Endo Final (Spring 2012)

Front 1

T/F

During endo diagnosis, the reasons patients give for seeking help are less important than the diagnostic test results

Back 1

False

(reasons can give more info than test results)

Front 2

T/F

A sinus tract from a necrotic pulp may drain into the gringival crevice

Back 2

True

Front 3

T/F

The dental pulp is well enervated w/ proprioceptive nerve receptors

Back 3

False

(PDL = proprioceptors)
(pulp = pain)

Front 4

T/F

Pain of non-odontogenic origin can refer pain to the teeth

Back 4

True

Front 5

T/F

Referred pain is the perceptio of pain in one part of the body that is distinct from the actual source of pain

Back 5

True

Front 6

T/F

An endondontic procedure that was performed well, but does not result in healing may be suggestive of a vertical root fracture, especially if a tooth doesn't heal after retreatment or apical surgery

Back 6

True

Front 7

T/F

A tooth with pulp necrosis, but no restoration or caries, is highly suspect to have a vertical root fracture

Back 7

True

Front 8

T/F

Most of the time, vertical root fractures are readily visualized on a periapical radiograph

Back 8

False

(usually can't see vertical fractures)

Front 9

T/F

It is often impossible to determine how extensive a crack is until the tooth is extracted

Back 9

True

Front 10

T/F

Tooth fractures are more common in the B-L direction than the M-D direction

Back 10

False

Front 11

T/F

The diagnosis of "chronic apical abscess" depends on the presence of a sinus tract along w/ other conditions

Back 11

True

(acute usually has no sinus tract)

Front 12

T/F

Condensing osteitis is always associated w/ symptomatic irreversible pulpitis

Back 12

False

(sometimes no symptoms = do nothing)
(symptoms = RCT)

Front 13

T/F

The patient's chief complaint should be paraphrased in the doctor's own words to avoid confusion

Back 13

False

(always in patient's own words)

Front 14

T/F

Whan an infected tooth drains through a stoma on the skin, this is known as a "sinus tract"

Back 14

True

Front 15

T/F

A tooth that is tender to percussion may have a pulpal diagnosis of "normal"

Back 15

True

(percussion tests PDL inflammation, not pulp)

Front 16

T/F

A tooth with caries can have a clinical pulpal diagnosis of "normal"

Back 16

True

Front 17

T/F

A tooth with a necrotic pulp may respond to prolonged heat, but should not respond to cold or EPT

Back 17

True

Front 18

T/F

A tooth with athe diagnosis of "acute apical abscess" is always associated with condiderable periapical radiographic bone loss

Back 18

False

(chronic does)

Front 19

T/F

A tooth with the periapical diagnosis of "asymptomatic apical periodontitis" is always asociated with an apical raiolucency

Back 19

True

(all apical periodontitis has bone loss)

Front 20

T/F

The dull ache of a symptomatic pulpitis is most likely carried out by the C-fibers in the pulp

Back 20

True

Front 21

T/F

Initial pulp tests following an injury frequenly give positive results, but such resluts may only indicate a transient pulpal response

Back 21

False

(recent injuries usually give no response, initially = false negative)

Front 22

T/F

Thermal and EPT are important tests in trauma cases because they indiate the presence or absence of nerve function in the pulp

Back 22

True

Front 23

T/F

Brushing with a soft brush and rinsing with chlorhiexidine is beneficial to prevent accumulation of plaque and debris around the splint

Back 23

True

Front 24

T/F

In treating mid-root fractures, the coronal segment USUALLY undergoes necrosis requiring a root canal

Back 24

False

Front 25

T/F

Milk and HBSS are favored over water for storage media because the osmolality of water causes rapid lysis of PDL cells

Back 25

True

Front 26

T/F

CBCT has been proven in the literature to be superior to conventional radiography for horizontal root fractures and resorption defects

Back 26

True

Front 27

T/F

Tetracycline antibiotics should be prescribed in avulsion cases in patients over 12 yrs old for both antiresorptive properties and antibacterial action

Back 27

True

Front 28

T/F

Inflammatory root resorption occurs as a response to the presence of infected necrotic pulp tissue and injury to the PDL

Back 28

True

Front 29

T/F

The IADT advises the splint time for a lateral luxation injury w/ buccal alveolar fracture to be 4 weeks

Back 29

True

subluxation = 2 weeks
extrusive luxation = 2 weeks
Avulsion = 2 weeks

Lateral luxaiton = 4 weeks
Mid-root fracture = 4 weeks
Alveolar fracture = 4 weeks

Cervical root fracture = 4 months

Front 30

T/F

Replacement resorption, or ankylosis, occurs more often with intrusive luxation and avulsion injuries due to denuded cementum on the root surface

Back 30

True

Front 31

T/F

Systemic diseases may cause pulpal injury

Back 31

True

(Herpes zoster)

Front 32

Tooth fractures are usually

A. horizontal
B. vertical in MD direction
C. vertical in BL direction

Back 32

B. vertical in MD direction

Front 33

Percussion test indicates:

