OPERATIVE DENTISTRY (21)-April, 1978 During preparation for 2 cas gold restoration, 6 the tooth tissue which is weakened by the ‘cavity preparation and subjected to damage by the forces of mastication must be 1. reduced and covered by the cast restoration. 2. strengthened by the use of cement or an amalgam core 3. protected by resorting to full coverage Of the tooth. 4. beveled, and the patient reminded not to 7 ‘exert undue forces on the tooth. ‘One of the best materials for sedation of the dental pulp is - cavity varnish. "calcium hydroxide. 3. zine oxide-eugenol. |. zine silicophosphate cement. a proprietary product of tried powder and distilled water. For a12 year old, the treatment of choice for a fractured mandibular lateral incisor involving the mesioincisal angle but not the pulp is 1. etching and placement of a resin restoration. 2. alingual dovetail inlay. 3. a pin-retained metallic restoration. 4. a porcelain-fused-tormetal crown, ‘The greatest percentage of tooth loss in the first two decades of life (except natural oss of deciduous teeth) Is due to 1. periodontal disease 2 treated dental caries. 3. untreated dental caries. 4, trauma to teeth from accidents. 10. For most effective cutting and long usefulness of a tungsten carbide bur, it should be 1. rotating slowly before contacting the tooth. 2. rotating rapidly before contacting the tooth. 3. placed in contact withthe tooth before Starting. 4. rotating rapidly before entering into the oral cavity. A posterior tooth under a heavy occlusal load hhas cusps undermined with caries. The restorative material of choice would be oH (On a rubber-dam replacement which isolated the six maxillary anterior teeth, the dentist ‘observed an unusual amount of wrinkling of ‘the rubber dam between the teeth. This “wrinkling is the result of 1. punching the holes too small. 2. punching the holes too far apart. 3. punching the holes too close together. 4. crowding and overlapping of the anterior teeth 5. teeth with broad contacts incisogingivally In restoring a Class II cavity, an onlay is indicated when the need for extra retention exists patient has a high caries index . opposing tooth has full coverage. dentinal support of the cusps questionable, ‘erupting but has not reached fenetind oceltion All of the above 1. None of the above ry Pa ‘An accurate diagnosis for dental caries can be ‘made without the use of dental radiographs when 1. only premolar teeth are present. 2 the patient is pregnant. 3. only deciduous teeth are present. 4, all posterior proximal surfaces have Previously been restored. 5. Any of the above 6. None of the above {In working as a team, the position of the chaitside assistant should be 1. lower than the dentist to facilitate visibility. 2. af the same height as the dentist because they are working as a team. 3. higher than the dentist for proper access and visibility to the patient's oral cavity. 4. varied, depending upon where the dentist is working.12. 13. 14. 15. ‘The use of functional occlusal registration presupposes that 1. the tweth to be restored are extruded. 2. the opposing teeth are in need of major restoration. 3. itis impossible to make use of an anatomic registration. 4. the opposing teeth are in harmony with the remaining dentition. 7. Following removal of the gingival retraction . exiracting the mandibular primary second molars placing a removable bite opener. extracting the first premolars. 34, The undesirable side-effect most commonly associated with the use of a buccal coil Spring as illustrated below is 1. pain. 2. gingival irritation. 3, severe mobility of the tooth, 4 tendency for the premolar to rotate. 5. tendency for the molar to intrude. 53 35. 36. 37. Most Class II malocclusions can be prevented by 1. maintaining the integrity of the primary fentition, 2. preventing deleterious habits (such as thumosucking, lip biting, etc 3. breast feeding 4, no known techniques. 5. (1), (2) and (3) above. A primary second molar of a seven-year-old patient is extracted for orthodontic purposes. ‘The apical one-fourth of the mesiobuccal root fractures and remains n situ. The dentist should 1. allow the root tip to remain in place and observe periodically Use a root tip elevator to remove the roots. ‘make a flap at the buccal aspect and remove the tip surgically. |. insert the thin beaks of the forceps into, the socket and remove the root. prescribe penicillin. For an eight-year-old patient with good posterior occlusion, no arch length deficiency, fone eentral incisor Severely rotated and a large diastema present, the procedure of 1. have the labial frenum excised. 2 rotate the tooth with an appliance, 3. examine for a supernumerary tooth. 4. inject thyroid hormone to stimulate ‘eruption of the lateral incisors. 5. None of the above [An interview with the parent prior to a ‘child's first appointment with the dentist is helpful because it informs the dentist about 1, whether the “tell, show, do” approach will be effective. 2. the type of behas response he may anticipate from the child. 3. the probable need for strong restraint during treatment. 4. whether he will be able to use a local anesthetic with this child. 5. all of the above.40. a. 42. year-old patient has an end-on molar ‘elation and normal vertical and horizontal ‘overlap. The mandibular lateral incisors are ‘erupting slightly lingually. The dentist should 1. insert 2 cefer him to an orthodontist 3. continue routine dental care and 4. lingual arch. developmental supervision. institute orthodontic therapy to reposition the lateral incisors and to correct the, ‘Class 11 molar relation. ‘The treatment of choice for a nonvital permanent incisor with immature root, evelopment is. 1. pulpotomy. 2 Silver point placement. 3, lateral condensation with gutta-percha, 4, retrograde root canal therapy with amalgam, 5. filling the canal with calcium hydroxide and CMCP. 47. Ina mixed dentition space analysis, the most careful estimate will only be accurate within 1. 0.5 mm. 2.20 mm. 3. 40 mm. 4, 6.0mm. ‘The purpose of employing loops and helices in wires in tooth-moving appliances Is to 1, provide a lighter force. 2. provide a longer lever arm. 3, lengthen the period between adjustment. 4, Allof the above 49, In correcting an anterior crossbite, the appliance to be used is determined by the 1. amount of overbite. 2 age of the patient. 3. cooperation of the patient. 4. All of the above PMA is a symbol for a 1. pulp capping material. 2 caries index. 3, periodontal index. 4, materia alba index. ‘The optimat time to employ an orthodontic appliance that takes advantage of growth is during 1, late primary dentition. 2. early mixed dentition, 3, late mixed dentition. 4. early permanent dentition, ‘The band and crib space maintainer is classified as 1. bilateral, fixed and functional. 2 unilateral, fixed and functional. 3, unilateral, fixed and nonfunctional. 4, unilateral, eemovable and nonfunctional. A four-year-old child has severe, acute dental pain. So many teeth are carious that the ‘determination of the offending tooth is difficult. The best diagnostic tool to be used is 1. percussion, 2. radiographs. 3, electric pulp testing. 4: to have the patient identify the offending tooth To regain arch length in the anterior segment ‘by moving the incisors labially, one should Use a tongue blade, 2. use an inclined plane. use a splitsaddle acrylic space regain evaluate the position of the teeth cephalomettically before beginning, Cleidocraniat dysostosis is of interest to the dentist because of |. premature loss of teeth. ‘concomitant micrognathia. high incidence of clefts. associated high caries index. 5. multiple supernumerary and unerupted teeth. yaere In terms of incidence of malocclusion, supervision of the child's development of ‘occlusion is most critical between the ages 1. 35 years, 2 6.10 years. 3. 11-16 years.51. 52. ‘The relationship between adequacy of dentition and speech proficiency is such that 1. if there are problems in dentition, there are likely to be problems in speech. 2, speech models may assume relative importance in certain cases, but normalcy of structure will dictate whether there will be normal speech patterns. 3. studies of normal youngsters indicate relatively great variance in the development Of speech skills. 4. All of the above 5. None of the above Frankfort-horizontat is a reference plane constructed by the joining of the following landmarks: 1. porion and sella, 2. porion and nasion. 3. porion and orbital. 4, nasion and sella. A child's behavior problem can be handled by {familiarization if the basis of the problem is 1. fear 2 pain. 3. anxiety. 4: attitude of the parents. To achieve normal occlusion, provided the molar relationship is correct, the most favorable eruption sequence in the maxillary arch is 1. first premolar, canine, second premolar. 2 canine, frst premolar, second premolar. 3. first premolar, second premolar, canine. 4, second premolar, canine, first premolar. ‘The most common nutritional problem in ‘twenagers, particularly in girls, is 1. drinking too much fluids, which leads to edema. . inability to chew harder foods, 3. intense abhorrence of meat and dairy foods. ‘overnutrition, particularly in caloric excess. . undernutrition, particularly in milk, fruit and vegetables. 87. 59. ‘The “V" principle of growth is best illustrated by the 1. nasal septum. 2 mandibular ramus. 3. mandibular symphysis. 4, spheno-occipital synchondrosis, {In the average child, teeth generally in the process of calcification at birth are 1, all primary teeth only. 2, all primary teeth and first permanent molars. 3, the primary anteriors, canines and first primary molars only. 4, all primary teeth and all permanent teeth, Ankylosis of teeth is generally observed after {a change in the continuity of the occlusal plane. This change is caused by 1. differential eruption sequences. 2 the ankylosed teeth sinking into the alveolar bone. 43. localized growth inhibition of the alveolar process. 4, continued eruption of non-ankylosed teeth and growth of the alveolar process. ‘The most common local cause of malocclusion 1. hypothyroidism. 2. presence of supernumerary teeth. 3, early loss of primary teeth, 4 late eruption of permanent teeth. 5, congenital absence of third molars “The greatest period of cranial growth occurs between 1. birth and 5 years of age. 2. 6 and 8 years of age. 3. 10 and 12 years of age. 4, 14 and 16 years of age. You should have finished at least this much of the ‘examination by 10:00 a.m. One hour is allowed for each 60 test items. 61. The eruption of permanent teeth in cases of ‘extremely early loss of primary teeth will fesult in 1. no change in the time of eruption. 