Articaine is unique among injectable local anesthetics because it:
C. contains both an amide and ester linkage
Tramadol posseses pharmacological properties that resemble
C. narcotic analgesics and TCAs
Which bacteria are facultative and associated with root canals requiring retreatment?
D. Enterococcus faecalis
Which type of microorganisms has not been detected in root canal infections?
D. None of the above
Which of the following fascial spaces lies between the levator labii superioris and elevator anguli oris muscles?
C. canine
Which of the following factors influences the spread of odontogenic infections?
C. anatomic position of the tooth
Which of the following fascial space infections is also known as a subperiosteal abscess?
D. body of the mandible
In a patient who presents with an acute apical abscess tooth #19 which has spread into the sublingual fascial space, the apices of tooth #19 lie ___ the attachment of the mylohyoid muscle?
A. above
Which of the following is not a clinical symptom of cavernous sinus thrombosis?
A. diarrhea
Which of the following fascial spaces contains the pterygoid plexus of veins?
C. infratemporal
The mandibular incisors drain into which of the following lymph nodes?
D. submental
The following intra-canal species or genera of microorganisms have been associated with clinical symptoms of pulp necrosis and apical periodontitis:
d. Actinomyces spp. and Streptococcus mutans, S. sanguis, and S. gordonii
C. Gram negative anaerobic rods, also known as black pigmented rods, Eubacterium spp. and Streptococcus anginosus
The most commonly identified microbial species in root canals with primary endodontic infections is:
D. Fusobacterium nucleatum
Placement of LPS in root canals of experimental animals leads to the development of periapical lesions. LPS is the only bacterial virulence factor capable of producing a periapical lesion.
D. First statement is correct and the second statement is incorrect
The most sensitive technique of detecting microorganisms in endodontic infections is:
D. The use of PCR amplification of conserved gene fragments from microbial DNA
It is estimated that the following percentage of oral microorganisms is uncultivable:
B. 50%
One of the most important virulence factors of black pigmented endodontic flora of the Porphymonas and Prevotella genera are their:
B. ability to degrade serum proteins, including immunoglobulins, making amino acids for fermentation
The question of whether chronic asymptomatic lesions not associated with sinus tracts have bacterial contamination has been controversial in the endodontic literature. The following statements generally describe the current knowledge in this area except:
a. Histologic techniques have localize bacteria in only a small group of these lesions
b. Obtaining a microbial sample of the periapical tissues by surgical curettage bears the risk of contaminating the lesion with sulcular and other oral bacteria unless very careful controls are used
c. Molecular identification techniques have identified DNA from a large number of bacterial species in these areas
d. Actinomyces spp. are capable of surviving in periapical tissues
e. The most accurate periapical specimens are taken through the root canal
e. The most accurate periapical specimens are taken through the root canal
Which of the following microorganisms obtained from primary endodontic infections has a high likelihood of co-existing in the same root canal sample?
B. Fusobacterium nucleatum and Peptostreptococcus micros
Bacteria from root canals with necrotic pulps could potentially gain access to the blood circulation during endodontic treatment and cause infective endocarditis (IE) in a susceptible patient. Which of the following groups/genera of bacteria common in endodontic infections have been most frequently implicated in IE?
A. Streptococcus viridans
Which of the following lesions typically occurs as a well circumscribed, unilocular radiolucency below the mandibular canal in the posterior mandible?
A. developmental lingual mandibular salivary gland depression
Stafne bone defects occur exclusively in the posterior mandible.
a. True
b. False
b. False
Which of the following lesions is a true cyst?
D. Eruption cyst
A residual radicular cyst is:
D. most likely the result of failure to curette the periapical lesion at the time of tooth extraction
A well-defined, multilocular radiolucency located between root canal treated tooth #21 and vital tooth #22 is least likely to be:
D. radicular cyst
A well defined radiolucency with central irregular radiopacities is located at the apex of tooth #19, which exhibits questionable vitality. The lesion is least likely to be a
D. periapical granuloma
A 50 year old man presents with a history of trauma to the anterior face and chin. Radiographic examination reveals a 2cm x 3cm unilocular radiolucency associated with the apices of the lower anterior incisors, which test vital. The most likely diagnosis is:
A. odontogenic keratocyst
A well-defined, unilocular radiolucency is located between the roots of the left maxillary lateral and cuspid teeth in a 35 year old woman. The canine has had root canal therapy. Which of the following lesions could be present?
D. All Options are correct
In addition to the ameloblastoma, which of the following lesions occurs most commonly in the posterior mandible, has an average age of occurrence in the 4th decade, does not show a strong gender predilection, can be uni- or multilocular, may be expansile and has a high level of recurrence if not completely removed?
C. odontogenic keratocyst
A well circumscribed unilocular radiolucency is located between the roots of root canal treated tooth #8 and vital tooth #9. The lesion is surgically excised 6 months after root canal treatment because it did not resolve. Microscopically the specimen consists of uninformed connective tissue containing large nerves and blood vessels. A cyst lining is present: it is fairly a flat cuboidal epithelium with areas of thin, non-keratinizing squamous epithelium blending with a small area of respiratory-type epithelium. Based on the clinical and microscopic evidence, the most likely pathogenic diagnosis is:
C. nasopalatine duct cyst
There are at least ___ types of sensory neurons that innervate teeth.