A. inflammation in pulp
B. inflammation in PDL
C. inflammation in surrounding tissues

Back 33

B. inflammation in PDL

Front 34

T/F

Pulpal inflammation cannot spread to the PDL

Back 34

False

Front 35

EPT is most useful in establishing necrosis in:
(select all)

A. immature teeth
B. mature teeth
C. recently traumatized
D. not recently traumatized
E. single canal teeth
F. multi-canal teeth

Back 35

B. mature teeth
D. not recently traumatized
E. single canal teeth

Front 36

At least __ radiographs should be taken if fracture is suspected

A. 1
B. 2
C. 3
D. 4

Back 36

C. 3

(3 different vertical angles)

Front 37

T/F

Pain is entirely a psychologic phenomenon

Back 37

False

(also physical)

Front 38

T/F

Pain results from 2 factors related to inflammation:
- chemical mediators
- pressure

Back 38

True

Front 39

T/F

Asymptomatic irreversible pulpitits is often an emergency condition that requires immediate treatment

Back 39

False

(No pain = not emergency)

Front 40

T/F

Analgesics will relieve the pain of a patient with a true emergency

Back 40

False

(good for mild-moderate pain, not severe pain)
(no pain medication can replace the efficacy of thoroughly cleaning the root canal to rid the tooth of the source of infection)

Front 41

T/F

Psychologic management is the most important factor to emergency treatment with an anxious patient

Back 41

True

Front 42

T/F

Localized swelling should be incised whether fluctuant or not fluctuant

Back 42

True

Front 43

T/F

The most consistent factor that predicts postendodontic pain is the presence of preoperative mechanical allodynia

Back 43

True

(preoperative mechanical allodynia = preoperative pain)

Front 44

T/F

Endotoxin is a component of Gram + cell walls

Back 44

False

(Gram –)

Front 45

T/F

IAN blocks provide adequate anesthesia for endo purposes 85-95% of the time

Back 45

False

(35-60%)

Front 46

T/F

Antibiotics are indicated when a patient presents w/ symptomatic irreversible pulpitis and symptomatic apical periodontitis

Back 46

False

(only use antibiotics if sign of spread of infection)

Front 47

T/F

The material of choice for indirect pulp capping is MTA

Back 47

False

(Indirect = CaOH)
(Direct = CaOH or MTA)

Front 48

T/F

Vital immature teeth WITHOUT fully formed apices are poor candidates for direct pulp capping

Back 48

False

(good candidates)

Front 49

T/F

Revascularization/regeneration procedures on non-vital teeth with apical periodontitis and immature apices are an alternative to apexification

Back 49

True

Front 50

T/F

Dentin that is formed as a result of indirect pulp capping is known as secondary dentin

Back 50

False

(tertiary/reparative dentin)

Front 51

T/F

If the conditions are right to pulp cap a carious exposure, the site should be rinsed w/ NaOCl prior to placing the capping agent

Back 51

True

Front 52

T/F

In general, partial pulpotomies should only be done on teeth with a pulpal diagnosis of reversible pulpitis

Back 52

True

Front 53

T/F

Routine root canal therapy is contraindicated in anterior teeth that have successfully undergone apexogenesis

Back 53

True

(apexogenesis = pulpotomy)
(apexification = RCT)

Front 54

T/F

Two major drawbacks of apexification are that the root thickness and root length will not be improved

Back 54

True

Front 55

T/F

When performing apexification utilizing CaOH, barium sulfate is mixed into CaOH to enhance radiopacity

Back 55

True

Front 56

T/F

If you have a vital pulp exposure in the clinic, you should confirm the exposure with an endo instructor before placing the rubber dam

Back 56

False

(place rubber dam before doing anything to avoid contamination)

Front 57

T/F

Anesthetic blockade of nerve conduction depends upon the length of the nerve exposed to the anesthetic solution

Back 57

True

(increased length = increased anesthesia)

Front 58

T/F

Lip numbness is not a guarantee for pulpal anesthesia when performing RCT

Back 58

True

Front 59

T/F

Patient anxiety may contribute to local anesthetic failure by reduced pain threshold

Back 59

True

Front 60

T/F

To overcome accessory innervation from the mylohyoid nerve, one can deposit anesthetic solution higher in the pterygomadibular space

Back 60

True

Front 61

T/F

Central sensitization is the increased excitability of central neurons, which can be the result of inflammation that activates the nociceptors in the pulp and periradicular tissues resulting in a barrage of impulses sent to the brain

Back 61

True

Front 62

T/F

When using an intrapulpal injection technique in an uncomfortable patient, it is not dependent on anesthetic solution, but requires significant back pressure to be effective

Back 62

True

Front 63

T/F

The use of an anesthetic with a lower pKa may increase the availability of usable base form and provide better anesthesia under inflammatory tissue acidosis

Back 63

True

Front 64

T/F

Clinical trials indicate that the intraosseous route of injection significantly enhances pulpal anesthesia after IAN block injection in endodontic pain patients

Back 64

True

Front 65

T/F

Achieving pulpal anesthesia in patients with irreversible pulpitis is significantly more challenging due to TTX receptors that are expressed during inflammation

Back 65

True

Front 66

T/F

The combination of acetaminophen and ibuprofen at the same time has been shown in studies to be significantly more effective in pain relief than narcotic pain medications