2, early eruption of the permanent teeth. 3. delayed eruption of the permanent teeth,“The cotton pellet applied to the pulpal stumps in the formocresol pulpotomy technique should be 1. slightly dampened with formocresol. 2. saturated with formocresol. 3, left in place for 15 minutes. 4, left in place after the second visit. 63. ‘A nonwital primary incisor (abscess due to trauma) in a four-year-old patient can be effectively treated by 1. pulpectomy. 2 extraction. 43, Seminute formocresol pulpotomy. 4, T-day formocresol pulpotomy.. Dental plaque of a person on a high protein, high fat, very low suerose diet would be 1, dense, heavily infected with streptococci 70. 2 thin, structureless with few organisms, 3, dense, heavily stained but with few ‘organisms. 4, none of the above. 65. The radiograph of a traumatized tooth is necessary to 1. assess the stage of root development. n. 2. determine the presence or absence of root fractures. 3, have a base from which comparisons can be ‘made with future radiographs. 4, Allof the above Disturbances in the morphodifferentiation sage of the development of the tooth germ results in an abnormal number of teeth, 72. 2: ameloblastomas. abnormal forms and sizes of teeth. all of the above, 67. A diagnosis of small occlusal cavities is ‘most readily made by the use of 1. bite-wing radiographs. 2. periapical radiographs. 3. panoramic radiographs. 4. transilumination. 5. an explorer and compressed ait. ‘The purpose of the Snyder testis to 1. predict the nature of the combined acidogenic organisms in the oral cavity. 2. determine the exact nature of a specific ‘organism related to caries prevalence. 3. predict the rate of salivary flow. 4 estimate the salvar dissolving capacity of enamel A child’s behavior is traced to his having heard about dental difficulties from his mother. The most satisfactory method (of handling the situation is to introduce another child as a good example. modify his fear by familiarization use small amounts of barbiturates. use firmness use NiO, A broad understanding of the “development” ‘of human behavior requires a knowledge of, the basie concepts of 1. maturation and learning 2. masculinity and femininity. 3. dependence and independence. 4, generalization and facilitation. ‘Amalgam often tends to discolor the tooth, This can be inhibited by using a rubber dam. "a zinc-ree alloy ‘an alloy containing zinc. calcium hydroxide on the pulpal floor. ‘eavity varnish on all cut surfaces. ‘An eight-year-old gil has lost both ‘maxillary central incisors in an accident. The best treatment would be to 1, do nothing except observe 2 move lateral incisors into the central incisor positions. ‘construct and place a space maintainer with bands cemented on the lateral 4, place a temporary prosthesis supplying atlificial crowns for the lost central 5. construct and install a permanent bridge Using the lateral incisors for abutments, 3.73. 74, 75. 76. 7. ‘The value of caries activity tests is their use in 1. gaining the child's confidence. 2. predicting the number of new lesions in a Specified time. 3. checking on the patient's cooperation in preventive measures, 4. determining whether a fixed appliance is better than a removable appliance. Mesial drift may occur asa result of, 1. interproximal caries, 2. interproximal attrition, 3. premature [035 of primary molars, 4, all of the above. A child has an extreme open bite, Only the ‘most posterior teeth contact those in the ‘opposite arch. The best procedure for the dentist would be to 1. refer the child to an orthodontist for treatment, remove the posterior tooth in each quadrant. ‘make an overlay denture to create occlusion. place bands on the teeth and place elastics 10 close the bite, Facial profite evaluation has been called the “poor man’s cephalogram.”” This is because (2) skeletal jaw relationshins ean be ‘observed, (b) posterior crossbites are revealed, {c)_tooth-to-jaw relationships can be observed, (4) bimaxitlary protrusion can be detected. 3 (chara a 2 (2), (6) and (a) 3. (3); (c) and (d} 4. (b), (c) and (a) 5. All‘of the above ‘The plaque matrix consists primarily of (a) levans. 'b) dextrans. (c} wophans. J hang (a 2 (a) and (c) 3. Allof the above 4. None of the above 57 78. 79. 80. 81. a child's behavior regarding preventing dentat disease and behavior in the dental office is unacceptable, the development of acceptable behavior is (a) a process (b) a single incident or event. (c) greatly influenced by the environment. (@) greatly influenced by the laws of learning, 1 (a and) ony 2: (3), (e) ang (4) 3. (b), [c) and (} 4. Alli the above Primate spacing in the primary dentition is observed between (2) maxillary canines and first molars. (5) maxillary canines and lateral incisors, (c) mandibular canines and first molars (a) mandibular canines ang lateral incisors, 1. a} and (e) 2 (a) ana (d) 3. (b) and {c) 4. (b) and (¢} 5. (d) only Which of the following factors will interfere with growth on a long-term basis? (2) Premature birth (b) Poor nutrition (c) Chronic disease (4) Cardiac malformations (uncorrected) (a) and (b) only (a), (b) and (d) (b) and {c} only b),(c) and (a) All’of the above Which of the following are true concerning ‘calculus formation of the dentition? (2) Does not occur in chitdren under 10 years of age {b) Has dental plaque as its precursor (c)_ May oceur at any age, but not as frequently in young children. 4. (a) and () 2 (a) and (c} 3. (b) and (c) 4. Allof the above 5. None of the above82. 83. ‘What dental sequela ae likey ina child with aistory of generalized growth failure ("failure to thrive") in the first six months of ite? Enamel hypoplasia Dentinogenesis imperfecta (c)_Retrusive mandible fo) Retna mana Small permanent teeth 18g 3. (a), (b) and (4) 4. i and (e) : i e) only All of the above Which of the following is related to ‘occipital anchorage? “1, Intra-oral force 2 Tipping a tooth 3. Extra-oral force 4. Bodily movement of a tooth {In order to reduce salvation prior to ‘cementing orthodontic bands, which of the following drugs might be used? 1. Atropine 2. Meprobamate 3, Pilocarpine 4. Gentian violet 5. Chloral hydrate Which of the following is most diagnostic of ankylosis of a primary molar? 1. Change in color 2. Cessation of eruption 3. Cushioned sound on percussion 4. Radiographic density of lamina dura 5. Loss of vitality on electri pulp test Which of the following is the most effective way to combat dental disease? 90. 1. Establishing a community fluoridation program 2. Careful dietary control emphasizing of sweets 3. Incremental dental care coupled ‘community water fluoridation 4, Use of a program composed of community water fluoridation and additional topical fluoridation 5. Regular prophylaxis followed by topical applications of fluoride 87. 88. 89. When opening the pulp chamber from the ‘occlusal surface of a maxillary primary second molar, how many pulpal horns could be exposed? When a successful calcium hydroxide pulpotomy thas been accomplished on a permanent molar, histologic section would show which of the following immediately under the calcium hydroxide? |. Necrosis Odontoblasts Calyx formation Reparative dentin Lymphocyte infiltration In the film below, if normal development continues, approximately how long will be until the mandibular first premolars erupt? 6 months 12 months, 24 months, 36 months 48 months A five-year-old child with a massive cellulitis ‘of dental origin did not respond to penicillin therapy and was prescribed a broad-spectrum tetracycline antibiotic, Itis possible that side effects of tetracycline administration will later be seen in which of the following permanent teeth? |. Canines and second molars . Premolars . Incisors and first molars Both (1) and (2) above Both (2) and (3) above91. 92. 93. The use of which of the following adjunctive aids is necessary to check on the efficacy of {an oral prophylaxis for a young patient? 1. Disclosing solution 2. Sandpaper strip, 3. Snyder test 4, Unwaxed floss ‘A boy and gir are at the same physical and intellectual levels, but their behavior is extremely different in the dental office. Which of the following is probably most significantly related to this difference? 1. Sex 2. Learning 3, Maturation 4, Dental health requirements Which of the following represents the normal relationship of the primary canines? siesicmmaheor 2 era oom a Heeger sates What single morphologic characteristic of the permanent first molar necessitates early restorative procedures in most children? 1. Mesial proximal contact 2 Deep grooves and fissures 3. Large pulp chamber 4, Early beginning of calcification 5. Presence of an auxiliary cusp 95. 97. Which of the following items is probably the east cariogenic? 1. Gum 2 Cookie 3. tee cream 4, Lifesaver 5. Soft drink In tooth or surface eating te fas amount of reduction isthe 1. distal, 2. buceal, 3. mesial. 4 Tingual. 5. occlusal In examining a child patient, normal gingiva is diagnosed on the basis of all of the following EXCEPT 1. contour. 2 stippling. 3. sulcus depth. 4, depth of vestibule. 5. tight-fitting gingival collar. ‘An ankylosed primary molar may result in all of the following EXCEPT 1. loss of arch length. Z a serious problem of extraction, 3, delayed eruption of the succeeding premolar. 4 failure of calcification of the permanent. successor. (SEE PAGE 71 FOR ANSWER KEY) 59NATIONAL BOARD DENTAL EXAMINATION PART IT ANSWER KEY ORTHODONTICS-PEDODONTICS - JULY 1977 No. Ans. No. Ans. No. Ans. No. Ans. 1. 6 26. 02«S 51. 3 76. 3 2. 4 27.00 4 52. 3 71. 1 3. 4 28.0 4 Cries 78. 2 4. 5 29.003 54.002 79. 3 5. 3 30. 4 55. 5 80. 4 6. 4 31. 2 56. 2 a1. 3 ce 4 32.0 1 57. 2 82. 1 8. 5 aac 58.0 4 a3. 3 aaa 34.0 4 59.3 84, 1 lo. 1 35. 4 60. 1 85. 2 Al eauial 36.0 1 61. 3 86. 3 12. 5 37. 3 62. 1 87. 4 13. 2 38.2 63. 1 ae. 1 14, 6 39, 3 64. 2 89. 3 us. 4 40.0 5 65. 4 90. 4 16. 1 41. 2 66. 3 91. 1 ww 1 42.00 4 67. 5 92. 2 18, 2 43.00 4 68. 2 93. 2 19, 2 44,003 69. 2 94. 2 20. 4 45.003 7. 1 95. 5 21. 6 46.0 3 71. 5 96. 4 22. 3 a7. 1 72. 4 97. 4 23. 5 48.0 4 73. 3 98. 4 24. 3 49.005 4.00 4 2.002 50. Zz cc Pat raeTest items 1-3 refer to the illustration below. 1. In the illustration above 1. caries 2. a flaw in the film. 3. a fractured cusp. 4. an identifying dot 2. In the illustration above, “b” represents 1. film fog. 2. film fold, 3. overexposure. 4, outrient canals. 5. processing error. 3. In the illustration above, 1. fluoride. 2 cone cutting 3. overexposure. 4. inadequate fixing. 5. paper stuck to film, 4. An oral condition which predisposes an individual to an increase in incidence and rate of development of dental carie 1. xerostomia, 2. leukoplakia. 