and did not
allow him to sleep till he came to your office, this patient most
probably has:



a. Reversible pulpitis.

b. Irreversible pulpitis.

c. Trauma from occlusion.

d. Pulp polyp.

e. Pulp necrosis.


f. None of the above.



3. A
65 years old male patient came to your office complaining of pain
related to tooth #36, the pain is provoked by drinking tee or coffee and
lasts for 10 minutes after removal of the stimulation, this patient
most probably has:


a. Reversible pulpitis.

b. Irreversible pulpitis.

c. Trauma from occlusion.

d. Pulp polyp.

e. Pulp necrosis.


f. None of the above.



4 . Causes of endodontic failures include:



a. Anatomy

b. Inadequacies in cleaning, shaping and obturation

c. Iatrogenic events

d. coronal leakage

e. all of the above





5. The best method to remove gutta perch during retreatment.



a. Thermal.

b. Mechanical.

c. Chemical.

d. Combination treatment.







6. Overextended gutta-percha should be removed:



e. with ultrasonic

f. by pulling it out or surgically

g. with rotary instruments

h. with solvents





7. Areas of rarefaction are evident on radiographic examination when:



a. The tooth is responsive to cold

b. The tooth is responsive to percussion

c. A tooth fracture has been identified

d. The cortical layer of bone has been eroded





8. Which is the best treatment of failed root canal therapy?



a. extraction of the tooth and placement of implant

b. retreatment of the root canal with gutta-percha and sealer cement.

c. periapical surgery with retrograde filling

d. prescription of antibiotic and strong analgesic





9. Anesthetic testing is most effective in localizing to which of the following?



e. Specific tooth

f. Mandible or maxilla

g. Across the midline of the face

h. Posterior tooth



10. One basic part of diagnosis is:



a. good administration of local anesthesia

b. clinical and radiographic examination

c. proper placement of rubber dam

d. none of the above

1. MCQ Questions:

A- The most reliable test to diagnose the condition of the pulp is:
a. EPT
b. cold test
c. percussion test
d. periapical radiographs


B- You want to do RCT for a lower premolar, what type of LA will you give?
a. Buccal infiltration
b. Mental block
c. Inferior alveolar nerve
d. Mental & inferior alveolar block



C- The concomitant pulpal and periodontal lesion
a. Consists of two distinct disease processes involving the same tooth

b. Is characterized by pulpal necrosis and the formation of a draining sinus tract through the attachment apparatus

c.Is best described as a periodontal lesion that exposes lateral or
accessory canals, resulting in pulpal inflammation or necrosis

d. Is the result of endodontic and periodontal lesions that have coalesced



D- Which of the following tooth groups is the most difficult to anesthetize

a. Mandibular premolars
b. Maxillary premolars
c. Maxillary molars
d. Mandibular molars

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