Back 66

True

Front 67

T/F

A 2. 0 mm root resection at 45º removes 90% of apical accessory & lateral canals

Back 67

False

3.0 mm at 90º

Front 68

T/F

Advantages of microsurgery include easier identification of root apices, smaler osteotomies, and shallower resection angles

Back 68

True

Front 69

T/F

The removal of diseased periapical tissues by periradicular curettage only eliminates the effect from the leakage, not the cause

Back 69

True

Front 70

T/F

The aim of root end preparation is to remove the intracanal filling material and irritants and to create a cavity that can be properly filled and sealed

Back 70

True

Front 71

T/F

Retreatment should always be considered on a tooth before considering apicoectomy

Back 71

True

Front 72

T/F

An indication for endo surgery is if retreatment of a failed RCT is impossible or would not achieve a better result due to iatrogenic error.

Back 72

True

Front 73

T/F

Using ultrasonics and the microscope in performing apicoectomies along with MTA as a root end filling has increased the success rate of endo surgery

Back 73

True

Front 74

T/F

One of the main factors in post-operative swelling is traumatic handling of the reflected tissue during surgery

Back 74

True

Front 75

T/F

Two major reasons for RCT failure are due to (1) Mesial-Buccal roots of maxillary 1st molars with an isthmus and (2) a missed MB-2 canal

Back 75

True

Front 76

T/F

A surgical complication such as perforation into the sinus has been shown in several studies to have no effect on healing

Back 76

True

Front 77

T/F

Intentional replantation is a good alternative to apical microsurgery when access to the apex is difficult

Back 77

True

Front 78

T/F

30% H₂O₂ associated with heat is a safe internal bleaching material and ha a low incidence of external root resorption

Back 78

False

(H₂O₂ + heat = ↑ risk)
(trauma = ↑ risk)

Front 79

T/F

Vitality of the pulp is usually compromised by SRP ONLY when this procedure compromises the blood supply through the apical foramen.

Back 79

True

Front 80

T/F

The apical progression of a perio pocket extending to the apical tissues may cause pulp necrosis. This is an example of primary perio with secondary endo.

Back 80

True

Front 81

T/F

The prognosis of bleaching a vital tooth discolored by the use of tetracycline during tooth development is very favorable and can be achieved by external bleaching

Back 81

False

(Not very favorable)
(external & internal bleaching recommended)

Front 82

T/F

Root resorption is a complication associated w/ internal bleaching and is more likely when heat is applied during treatment

Back 82

True

Front 83

T/F

An isolated deep perio probing can be a consequence of an exacerbation of a chronic apical lesion in a tooth with a necrotic pulp which may drain coronally through the PDL into the gingival sulcus

Back 83

True

Front 84

T/F

The placement of a base at the CEJ during bleaching procedures is NOT necessary when sodium perborate/water mixture is used

Back 84

True

(base is ALWAYS needed)

Front 85

T/F

Dentinal tubules are NOT common pathways for the spread of inflammation from an infected pulp into the periodontium in a tooth with no history of trauma, root resorption, and SRP

Back 85

True

(accessory canals can be)

Front 86

T/F

In a tooth with primary perio, the pulp is usually non-vital, and therefore not responsive to EPT and cold tests.

Back 86

False

(Primary perio = vital)
(Primary endo = abnormal/non-vital)

Front 87

T/F

Furcation radiolucencies can be associated w/ non-vital and infected teeth with no perio disease present. In this case, these radiolucencies will resolve by endo treatment.

Back 87

True

Front 88

T/F

An unrestored, previously endodontically treated tooth that has no signs of periapical disease & is asymptomatic, but the fill has been in contact with oral fluids for along time should be retreated before being restored

Back 88

True

Front 89

T/F

Posttreatment disease is defined as persistent or reintroduced endodontic disease

Back 89

True

Front 90

T/F

Once a root canal space has been adequately cleaned & obturated, posttreatment disease from microorganisms can NOT occur

Back 90

False

(?? Adequately cleaned should be OK ??)

Front 91

T/F

A crowned tooth that needs RCT should always have the crown removed prior to completing the access

Back 91

False

(can drill through crown)

Front 92

T/F

When attempting retreatment, drilling out a post increases the chance of perforation

Back 92

True

Front 93

T/F

If a post cannot be removed for retreatment, the tooth should be extracted, regardless of the reason for the post removal

Back 93

False

(Disease = apical surgery)
(Restorative reason = restore – unable to restore = extraction)

Front 94

T/F

The 1st step in retrieving gutta-percha from a tooth that had RCT at UIC is to use a hot instrument to remove the coronal segment.

Back 94

True

Front 95

T/F

Carrier-based gutta-percha obturation is easier to remove than standard cold lateral condensation or gutta-percha

Back 95

False

(harder, due to presence of carrier within gutta-percha)

Front 96

T/F

Sargenti method of root canal therapy is taught only at NYU, Boston University, and SIU schools of dentistry in the US

Back 96

False

(Not taught in schools in US)

Front 97

T/F

There is no effective solvent for removing N2 from the root canal system

Back 97

True