3. pharyngitis. 4. herpes stomatitis 5. median rhomboid glossiis. 5. The most common malignancy within the coral cavity is the 1. ameloblastoma, 2. adenocarcinoma. 3, basal cell carcinoma, 4, malignant mixed tumor. 5. squamous cell carcinoma. ORAL PATHOLOGY § RADIOGRAPHY-July, 1977 6. The characteristic lesion of herpes virus 10. infections on the skin or mucous membranes is tumefaction. hyperkeratoxis. abscess vesicle. A maxillary lateral incisor with nonvital pulp and with periapical radiolucency is suitably treated and the root canal appropriately filled after two successive negative cultures of the apical area, The most common result of such tweatment is 1. radiographic resolution of the periapical lesion within 2-3 weeks and an uneventful subsequent history. 2. radiographic resolution of the periapical lesion within 6-12 months and an uneventful subsequent history. 3. no change in the periapical area during 12 months or more, subsequent history otherwise uneven ful 4, reappearance within 12 months of symptoms attributable to periapical infection. ‘Two or mote teeth united only by cementum is designated as 1. fusion, 2, sclerosis, 3. gemination 4: dilaceration. 5. eonerescence. In normal dental diagnostic procedures, the principal radiation hazard to the operator Is produced by 1. gamma radiation. 2. primary radiation. 3. secondary radiation, 4, none of the above. The most common complication of rheumatoid arthritis involving the temporomandibular joint is |. subluxation. fibrous ankylosis. 3. osteoma of the condyle. |. resorption of the condyle, 9. synovial chondromatosis.. a1: 12. 13. 14. Al teeth in the radiograph below have a 15, ‘normal response to ordinary vitality tests ‘The radiolucent areas at the root ends of central and lateral incisors are 16. 1. granulomas. 2. radicular cysts 3, chronic alveolar abscesses. 4 periapical cemental dysplasia (cementomas). Most cases of pulpitis are caused by 1. injudicious cavity preparation. 2. excessive heat incident to dry poli of restorations. 7. 3. chemical irritation from sterilizing agents or filling materials. 4, bacterial invasion from a carious lesion. 5, bacterial invasion from the bloodstream. 6. severe trauma The acute periapical abscess 1, may be accompanied by regional lymphadenopathy. 18. 2. is usually asymptomatic. 3. has inevitable severe systemic manifestations 4. isnot relieved by drainage Chronic hyperplastic pulpits is essentially a 1. necrotizing lesion. 2. suppurative lesion. 3, proliferation of chronically inflamed pulp tissue 4. very sensitive, painful lesion, 5. Allof the above 61 ‘The radiopacity that frequently obliterates the apices of maxillary molars when using the bisecting principle of intra-oral radiography isthe 1. zygoma and the zygomatic process of the maxilla, 2. orbital process of the zygomatic bone. 3. palatine bone and the zygoma. 4, maxillary sinus, ‘There is a radiopaque area on the distal root of the mandibular tight first molar. The ‘radiographic diagnosis would probably be ‘osteoma, ‘eementoma, ‘eburnated bone. condensing osteitis 1 2 3 4 “Sulfur granules” are of diagnostic value in suspected cases of histoplasmosis. actinomycoss. lead sulfide tissue deposits scrofula, furuncuiosis. ‘An 18-year-old man complains of a painful swelling in the palate. Examination reveals soft, fluctuant, tender mass in the midline ‘of the hard palate, The teeth test vital and there is no evidence of periodontal disease. Radiographs, however, reveal a wel-defined radiolucency between the roots of the ‘maxillary central incisors. Clinical and fadiographic findings are compatible with the diagnosis of a lateral periodontal cyst. slobulomaxillary cyst. Incisive canal cyst |. nasolabial cyst19. ‘The lesion illustrated below was excised from the lower lip of a 14-year-old boy. It consisted of a central cavity filled with clear fluid and lined with granulation tissue only. Surface epithelium was extremely thin but intact. ‘A few collections of salivary gland acini and ‘bundles of skeletal muscle fibers 3. mucocele. 4, sebaceous cyst. 5. pleomorphic adenoma. ‘A young woman is admitted to the hospital. Petechiae on the oral mucous membrane and marginal gingival hemorrhage are noted. Platelet count is 45,000/mm.* with increases in bleeding and clot retraction time. The RBC and differential ae normal. Probable diagnosis is 1. infectious mononucleosis. 2 thrombocytopenic purpura. 3. monocytic leukemia, 4 pernicious anemia. 5. hemophilia. Characteristic dental findings of cleidocranial dysostosis include 1. increased caries susceptibility. 2..enamel hypoplasia and lack of enamel formation. 3. juvenile periodontosis and subsequent premature loss of teeth, 4. failure of shedding and eruption, and numerous unerupted supernumerary teeth. 5. all ofthe above. 62 22. 23. 24, Multiple giant cell lesions of bone are associated with 1. pituitary deficiency. 2 hyperparathyroidism. 3. Addison’s disease. 4. hypothyroidism. 5. diabetes. ‘The rarefaction occurring in the bone from an fected deciduous molar, as studied radiographically, most frequently appears. about the apices. between two teeth. in the bifurcation. around the developing permanent tooth. 5. a8 a uniform widening of the periodontal ligament space. vaepe In the absence of clinical signs for symptoms, the most likely interpretation of the area indicated by arrow on the radiograph below would be 1. osteoma. 2 cementoma. 3, socket sclerosis. 4, hypercementosis. ‘A congenital epulis of the newborn is most likely torresemble microscopically 1. an epithelial pearl 2 a gingivitis granuloma gravidarium. 3, an aberrant sebaceous gland. 4, a granular cell myoblastoma. 5. a peripheral giant cell granuloma.26. 27. 28. 30. ‘The radiographic examination of a patient 20 years old disclosed a circumscribed radiolucent lesion 2 em. in diameter in the mandibular right molar region. The lesion was sharply outlined but lacked a radiopaque periphery, was somewhat irregularly shaped and extended 5 to 6 mm. above the apices of the molars and 10 mm. inferiorly toward the lower border of the mandible. There was no evidence of involvement of the cortex or expansion of the bone and the lesion was asymptomatic. All teeth tested within a fnormal vitality range. These findings would suggest 31. 1. dentigerous cyst. 2 radicular cyst. 3. compound odontoma. 4, simple bone cyst. Caries on a proximal surface usually starts F 2 2. 1, buceal to the contact zone and the ‘marginal ridge 2, lingual tothe contact zone and the marginal ridge. 3. between the contact zone and the dentinoename! junction. 4, between the contact zone and the est of the gingiva. 5, distal to the contact zone. 6, atthe contact zone 33. {An inflamed capillary hemangioma of the oral cavity looks similar, microscopically, to 1. anewus. 2, aneurofibroma. 3, an angiosarcoma. 4, apyogenic granuloma. ‘A periapical radiograph of the mandibular premolar region reveals a completely ‘embedded supernumerary tooth, superimposed fon the roots of both premolars. With another film in the same position, a second projection is made from a more mesial horizontal angulation, In the second film, the image (of the supernumerary tooth appears to have shifted distally from its original position. ‘This would indicate that the supernumerary tooth lies 1, buccal to the premolars. 2 lingual to the premolars. 3. in the same plane as the premolars. ‘A patient complains of numbness of the lower lip. There is no history of tooth extraction. ‘The condition is likely to be related to 1. infection. 2, metastatic neoplasm. 3. dental manipulation. 4: disease of the central nervous system. Ground sections of early dental caries of enamel exhibit 1. accentuated bands of Retzius and cross Striations of enamel rods. 2, zones of fatty degeneration and sclerosis ‘of enamel rods. 3, accentuated Owen’s lines of contour and ‘marked interglobular areas. 4, zones of fatty degeneration and interglobular enamel Histologic findings seen in a biopsy of an texpansile poorly-demarcated, finely trabeculated radiopaque lesion in the maxilla ‘of an 18-year-old girl consisted of randomly distributed spicules of osteoid scattered throughout a young connective tissue stroma, The most likely diagnosis is 1. von Recklinghausen’s disease of bone, 2. fibrous dysplasia of bone: 3. Paget's disease of bone. 4, ameloblastoma 5. osteosarcoma, ‘The firm, painless lesion of the palate illustrated below had been present for at least 10 years and increased in size very slowly. The most likely diagnosis is totus palatinus retention cyst. ‘median palatal cyst. pleomorphic adenoma. Carcinoma of the antrum.36. ‘The first consideration in the differential diagnosis of a painless palatal perforation ‘would be syphilis. histoplasmosis. scrofuloderma. actinomycosis. ‘A 41-year-old woman has periodic burning of her buceal mucosa. Clinical examination reveals the presence of slightly elevated, ‘rayish-white linear plaques. Biopsy of one (of these reveals mild surface keratosis, acanthosis, vacuolation of many of the cells of the basal cell layer, and a dense inflammatory cellular infiltrate sharply delineated to the subepithelial connective tissue. The diagnosis most consistent with these changes is |. leukoedema - leukoplakia. lichen planus. white-sponge nevus - benign mucous membrane pemphigus. Hereditary hemorrhagic telangiectasia shows characteristic vascular lesions. which occur most often on the li 2. tongue, 3. gingiva, 4 buccal mucosa. 5. salivary glands. Chronic osteomyelitis with prc periostitis of the mandible (Ga ‘nonsuppurative sclerosing osteitis) characterized clinically mainly by marked 1. endosteal bone formation. 2. periosteal bone formation. 3. resorption of cortical bone. 4. resorption of medullary bone. ‘Three inherent characteristics of the radiographic film are 1. distortion, density and contrast. 2 penumbra, contrast and detail. 3. definition, contrast and density 4. definition, contrast and distortion. 39. a. 42. Absorption of photons produced by a 100-kVp x-ray machine operating at maximum ‘output is primarily by 1. photoelectric effect only. 2. compton effect only. 3. 75% photoelectric, 25% compton. 4, 50% photoelectric, 50% compton. In inflammation of periodontal tissues, edema is most likely responsible for 1. alteration in contour of free gingiva. alteration in color of free gingiva 3. presence of pain. 4, bone loss. A patient exhibits multiple radiolucent areas in the jaw bones which simulate both periapical and periodontal lesions. The ‘serum calcium is 13.5 mg% and serum phosphorus is 2.3 mg%. A biopsy from ‘ne of the radiolucent areas reveals a iant cell lesion. The most likely diagnosis is 1. hyperparathyroidism. 