B. 6
Sensory innervation of teeth terminates primarily in the:
E. all of the above
Each A delta fiber innervates only one dentinal tubule.
a. True
b. False
b. False
The first nerve that enters dentin during development targets:
C. the side of the cusp closest to the occlusal plane
The response of sensory neurons to pulpal injury:
D. appears to regulate the rate of pulpal necrosis
Which of the following stimuli are effective for stimulating pulpal nociceptors?
E. all of the above
Reduction in the number of primary odontoblasts during tooth development is thought to be due to:
A. apoptosis
The two types of tertiary dentin are:
D. reactionary / reparative
Each of the following is an important bacterial virulence factor EXCEPT:
B. A factor that neutralizes chemotaxins
Release of which of the following produces vasodilation?
A. CGRP
Which of the following best describes the initial inflammatory response to caries?
D. cell mediated immune response
The key cells in initiating a chronic inflammatory reaction are:
E. macrophages / CD4+ cells
Which one of the following statements is FALSE?
C. Coagulation necrosis is the result of T cell activation
Antigens entering the pulp are captured and processed by:
E. dendritic cells
Pus is formed chiefly by:
B. autolysis of neutrophils by their own lysosomal enzymes
Leukocyte adhesion molecules include the following EXCEPT:
E. NFΚ
The following cells function as antigen presenting cells EXCEPT:
A. γ-δ cells
Macrophages are considered the primary mediators of the inflammatory process for the following reasons EXCEPT:
E. They are capable of producing a specific reaction to proteins or large polysaccharide antigens
NK cells exert their actions against infected cells primarily through the following mechanisms:
a. Production of IL-2, which stimulates the activation of macrophages
b. Stimulates the activation of B cells to produce antibodies
c. Binding to Fe receptor of opsonized infected cells, then killing the cell, a process known as antibody-dependent cell-mediated cytotoxicity
d. Phagocytosis
e. Apoptosis
c. Binding to Fe receptor of opsonized infected cells, then killing the cell, a process known as antibody-dependent cell-mediated cytotoxicity
d. Phagocytosis
The following molecules are chemokines EXCEPT:
A. IL-5
Which of the following is true regarding the structure of an antibody molecule?
a. There are two small light chains and two large heavy chains
b. The constant region is the antigen-binding site whereas the variable region has the effector function
c. Each chain has both a variable and a constant region
d. a and c
e. a, b, and c
(A) There are two small light chains and two large heavy chains
(C) Each chain has both a variable and a constant region
The following cytokines are members of the TH1 response EXCEPT:
B. IL-10
Which one of the following cytokines is not a member of the TH2 response?
B. IL-12
Which statement does not describe one of the functions of the complement system?
A. Activates T helper cells to produce IL-2.
Which of the following statements is true about the molecules of the Major Histocompatibility Complex (MHC)?
a. MHC class I is expressed on all nucleated cells.
b. MHC class I-restricted cells are recognized as self by CD8+ or cytotoxic T cells.
c. MHC class II is expressed on a small group of cells collectively called Antigen Presenting Cells (APCs).
d. Bacterial antigens are presented to MHC class II-restricted CD4+ T helper cells in the context of the MHC class II molecule on the APC and the T cell receptor (TCR) on the T cell.
e. All of the Above
(E) All of the Above
Phagocytes of the innate immune system include:
B. macrophages / neutrophils
Which of the following is a chemotaxin of the complement system?
E. C5a
Myeloperoxidase is involved in the conversion of:
B. H2O2 to HOCl
Activation of macrophages involves which of the following cytokines?
E. INF-γ
Using the HMP shunt, glucose consumed by activated neutrophils is converted to:
A. lactic acid
When bacteria begin to enter the pulp from a carious lesion, which of the following inflammatory cells are present in greatest number?
E. neutrophils
The four components of the trigeminal nucleus involved in pain processing include all of the following EXCEPT:
D. post ganglionic sympathetic neurons
Sigurdsson and Maxine found that referred pain experienced by patients suffering from irreversible pulpitis can be:
A. reduced by activation of nociceptors at a distant site
The findings of Klausen et al. indicate that:
a. irreversible pulpitis is associated with thermal allodynia
b. acute apical periodontitis is associated with mechanical allodynia
c. odontogenic pain can induce specific types of allodynia in patients
d. a and b
e. a, b, and c
(E) a, b, and c
Studies by Kwan et al. (Sessle's lab) and Narhi's group indicate that pulpal inflammation can induce:
a. expansion of receptive field size in the trigeminal nucleus
b. increased spontaneous activity in the trigeminal nucleus
c. central sensitization
d. expansion of peripheral receptive fields (by sprouting)
e. all of the above
(E) all of the above
One of the best predictors of post-operative pain is pre-operative endodontic pain.
a. True
b. False
a. True
In Mumford and Newton's studies on electrical pulp testers, the pulse duration is ___ correlated with the threshold current needed for a positive test.
B. inversely
In Mumford and Newton's studies on electrical pulp testers, probes with a smaller surface area required ___ current for a positive response as compared to probes with a larger surface area.
B. smaller
Studies by Absi et al. indicate that hypersensitive dentin is characterized by having ___ as compared to control dentin.
a. greater density of tubules
b. larger tubule diameter
c. less organic material
d. a and b
e. a, b, and c
(D) a and b
Studies by Tagami et al. indicate that the hydraulic conductance of dentin is ___ in dentin from younger patients as compared to dentin from older patients.
C. greater
Which of the following agents has been shown to have clinical efficacy for reducing dentinal hypersensitivity?
a. application of unfilled resins
b. burnishing the dentin
c. application of KNO3
d. guanethidine
e. all of the above