2. hypoparathyroidism. 3. multiple myeloma. 4, Hand-Schiiler-Christian disease 5. myxedema. ‘The sudden development of intensely red, \wheal-lke lesions on the oral mucosa which rapidly progress to thin-walled vesicles that rupture to leave superficial ulcerations ‘covered by adherent yellowish-white ‘membranes suggests a diagnosis of 1. Behcet's disease, 2. Reiter's syndrome. 3. pemphigus vulgaris 4, erosive lichen planus. 5. erythema multiforme. Leukemic gingivitis, because of spontaneous ‘hemorrhage and necrosis, may be 1. necrotizing ulcerative gingivitis. 2 thrombocytopenic purpura. 43. infectious mononucleosi 4, desquamative gingivitis.45. 46. 47. Some microorganisms produce a diffuse, spreading inflammatory reaction due to’ the elaboration of 1, coagulase 2. peroxidase 3. bradykinin. 4, leukotaxine 5. hyaluronidase. With 2 20-film CMRS, a patient using a lead apron would be exposed to approximately. Facial Gonad Exposure Exposure 1. 23k osR 2 34k OSR 3 358 05 mk 4 35K 0.03 mR, 5. STR 0.005 mk 6 79R (0.003 mR Radiographically, nutrient canals appear only |. in the middle to lower G.1. tract. With the terminal point or area at the surface of bone. | with the terminal point or area at the apices of teeth. |. a5 radiolucent areas. - as radiopaque areas. >. None of the above. Nutrient canals, by definition, do not appear on a radiograph, Hyperplasiarassociated with the border of an ill-fitting denture (epulisfissuratum) ‘most similar histologically to |. papilloma. 9: verruca vulgaris. 3. pyogenic granuloma, irritation fibroma, - peripheral odontogenic fibroma with calcification. peeps Cleft lip associated with cleft palate 1. results fom the allure ofthe ai process to fuse. 2, may cause an impediment of speech in children. 3, may interfere with suckling in infants 4 can be easly treated by surgical closure. 5. All of the above 65 49. A 68-year-old man hasan ulcerated lesion of the lower lip surrounded by a white plaque (see below). The duration of the "sore" is approximately three weeks although the “white patch” has been present for at least six months. The patient is a pipe ‘smoker. Oral hygiene is poor and many teeth exhibit mobility. Following the oral ‘examination and case history, the procedure would be 1. plague control. 2. periodontal therapy. 3. biopsy of the lesion on the lip. 4. replacement of missing teeth with appropriate appliances. 50. Serum hepatitis is caused by 1. avirus 2 a fungus, 3. a bacillus, 4. an allergic reaction to serum. 5, ateaction to local anesthetic. 51. Epstein pearls are the same as enamel pearls. imperfections in the tooth bud. 3: seen in vitamin D deficiency. small keratin cysts of the newborn infant, 52. Intraoral myoblastomas occur more frequently in the 1. tongue. 2 palate. 3. gingivae 4, cheek along the line of occlusion of the teeth,53, The most reliable single histologic criterion for a diagnosis of oral squamous cell carcinoma is |. invasion : degeneration, pleomorphism. encapsulation. hhyperchromatism, 4. Lack of response at any level ina pulp vitality test can be used to differentiate between a 1. cementoma and a periapical granuloma. 2. cementoma and an incisive canal cyst 3. globulomaxillary cyst and a traumatic bone cyst 4, periapical granuloma and an apical periodontal cyst 5. petiapical granuloma and condensing osteitis 55. The entity as shown in the radiograph below is most likely to be nutrient canal static electricity. 3. anterior palatine nerve. posterior superior alveolar nerve. partial of incomplete embalming of a cadaver. 56. A constant feature associated with the radicular cyst is 1, an impacted tooth. 2 a missing tooth 3, a nonvital tooth. 4, an anomalous tooth. ‘5. a compound odontoma. 87. 59. 61. 62. [An area of radiolucency about the crown of fan unerupted tooth which has obviously. Completed its development suggests 1. amedian cyst. 9. an impaction. 3. a dentigerous cyst. 4, a primordial cyst The most common cyst in the oral regions is, 1. amedian cyst. . a radicular cyst. a follicular cyst a nasolabial cyst. fan epidermal inclusion cyst. The process of dental caries consists of a 1, dissolution of the enamel matrix by proteolytic bacteria and a destruction Ef dentin by aeidogenie microorganisms. 2. demineralization of tooth substance and lysis of organic elements by an adherent community of microorganisms. 3. dissolution of enamel and dentin by acids produced by the bacterial 4, dissolution of the tooth by Ifa caries susceptible animal is born and raised in a germ-free environment, it will develop carious lesions in its teeth if 1. iteats either a low carbohydrate or a high carbohydrate diet. 2. specific strains of cariogenic ‘microorganisms are introduced. 3, iteats a high carbohydrate diet. 4, other germ-free animals are kept in the same chamber. ‘The etiology of multiple neurofibromatosis is 1 avieus, 2 aninjury. 3. genetic. 4, endocrine dysfunction. ‘An excisional biopsy of a 5 mm, nodule on the side of the tongue was diagnosed histologically as fibroma. This patient should have 1. radiation therapy to the site of biopsy. 2. reexcision with wider margins. 3 hemisection of the tongue. 4, no additional therapy.65. 67. ‘Microscopically, the primary cells which characterize eosinophilic granuloma are 1. fibroblasts. 2. histiocytes. 3. plasma cells. 4, epithelial cells. 5. eosinophils A patient has a swelling of long standing at the ala of the nose on the left side. Examination reveals a swolling in the floor of the nostril and beneath the upper lip. There iso pain and regional tecth are vital. Radiographs show no 69. boone change. The preliminary diagnosis would be 1, alveolar abscess. 2. incisive canal cyst. 3, nasolabial cyst. 4, dermoid cyst. 5. maxillary sinusitis. “The primary cause of radiation damage is 1. ionization. 2. direct effect. 70. 3. genetic damage. 4. indirect effect. A patient exhibits marked attrition of the ‘deciduous and permanent teeth and radiographs reveal a marked tendency toward obliteration of many pulp canals. The patient's mother and brother also hhave had histories ofthis condition. The most likely diagnosis is 1, enamel hypoplasia. 2. ename! hypomaturation. 3. dentinogenesis imperfecta. 4, mottled enamel. 5. none of the above. n. ‘The efficiency of x-ray production in an xray machine depends upon the target mat applied kilovoltage. (c) output of the machine. (@) cooling curve of the machine. 1. (2), (6) and (4) 2 (a)'and (b) only ats 4. (¢) only, 5. (C) and (4) Apical root resorption is seen in fibrous dysplasia periapical cyst. ic) osteomalacia, periapical granuloma. 1. (a) only 2. (a), (b) and (c) 3. (b) and (d) 4. (d) only. 5. Allo the above ‘The effective focal spot is fa) larger than the actual focal spot. 'b) smaller than the actual focal spot. (c) in the shape of a square, (d)__in the shape of a rectangle. fig 4, (b) and (c) 5. (b) and (d) Which of the following bone diseases are hereditary? fa) Osteogenesis imperfecta IS) Oa Horne cyatin (c) Cleidocranial dysostosis. a Ce (e) Multiple myeloma 1 fang ta 2. (a), (¢) and (e) 310) eh and ah 4, (0), (4) and (0) 5. (c);(@) and (e) Which of the following radiographic findings are characteristic of incisive canal cysts? fa) A rounded delineated rarefaction b) No definite outline, with tendency to blend into the surrounding bone (€) May be confused with a radicular cyst involving the anterior teeth (4) Located atthe maxillary median line (e) Located between canine and lateral incisor 1. (a) and (4) only 2. (a), (c) and (d) 3, (a), (c) and [e) £ PL eanate) 5. (b)'and ()73. 74, 72. Of the materials used in dentistry today, Which are the most difficult to distinguish radiographically from caries? ine oxide Composite resin Methy! methacrylate Zine phosphate cement Calcium hydroxide methyl cellulose paste (a) and (b) a) and (c) 'o) and (d) (¢) and (e) (d) and (e) 76. Which of the following factors may increase the siz of the penumbra? (a) Small focal spot 5) Short objectfilm distance fc) Long source-object distance 3) Movement of the tube (a) ana to) (a) and (4) b) and (a ad (a id) only Al of the above 7. Which of the following have been considered a8 etiologic factors in the ankylosis of the temporomandibular joint? Birth injury 78. Rheumatoid arthritis, Je) Malunion of condylar fractures Abnormal intrauterine development ‘Trauma to the chin forcing the ‘condyle against the glenoid fossa, particularly with bleeding into the joint space | (b) and (c) fe) and (a (a) and (e (b), (c) and AAllof the above 78. Which of the following clinical manifestations of syphilis may involve oral mucous membranes? (a) Mucous patch b) | Chancre. Gumma (d)_ Tabes dorsalis (e)Hepar lobatum (a), Ol and (d) a)'and (c) only I ofthe above A radiograph reveals a radiolucent shadow ithe apex of the malay right canta incisor. There is no break in the cont the lamin dur andthe tooth responds” ‘normally to the pulp tester. There are no clinical signs or symptoms. What is the most probable explanation of the radiolucent shadow? 1. Trauma 2. Infection 3. Chemical artifact 4, Anatomic landmark Which of the following regions in the crown of a tooth is often mistaken for caries in the dental film? 1. Pulp horn 2 Marginal ridge 3. Secondary dentin 4. Cementoenamel junction Which of the following groups of conditions has lesions of the oral mucosa which may ‘pass through a stage in which they appear as vesicles? 1. Henpes simplex, pemphigus and varicella 2 Verruca vulgaris, herpes simplex and tuberculous uleer 3. Hyperkeratosis, mucous patches and Fordyce granules 4, Pemphigus, erythema multiforme and angioneurotic edema ‘5. Koplik spots, purpura hemorrhagica and cancrum oris79. A patient has a 7x5 cm. soft swelling at the angle of the mandible anterior to the sternomastoid muscle. The patient states that he has been aware of the swelling most ‘of his life and that there has never been any pain associated with the swelling. The regional Iymph nodes are nonpalpable. Biood and urine tests are within normal limits. Radiographic surveys of the teeth, jaws and cervical spine are negative. Aspiration of the swelling reveals 2 yellow-brown fluid, What condition is most Suggestive on the basis ofthe clinica examination and the laboratory findings? 1. Submylohyoid dermoid cyst 2, Follicular ameloblastoma 3. Thyrogiossal duct cyst 4, Branchial cleft cyst ‘A 46-yeat-old man has a buccal lesion ‘characterized by deep ulceration. The lesion has a red, raised border and is 0.5 em. in meter. The patient indicates that the Tesion is painful, that it has been present for about four weeks, and that he has suffered from such lesions as long ashe can remember, as evidenced by numerous scarred areas. Which of the following conditions is most suspect on the basis of the clinical findings and the case history? 1. Pemphigus 2. Herpes simplex. 3, Erythema multiforme 4, Periadenitis mucosa necrotica recurrens Which of the following has been determined to be the most cariogenic carbohydrate? 1. Starch 2 Sucrose 3. Glucose 4, Glycogen 5. Dextranase 6. Al are sugars and, thus, equally cariogenic. Which of the following lesions is the most Frequent cause of resorption at the root apex? 1, Cementoma 2. Fibrous dysptasia 3. Primordial cyst 4 Periapical granuloma 5. Globulomaxillary cyst 83, A patient is concerned about yellow spots in his mouth. Examination reveals many ‘chamois colored, flat or slightly elevated ‘spots distributed bilaterally on the buccal mucosa, There are no other clinical findings. ‘What condition is most suspect? 1. Chickenpox 2, Lichen planus 3, Fordyce spots |. Koplik spots 5. Herpangina ‘An oral examination of a three-year-old child revealed only deciduous canines and first ‘molars present. During general observation Of this child, it was noted that the complexion ‘was very light, the hair was fine and light, and the overall appearance of the face was that of an older person. Which of the following ‘conditions fs suggested? 1, Cleidocranial dysostosis 2 Osteogenesis imperfecta 3. Hereditary ectodermal dysplasia 4, Crouzon’s disease Which of the following would most likely ‘be associated with a nonvital tooth? 1, Radicular cyst 2. Internal resorption 3. Periapical cementoma 4 Hyperplastic pulpitis 5, Active formation of a true denticle (Of the following salivary gland lesions, which is usually associated with the sicca syndrome? 1, Mixed tumor 2. Adenoid cystic carcinoma 3. Mucoepidermoid carcinoma 4, Benign lymphoepithelial lesion Using "B" speed film exposure to the patient at 3 feet is I roentgen, What would the ‘exposure be with “1D” speed film at 6 feet? (Assume all other exposure factors to be the sare.) 1 BR ZAR 312k 4 3/AR89. 91. 92. 93. Which of the following blood dyscrasias has a acial predilection? 1. Purpura 2 Leukemia 3. Hemophilia i Polycythemia 5. Sickle cell anemia Each of the following neuralgia is related to Involvement of a specific nerve or gan The nerve involved in each disease is listed after the disease. Which combination is INCORRECT? Bell’s palsy - 7th nerve 2. Herpes zoster » Sth nerve 3. Tic douloureux - Sth nerve Auriculotemporal syndrome - Sth nerve Glossopharyngeal neuralgia - 9th nerve Which of the following is untikely to cause enamel hypoplasia? 1. Rickers 2 Fluoride 3. Congenital syphili 4, Exanthematous diseases 5. Cleidocranial dysostosis Which of the following conditions is least likely to show oral manifestations? 1. Psoriasis 2: Pemphigoi 3. Periadenitis Behcet's disease Stevens-Johnson syndrome 97. Of the following locations, the one in which the prognosis of epidermoid carcinoma is least favorable is the ower lip, ‘upper lip. ). hard palate ‘buccal mucosa. posterior lateral border of the tongue. [All of the following may have similar radiographic findings EXCEPT 1. an ameloblastoma, 2 aradicular eyst. 3. a complex odontoma. 4, an eosinophilic granuioma. 5. a lateral periodontal cyst. Congenital syphilis and Hutchinson's triad include each of the following EXCEPT 1. Ghon complex. 2, mulberry molars. 3, notched incisors. 4: interstitial keratitis, ‘5, nerve deafness, rhagades, saddle nose. ‘A number of conditions may present as periapical radiolucencies. These include Bil of the following EXCEPT 1. dental granuloma. 2. periapical cemental dysplasia. 3, metastatic carcinoma of the breast. 4, multiple myeloma, 5. hypercementosis. All of the following diseases may be associated ‘with pigmentation in oral regions EXCEPT. ‘Albright’s syndrome. Peutz-Jeghers syndrome. Albers-Schdnberg disease. ‘The giant call granuloma is characterized by all of the following histopathologic features EXCEPT 1. foci of hemorrhage. 2, scattered eosinophils. 3. deposits of hemosiderin. 4. many multinucleated giant cells. '. astroma consisting of fusiform and round fibroblasts. (SEE PAGE 72 FOR ANSWER KEY) 70NATIONAL BOARD DENTAL EXAMINATION PART IT ANSWER KEY ORAL PATHOLOGY AND RADIOGRAPHY - JULY 1977ENDODONTICS-PERIODONTICS (27) ~ December, 1978 [335 3’ matt 1937 © 37. 377 mm i al 76 T y3| $35 [755 iS2il633.345, 231325|623 313} i f ra peepee 735) areas t sv iolsaels2q [335 [51a 33] it 777133 72a 3 535/537 ial 3 |. 380ud“youuu e Sursn uaye 210m sounsodxa soUaNsog“Test items 1-16 refer to the illustrations on the two preceding pages and to the following description. Miss Smith, a 45-year-old housewife-student, comes to your office complaining of pain in the upper right molar area MEDICAL HISTORY: ‘Miss Smith says that she is in good health; however, insulin for control of diabetes “for many years.” Several years ago, she had mononucleosis and was “run down for months.” ‘She last saw a physician five years ago. At that time, she was put on tranquilizers to control nervousness; however, she stopped taking them shortly after they were prescribed. The only medication she takes today is insulin. DENTAL HISTORY: ‘Miss Smith has had regular dental care most of her life. As a teenager, she had four premolars extracted at the beginning af orthodontic therapy. She wore bands for three years and a retainer for several years, thereafter. Her front teeth had been crowded, 50 she was pleased by the results. She is aware of ndingher teeth at night and at school, She had c gris her four “wisdom” teoth extracted whi The lower two were impacted. She had be done “at almost every dental visit” as a young woman. Recently, she has had only a few Biger “fillings” putin, replacing old, smaller ones. Asa ‘young woman, she had an episode of “‘trenchmouth”” ‘which was treated with penicillin by her doctor. Her Tast dentist, who died “about a year ago,” had been telling her that she was getting a “gum problem” for several years but had not suggested any treatment or Teferral. Other than the pain in her upper right molar area, she is symptom-free at present. ORAL HYGIENE HISTORY: Miss Smith uses a stiff, natural toothbrush with a roll stroke “after every meal.” She uses floss to Clean out food which catches between her “back teeth. She uses no other adjuncts, is not familiar with stain tablets and has heard about plaque on TV but “doesn t know what itis for sure.” She has her teeth cleaned by her dentist or his hygienist at least once a year. Her last prophylaxis was more than a year ago ‘OCCLUSAL FINDINGS: ‘Miss Smith has an initial centric relation prematurity between the maxillary and the mandibular second molars. She has a mm. anterior slide with a slight Teft deviation in closing from retruded contact position to intercuspal position. In right lateral Movement, she has group function and no balancing Contacts. In left lateral movement, she has “cuspid rise” with a balancing contact of the right second molars. Her protrusive movement is evenly distributed among the incisors. ‘The most significant part of this patient's medical history, as it pertains to dental treatment planning, is that she 1. stopped taking tranquilizers to control nervousness. 2. is acontrolled diabetic 3, is run down from mononucleosis. 4, may be an uncontrolled diabetic. 5, takes insulin daily. In her maxillary molar regions, which of the following radiographic findings will NOT affect treatment planning? 1. Suggestion of furcation involvements on. the first molars 2. Proximity of the maxillary sinuses to the ‘molar root tips 3. Amount of vertical and horizontal bone 4, Noss. Proximity of first and second molar. roots Which of the following modes of therapy could be useful in treating the maxillary right canine? ) Osseous resection fb) Osseous coagulum graft (c)_ Bone marrow graft (i) Gingivectomy {e) Root planing and curettage 1 (3 Qlanate) 2 (a), (a) and (e 3. (bs & and [e) 4 (@),(@) and le 5. Allof the above Instrumentation to debride the affected areas would have been a preferable approach to ‘penicillin therapy in treating her episode of necrotizing ulcerative gingivitis because 1. she has now been sensitized to penicillin. 2. penicillin therapy will not eliminate the signs and symptoms of N.U.G. further tissue loss is more likely with systemic therapy than immediate local therapy. 4, instrumentation is less expensive than long-term penicillin therapy.OF the following teeth, which would be the ‘most likely candidate for root amputation? Maxillary right second molar Maxillary right first molar Maxillary left first molar Maxillary left second molar Mandibular left second molar veer {In right lateral excursion, which of the {following considerations would favor “cuspid rise” over group function as a goal of ‘occlusal therapy? {a} Extensive bone toss around each 10. of the maxillary posterior teeth, and the canine {e) ark ot ably of he cannes le} Considerable mobility of the maxillary premolar (@) Absence of balancing contacts 1 (a)and (b 2 {a) and (c) MW 3. (2) ana {g) 4 (bande S teh and () In right lateral excursion, which ofthe following considerations would favor group function over “cuspid rise” asa goal of ‘occlusal therapy? {a} Extensive bone loss around each of the maxillary posterior teeth and the canine (6) Lack of mobility ofthe motars and the canines 12. (€) Considerable mobitty ofthe mmaxilary premolar (4) Absence of balancing contacts 1 Ghana (o 2 Gea} 3. (abana la) & {pana (and (d) 13. If both her maxillary right first and second molars are retained intact and treated surgically, use of which of the following devices would permit thorough plaque removal between these teeth? Soft toothbrush with interproximal technique Dental floss Perio Aide® Interdental brush Water Pik® None of the above Parente Several of her teeth have inadequate attached gingiva; however, free gingival grafts are NOT indicated in these areas because osseous problems affecting the involved teeth would make selection of a different surgical approach preferable. 1, Both parts of the statement are TRUE, 2 Both parts of the statement are FALSE, 3. The first part of the statement is TRUE, the second partis FALSE. ‘The first part of the statement is FALSE, the second part is TRUE. The patient had necrotizing ulcerative gingivitis “asa young woman.” The age at which she was most likely to have had the disease 1. under 10 years. 2 13:30 years. 3. 3045 years. Her anterior slide from the retruded contact position to the intercuspal position is a “Jong centtic."" A long centric should be eliminated in occlusal adjustment {equilibration) whenever detected. 1. Both statements are TRUE, 2 Both statements are FALSE. 3, The first statement is TRUE, the second is FALSE. 4. The first statement is FALSE, the second is TRUE. ‘The vertical radiolucent “line” between left lateral and central incisors is an artifact a fracture i 2 nutrient canal 2 fistula or a sinus tract. none of the above. 1 Which of the following teeth probably act as plunger cusps causing food to wedge between her teeth? fa) Maxillary right first molar (o) Maxillary right premolar c) Maxillary eft first molar (d) Maxillary left second molar veees 214. 15 17. The best immediate treatment for her bruxism problem would be 1. to refer her for psychlatic counseling 2 Gimination of the balancing interference. 3. temporary splinting of mobile teeth. 4. toconstract an occlusal (night) guard Her recession may be due to (2) chronic inflammatory periodontal disease. {b) frequent use of a stiff toothbrush {o)_ prematurity in retruded contact position, (4) diabetes. {a} and (b) only {a}, (6) and (a) {2} and (c) only {a}, (c) and (d) {)'and (a) only {), (@) and (a) Which of the following diagnoses of her ‘current status are correct? (a) Necrotizing ulcerative gingivitis fb) Generalized moderate-tosevere periodontitis c)_ Generalized severe periodontitis (d) Secondary ocelusal trauma fe) Primary occlusal trauma (a), (b) and (d) a), (b) and (e) 3 and (d) only nego 8 and (e) opaene Heavy fibrous gingival hyperplasia is best treated by subgingival curettage. scaling and plaque contol. reverse bevel flap operation. Singivectomy or gingivoplasty. Beye Bleeding upon gentle probing is indicative of food impaction. crestal bone los. Ulceration of the sulcular epithelium, ‘apical migration of the epithelial attachment. all of the above. 19. 21. 22. 23. 24, When the free margin of the gingiva is enlarged aa result of inflammation, its crest moves. 1. apically. 2 distally. 3. mesially. 4 comically 5. occlusal, Water irrigation devices have been shown to climinate plague disiodge food particles from between teeth. disinfect pockets for up to 18hours. prevent calculus formation. diminish plaque formation. All of the above oye wo Frequent brushing helps to prevent calculus formation by 1. neutralizing toca acidity. 2. breaking up the matrix of plaque. 3. removing the Ca/P ions which attach to tooth surfaces. 4. removing food particles on teeth and interproximal areas. 5. Allof the above The periodontal condition which usually has the worst prognosis is occlusal traumatism, gingivitis, juvenile periodontitis (periodontosis) periodontal atrophy. ‘moderate periodontitis. When inflammation in the gingiva extends into the deeper supporting tissues and part of the periodontal ligament is destroyed, the diagnosis is 1. gingivosis. 2. chronic gingivitis. 3, juvenile periodontitis (periodontosis). 4. dependent upon the age of the patient. ‘An carly effect of primary traumatic occlusion 1. vertical pocket formation. 2. generalized alveolar bone loss. 3, Undermining resorption of alveolar bone. 4. hemorrhage and thrombosis of blood vessels in the periodontal ligament.2. 27. 30. Utastructural and biochemical suidies have shown that plaque microorganisms produce substances which separate them from one ‘another and form a matrix for further plaque ‘accumulation. This “matrix” is made up of dextrans (glucans) and 1. tevans (fructans). 2. mucoproteins. 3. disaccharides. 4. lipoproteins. 5. monosaccharides. ‘Unilateral mastication will tend to result in. 32, 1. greater accumulation of plaque on the used side 2. greater accumulation of plaque on the ted side 3. Sipeaterdegee of periodontal disease onthe used side heavier and more dense bone support on the unused side. [An example of acute inflammatory gingival talargement is mast likely 1 be seen ia. patient exhibiting 3. 1. periodontal cyst. 2 Bregancy ging. 3, Bilsntind hyperplasia. 4. eredltary Moromatoris. Flowing shouldbe performed 1. daly 2 beginning when teeth first erupt. 34, 3 screrl tmes a week 4 Whenever food becomes impacted. 5. when periodontal dacs present Gingival curettage is indicated in the treatment of 1. inflamed and edematous gingiva 2. fibrotic gingiva. 3. Bleeding gg 4. all of the above. 35. Sone of the above. Necrotic pressure areas, undermining bone resorption and endosteal bone formation are all associated with iuvenile periodontitis (periodontosis). periodontal cyst. periodontal abscess. Drimary occlusal trauma. chronic destructive periodontitis. peepee Gingivitis is characterized by increased depth of the gingival sulcus. swollen marginal tissue. bone loss apical migration of the epithelial attachment. all of the above. ‘only (1) and (2) above. Pen “The diagnosis of necrotizing ulcerative gingivitis is best made by 1. biopsy. 2. exfoliative cytology. 3. bacteriologic examination. 4. clinical signs and symptoms. 5. 6 ‘psychological profil. ‘utritional analysis. ‘A two-day otd developing plaque would ‘consist primarily of filamentous organisms. ‘gram-positive cocci and rod-like organisms. ‘a structureless, non-mineralized pellicle. Spirochetal organisms. ‘Among the following, the most efficient method of brushing is 1. suleular brushing 2 the Stillman technique. 3. the side-to-side technique. 4. the Charter technique. {in the treatment of occlusal trauma, the tip of the cusp of a mandibular tooth isin premature contact in centric occlusion, yet in ‘harmony in lateral excursion. The procedure of choice is to 1. remove the contact in lateral excursion. 2 deepen the fossae of the opposing maxillary teeth. 3. reduce the cusp helght of the same mandibular tooth. 4. remove the centric contact by grinding both maxillary. and mandibular teeth.37. 38. The two major periodontal considerations in preserving and maintaining the natural dentition involve {a) establishing health of the marginal gingiva. ® ‘eliminating centric slide. lc) restoring all missing teeth. (@) developing functional heaith of supporting tissues. (c) performing complete occlusal. adjustments 1 2 (a)and (a) 3. (a) and (e) 4. (b)and (a) s. f and} 6 £6 fi and (b 40. aa) and (e) Antibiotics may be useful in the treatment of a) herpetic gingivostomat (>) necrotizing ulcerative gingivitis. (2) desquamative gingivitis (2) periodontal abscesses. 1. (a) and (b) 2 (a) and (c 3. (a) and (a) 4 & 'o) and tc (b) and (a) a. Regular effective removal of dental plaque by the patient is important because this will help to (a) reduce calculus formation. (0) prevent dental cares and Pertodontal disease (©) feduce existing gingival inflammation (a) rede root sensitiv a}, (6) and fe) (a), (b} and (a) (and (3) (fb), (c) and (a) All of the above vaeee 79 Subgingival curettage may cause (a) pocket elimination é oot sensitivity root exposure. gingival inflammation. 1 {0b} and fe 2 (ah, (b) and (a) 2 {ah fe anata} & Ba 5. All‘of the above In periodontitis, the roots are planed before surgery because (2) some ofthe pockets will shrink {o) hemorrhage during surgery will be diminished. () removing all calculus during surgery takes too long, (€) the operator can then evaluate the patient's motivation in hygiene. {e) the tissues will heal faster after surgery A and (b) only ja), {b) and (c) (2), (c), (a) and (e) (b) and (c) only All of the above None of the above opevn Problems relating to improper use of the pedicle or the lateraly-positioned flap to Cover a dehiscence are (a) unpredictability of reattachment procedures. Infection. (c) creation of anew dehiscence at the donor site. (d) extreme patient discomfort. (c) presence of undetected occlusal y Bae 3. (b) and (¢} : 6. S) anaes42. Of the following, which are the most successful methods of preventing periodontal disease in the general population? (a) Routine oral prophylaxis b) Fluorides (c) _Antiboties (d) Oral hygiene le) Vitamin supplements 1. {3 (b) and (¢) 2 (a) 2ng (d) only 4 pice J rata 5. (c) and (e) Which of the following procedures might be 46. useful in reducing tooth mobility? (2) Repositioning of the tooth out of occlusal trauma (0) Endodontic therapy {c) Occlusal adjustment (d) Reduction of inflammation in the periodontium 2) and (6) ont ® ei o ana) on 8 hang {c) and (d) only (@) only A of the above noweene 47. Which of the following root surfaces are most likely to have flutings which will make thorough root planing difficult? (a) Mesial surfaces of maxillary first premolars (b) Mesial or distal surfaces of ‘mandibular incisors c) Mada surtices of maxi incor Distal surfaces of maxillary canines fa) \ze0 i zit (and (a) 48. Which of the following are essential characteristics of gingival (pseudo) pockets? {a} eration of ning eet 'b) Apical migration of epithelial ‘attachment {Bent oer 3 mm, (d) Destruction of some or all adjacent transseptal connective tissue fibers. (e) Bone resorption 1 ft. {b) and (c) 2 {a) and (c) only 3. ey. {chand ( ae lon BUS oe Which of the following are associated wi secondary occlusal traumatism? fa) Mobility 'b) Migration (c)Inflamed gingivae id) Extensive bone loss 1. (a), (b) and o} 2 (a), (b) and (a) 3. (a) fe) and (a) 4 (b), (e) and (a 5. Allof the above Which of the following accurately describes the removal of the bone indicated by shaded areas A and B in the diagram? Ais osteoplasty, B is ostectomy. Ais ostectomy, B is osteoplasty. Both are forms of osteoplasty. Both are forms of ostactomy. aypeWhich of the following is most likely to Periodontal examination has revealed that precede the formation of plaque on tooth four teeth of a mandibular posterior quadrant surface? have enlarged fibrous gingivae with interdental pockets of 446 mm. which do not traverse the 1. Inflammatory exudate mucogingival junction. Neither radiographs, 2. Decakification ‘or probing suggests infrabony defects. Which 3. Pollicle Of the following treatments would NOT be 4. Basic glycoproteins appropriate? 1. Gingivectomy 2. Buccal flap with lingual gingivectomy 49, Which of the following is most likely to cause 3. Subgingival curettage and root planing. Bingival recession? 4. Full thickness buccal and lingual flaps 1. Toothbrush abrasion 2 Occlusal trauma 65. Gingival width apicocoronally is generally 3. Poor home care east in which of the following? 4, Improper deflecting contour: 5. Necrotizing ulcerative gingivitis Facial of the maxillary first and second molars 2. Facial of the mandibular first and 50. Which of the following is the most likely second molars indication for soft tissue curettage? 3. Lingual of the mandibular first and second molars L.Fibrotic gingiva 4, Facial of the mandibular first premotars 2 Deep pockets with inflamed gingiva 3. Shallow pockets with inflamed gingiva, 56. On which of the following teeth is a free gingival graft leas likely to be an appropriate form of therapy? 51. Apatient who had been treated surgically for ‘a buccal bifurcation problem has not been 1, Mesiobuccal root of the maxillary first Able to keep the exposed furca plaque-free by molar Using only a soft toothbrush. Use of which of 2. Facial surface of the maxillary canine the following would NOT add to his orat 3. Facial surface of the mandibular third hygiene regimen? molar 4. Facial surface of the mandibular first 1, APerio Aide® premolar 2 Stim-U-Dents® 5s. Facial surface of the mandibular central 3. Arubber tip stimulator incisor 4. A floss-threading device The sentences in items 57-59 consist of two main 52. Which of the following factors does NOT parts. Which of the following describes each item? | complicate adequate oral hygiene performance? Interdental calculus Both parts of the statement are TRUE, 1 2. Overhanging margin 2. Both parts of the statomentare FALSE. 3. Orthodontic band 3. The first part of the statement is TRUE, 4. Fixed bridge the second partis FALSE. 5. Open contact, 4, The first part of the statement is FALSE, the second part is TRUE. 63. Which of the following statements about the relationship of plaque to dental disease is NOT correct? 57. Bone resorption appears to be caused by a large multinucleated cell and this cel is 1. Plaque and sucrote ae necessary for cares. Called an osteceyte 2 Plaque alone will cause gingivitis 3. Compete removal of plaque fram teeth fon daly basis should prévent both gids and cris. 58. Plaque wll form inthe absence of sucrose; 4, Eames is necessary for plaque Formation however itis not capable of eausing which will ead to gingivitis. gingivitis.61. 62. 63. Excessive occlusal forces may produce widening of the periodontal ligament and this widening results from resorption of the alveolar bone. Most epidemiologic studies indicate that gingivitis in children is relatively common. On A world-wide basis (disregarding data collected in the U.S.A}, a strong positive association between specific nutritional deficiencies and the presence of periodontal disease in children and adults has been demonstrated. Both statements are TRUE. Both statements are FALSE, The first statement is TRUE, the second Is FALSE. ‘The first statement is FALSE, the second is TRUE, Sees ‘A common gutta-percha solvent is alcoho. chloroform. Ceesatin® beechwood creosote. camphorated p-chlorophenol. veeee ‘The most frequent cause of failure in endodontic therapy is indiscriminate instrumentation, failure to sterilize the canal Use of improper intracanal medication, oor condensation and incomplete filfing of the canal ayer ‘A radiolucent area appearing between the apices of a vital maxillary lateral incisor and avital maxillary canine is probably an apical cyst. a radicular eyst. a periodontal cyst ‘an incisive canal cyst. a globulomaxilary cyst. peers ‘The most frequent cause of persistence of positive cultures from a root canal is 1. improper drug therapy. 2. contaminated culture medium. 3. overinstrumentation of the root canal. 4. seepage of saliva into the area of operation. 67. 70. Generalized malaise and elevated body ‘temperature are most frequently associated with 1. acute pulpitis. 2. acute apical abscess. 3. necrotic pulp. 4. chronic apical periodontitis. If corticosteroids are used as a component of root canal medicaments, microorganisms are destroyed. leukocytic infiltration results. antibacterial action is enhanced. ‘exacerbation of infection may occur. Bismuth compounds have been included in some root canal filing materials because they are radiopaque. ‘germicidal. anodyne. adhesive. eye Sterilized endodontic instruments will be free of all viable 1. microorganisms. 2. spore-forming and nonspore-forming, bacteria pathogenic to man. 3. bacteria pathogenic to man, except 4. ‘5. bacteria, except the thermophit Severity of the course of a periapical infection depends upon the resistance of the host virulence of the organism. ‘number of organisms present. All of the above Only (1) and (2) above Radiographs of periapical areas of rarefaction are important in diagnosis because they demonstrate 1. the existence of an infective process. 2. variations in densities of structures. 3. when periapical and pulpal areas have been rendered sterile. 4, the size of a periapical lesion, thus distinguishing between a cyst and a granulomaPercussion is a dental diagnostic procedure used in determining whether Most useful in differentiating between an acute apical abscess and an acute periodontal abscess is 1. the tooth i vita. 2. the pulp ishyperemic. |. palpation. 3. a periodontitis exists. radiographs, 4, the pulp is metaplastic. anesthetic test. 3. Allof the above percussion test. pulp vitality test. Pulp capping and pulpotomy can be more successful in newly erupted teeth than in adult teoth because When root canal instruments (files and reamers) are sterilized in a glass bead sterilizer at 450°F, they should be placed in the sterilizer for 1. a greater number of odontoblasts are present. there is incomplete development of nerve endings. an open apex allows for greater 2seconds. 5 seconds. 10 seconds. 20 seconds. circulation, the volume of pulp is relatively greater in young teeth, ). 32-year-old male complains of throbbing pain in the upper right quadrant. The pain is Spontaneous and usually lasts several hours. Al tests are within normal fimits except fadiographs, which show a large carious lesion in the maxillary fist premolar. After 1 file excavation of all car 2. broach. produced, The most probable diagnosis is ‘The root canal instrument most likely to break during use isa 3. reamer. 4. wophine. 5. spreader. Hertwig's root sheath arises from the 1. odontoblasts. 2 dental papilla. 3. dental follicle. 4. dental epithelium. stellate reticulum. ‘The most frequent cause of pulpal inflammation is ‘A radiograph of the mandibular anterior teeth in a patient reveals radiolucencies about the apices of right lateral and central incisors. No restorations or cavities are present. There {sno pain or swelling and the pulps are vital ‘The diagnosis is periapical granuloma, cementoblastoma. radicular cyst. chronic abscess. necrosis. intemal resorption. reversible pulpitis. irreversible pulpits. hyperplastic pulpitis. ‘The efferent nerves found in the dental pulp somatic motor fibers. sympathetic postganglionic fibers. parasympathetic postganglionic fibers. both somatic motor and autonomic postganglionic fibers. More than one main canal occurs a significant per cent of the time in the maxillary first molar distobuccal root. maxillary fist molar lingual root. ‘mandibular central incisor. All of the above Only (1) and (2) above Ageing of the pulp is evidenced by an increase in 1. vascularity 2. cellular elements. 3. fibrous elements of the pulp. 4, noncaleified areas within the pulp.83, Tissue reaction to an irritant may include fa} tissue necrosis. (b) tissue hyperplasia. ic} tissue hypertrophy. (4) inflammation. 1. (ah or(a) 2 (b)only 3. (b) or (e) £ (only 5. Any of the above istologic characteristics of an atrophic pulp {a} smaller than normal cells (b) an increase in the number of cells. (c}__ an increased quantity of collagen. (4) _ an increased amount of reparative dentin. {e} dystrophic calcifications 1. fa), (b), (c) and (e) 2 {al, (c) and (d) a}, (c) and (e) only {b), {e), (2) and (e) fb), (d) and (e) only ) 3 4 3 6 (d)'and (e) only 85. Which of the following are valid reasons for periapical surgery? {3} Biopsy fb) To romove necrotic cementum {c) Convenience {d) To treat periapical lesions clearly dofined by a radiograph 1 hand 2 [aland 3. (a) and (a 4 (phand{e 5. {b) and ‘ 6 {e) and (a) 86. When would the need for amputating a root of a multirooted tooth be considered? 1. Ione root had extensive nonrestorable foot caries 2 fone root had severe internal or external resorption 3, fone root had lost its alveolar bony support 4. Any of the above 5. None of the above Which of the foliowing tests is most accurate to differentiate granuloma, chronic alveolar abscess and radicular cyst? Biopsy Percussion Thermal test Electric pulp test Radiographic examination ‘A patient has a draining fistula apical to tooth #10. The tooth, which is restored with a post and crown, had a root canal filling and an apicoectomy one year ago. Radiographically, the tooth measures 14 mm. in length. Adjacent teeth respond normally to pulp testing. Which of the following is the most acceptable treatment? 1. Retreat and refill the canal with guttarpercha, 2. Retreat and refill the canal, then perform ‘an apicorctomy. 3, Retreat by surgery using a retrofil amalgam, 4. None of the above A patient of record calls late Saturday night ‘because of severe, throbbing pain aggravated bby “heat, biting and touching” in a mandibular premolar. What procedure is recommended? 1. Instruct him to apply ice intermittently, take aspirin, and call Monday for an appointment. 2 Soc him at the office and initiate endodontic treatment. See him at the office, remove the carious dentin and place a sedative zine ‘oxide-eugenol cement 4. Prescribe an analgesic and refer him to an endodontist. 5. Refer him to the hospital oral surgery department for extraction, Ideally, what control tooth or teeth should be utilized when testing a suspected pulpally involved tooth? Adjacent teeth only ‘Suspected tooth only ‘Opposing teeth and adjacent teeth Contralateral tooth and opposing teeth Adjacent teeth and contralateral tooth paepe91. Histologically, the dental pulp most closely resembles what type of tissue? 1 2 3 4 92, Whats the response of anarma! pulp to the application of intense heat or cold? L 2 3 4 5. 1 z 3 4 1 2 3. 4 5. 94. A traumatized tooth with a necr shows 2 periapical area of rarefaction. radiographically. The pulpal area is closed. Viable microorganisms might be cultured from the canal in approximately what percentage of the cases? Nerve tissue Vascular tissue Granulation tissue Loose connective tissue No response by a normal pulp Pain which lasts for 30-60 seconds Feeling of warmth or coldness on the tooth Pain which lasts for 10-15 minutes after the stimulus is removed Pain which lasts for only a short time after the stimulus is removed Pulp cap Pulpotomy Pulpectomy Extraction’ 10 percent 30 per cent 40 per cent 80 per cent 100 per cent 93. Five hours ago, 2 7-yearold boy fell off of his bicycle. He fractured his maxillary right Central incisor at the level of the gingiva. The ‘exposed pulp is still vital. What is the- treatment of choice for this tooth? pulp. 95. 97. Which of the following periapical conditions is NOT a variation of the granuloma? yaeee Chronic alveolar abscess Phoenix abscess Radicular cyst Gholesteatoma Sear Internal resorption is feast likely to continue in a tooth with 1 2 3 4 Bi a necrotic pulp. ‘acute pulpitis. chronic pulpitis. acute pulpalgia. pinkish discoloration of the crown. ‘The desired biologic results in root canal treatment of a tooth with a periapical lesion include all of the following EXCEPT ayes regeneration of dentin. apical seal of cementum. regeneration of alveotar bone. reattachment of the periodontal ligament.NATIONAL BOARD DENTAL, EXAMINATION PART II ANSWER KEY ENDODONTICS-PERIODONTICS - DECEMBER 1978ENDODONTICS-PERIODONTICS-December, 1977 “Ny aioe 72331Ne e oe Co ee COORD @ SOAS 438-7 225 227 aaa24 a2 My 1% us Wya2d 123 s‘Test items 1-19 refer to the illustrations on the two preceding pages and to the following description VITAL STATISTICS: 51-year-old Caucasian male; a retired military colonel REASON FOR SEEKING TREATMEN "Bleeding gums,” mouth odor and discomfort ‘upon chewing HISTORY OF PRESENT DENTAL ILLNESS: In 1949, a mandibular removable partial denture was constructed to replace tooth #30. This denture was worn for two days only. The patient stated that it did not fit correctly. In 1961, he was bothered by gingival bleeding, whereupon a gingivectomy was performed in the maxillary right Quadrant. During this therapy and immediately following, he was given oral hygiene instruction and a thorough prophylaxis. He has since had a ‘greatef dental awareness. Since 1961, his teeth hhave been cleaned once a year. Recently the patient has become alarmed by the gradual loss of teeth (“one by one") and he wishes to prevent further loss. The patient is a heavy cigar smoker, He brushes twice a day with a stiff brush and routinely uses a stimulator tip, mainly to remove Food. He admits to occasional clenching, especially before his retirement a year and a half ago. MEDICAL HISTORY: The patient sin good physical condition, has a regular annual physical examination, and isnot presently under the care of 3 physician. He had Theumatic fever a8 a child and has a heart murmur of “some concern” to his physician. ‘The femaining ‘medical history i essentially non-contsibutory, with the exception of a possible peniclin allergy. In 1953, the patient was hospitalized because of an allergic response following combined penicilin and sulfa drug therapy. Although it was never established ‘which agent caused the allergic reaction, penicillin ‘was suspected, The patient has no other known allergies. He is not taking any medication at present. ‘ORAL FINDINGS: ‘The tongue, cheeks, lips, muscles and TM] are all within normal limits as are soft tissues of the palate, floor of the mouth and pharynx. The gingiva is pink and firm with prominent stippling, ‘There is moderate gingival recession posteriorly in the maxilla and distal to tooth #29 which bypensensitne, There is bleeding upon probing. Stain is present on lingual and interproximal surfaces of the maxillary teeth and there slight plaque accumulation interproximally. The zone of gingiva is of adequate width except in the area of teeth #29 and #28 where there isa high frenum attachment. OCCLUSAL FINDINGS: ‘The patient has a 2 mm, slide to the anterior and to the right in closing from centric relation to centric occlusion. Centric prematurities exist In the right first premolar and left second premolar areas. Group function occurs in both Tight and left lateral movements. Balancing (non-working) side contacts exist between the maxillary premolar and the mandibular first ‘molar in right lateral and between the ‘molars in left lateral excursions. A protrusive prematurity exists with the right molars. Heavy faceting and wear can be noted in each of these occlusal relationships suggesting that the patient clenches and grinds his teeth frequently. 1. Which of the following osseous procedures ‘is least likely to be an effective means of ‘resolving the osseous cratering on the mesial of the maxillary left premolar? 1. Intrzorat autogenous bone graft 2 Mac erest marrow graft 3. Osseous coagulum graft 4, Osseous resection 2. The mobility in the mandibular anterior teeth may best be negated during treatment by 1. sealing and curettage. 2. occlusal grinding. 3. wire ligation 4: gold inlay appliance. 5. swinglock partial denture. 3. The severe root hypersensitivity in the ‘mandibular right second premolar most likely 1. results from occlusal trauma. 2. is due to exposed nerve endings. 3. results from plaque accumulation on the root. 4, could be controlled by use of deser toothpaste 4, The patient's gingiva is stippled, coral pink and firm; therefore, little shallowing of pocket depth is likely to occur following root planing. 1. Both parts of the statement are TRUE, 2. Both parts of the statement are FALSE. 3. The first part of the statement is TRUE; the second part is FALSE. 4, The first part of the statement is FALSE; the second partis, TRUE,5. 7 Referring to the illustrations, if the mandibular 9. left second molar isto be retained, which of the following measures would be required to its Future use? a) Splinting it to the adjacent first molar (b) Surgically eliminating the distal crater ‘and buccal furcation involvement {¢)_Orthodontically depressing the tooth (d) Performing a tuberosity reduction on the maxillary left ridge Restoratively correcting the crown height (a), (b) and (d) fh i é 5 (b) "6 and (6) zag) ‘The presence of stippling in the mandibular anterior region 8 & 1) and e 5 hana, 4. (b) and (c) indicates normal tissue present. suggests the inflammatory process is chronic. is a result of fibrosis. is the result of heavy smoking. 10. “The patient's clenching and grinding habits ‘ean be controlled during therapy by means Of which of the following techniques? ‘Occlusal guards Definitive occlusal equilibration Psychological counseling. Tranguilizers 5. All of the above u. The presence of recession in the maxillary right ‘quadrant may be due to which of the following? Improper toothbrushing gar chewing History of earlier gingivectomy Occlusal trauma fe) Passive eruption (a ) (<) \) (a) or (b) or (d) fa) oF iE d) 1} (co (2) or (d) oF (e) (c) or (a) o (e) vey From his dental history and the evaluation of his present plaque control, which of the following measures should be considered to improve his oral hygiene? @ (0) Use of a suloular brushing technique (c) Elimination of his smoking habit {d) Introduction of a daily flossing program Motivation to continue his present program but to add daily flossing (a), (b) and (c) a bed Introduction of a plaque disclosing agent ) fa), {c) and (4) (bo), (c) and (d) xf HBS ‘The prognosis for the mandibular right second molar is poor because of inadequate root canal therapy. severe bifurcation involvement. (c) internal root resorption. (d) mobility and trauma from occlusion, le) marked buceal bone exostosis. 1. (a) and (b) only 2. (a), (b) and (e) 3. {2Vand eh 4. {b) and {d) 5. (c) and (e) ‘The migration of the maxillary right lateral incisor (a) renders the prognosis of this tooth hopeless. (b) indicates that tooth movement ‘was due to pocket formation. (©) _ indicates severe 10ss of periodontal support on the distolingual aspect Of the tooth. (2) _{s the result of the tooth moving, into a state of equilibrium. 1. (a) and (o) : (a) and (A) 3. (b) and (c) 4, (b) and (d)12. 13, 14. 15. The patient is a heavy cigar smoker and has ‘a problem with staining on his teeth, This problem could bese be controlled by which oral hygiene procedure? 1, Increased use of detergent foods 2. Use of a stiffer toothbrush 3. Introduction of daily flossing 4, Use of a Perio Aide® 5S. None of the above What would be the antibiotic of choice prior to instrumentation? 1. Lincomycin 2. Erythromycin 3. Tetracycline 4, Sulfas 5. Penicilin ‘The patient’s gingiva is described as pink, firm and stippled; however, he complains of “bleeding gums” and bléeds upon probing. Which of the following statements is NOT true? 1. Inflammation must still remain in the deeper tissues. 2. The probing was done too vigorously. 3. The disease must be chronic in nature, 4, Plaque cannot be removed from pockets as deep as those in this patient's mouth. If the mandibular right second premolar were to be used as an abutment in a fixed periodontal splint, which of the following Surgical techniques might be employed t0 ‘rete a broad band of attached gingiva? ( flap) fe) Rice gnoval eat ‘Apically-positioned flap with marginal denudation (4) Freneciomy (frenum repositioning) he ace eta ony (a) Pedicle graft (laterally-positioned 1 2 4 1 the mandibular left first molar is to be saved, which of the following surgical techniques would NOT be helpful? 1. Curettage 2. Gingivectomy 3. Osseous grafting 4 Extraction of tooth #18 5. Osseous recontouring 17. On which of the following teeth can infrabony crater formation be noted? {a} Maxillary right lateral incisor {b) Maxillary left cenzral incisor (c)_ Maxillary left premolar (a) Mancha st ol fe) Mandibular right first premolar (a), (b) and (<) (a), (2) and (2) by, (e) and (d) {el and fo ie) (d) and (e) aero 18. On the basis of the findings presented, which (of the following conclusions could be made Concerning the mandibular right first premolar? 1. Food impaction caused the deep mesial pocket, 2. The deep mesial pocket caused the Jistal migration of the tooth 3, The centric prematurity caused ‘mesial open contact. 4, None of the above could be established from the findings. 19. Which of the following findings can be seen on the radiographs of the maxillary left premolar? (a) Thickening of the tamina dura (b) Widening of the periodontal ligament space (¢) Suggestion of a deep mesial crater (d) Vertical bone loss fe) Horizontal bone loss 1 2 3. 4 (a), (b) and (c) fo and i) and (e} fh and fa (d) and (e I OF the above 20. Which of the following procedures has as its ‘most important objective the elimination of ‘existing inflammation? 1. Gingival surgery 2 Mucogingival surgery 3. Root planing and curettage 4, Occlusal correction 5. Splinting,22. 24. 25. Pellicle formation involves which of the following? 1. Selective adsorption of acidic alycoprotein from human saliva 2, Focal areas of mineralization 3. Bacterial colonization 4, None of the above Which of the following lesions may create ingival deformities which will require Singivoplasty to eliminate the defects? 1. Herpetic gingivostomatitis 2. Desquamative gingivitis 3, Erosive lichen planus 4, Necrotizing ulcerative gingivitis 27. {n chronic periodontal disease, how does the inflammation spread from the interdental papilla to the underlying bone? 1, Externally to the facial or lingual periosteum and then into the bone 2. Directly into the bone through the perivascular tissue 3. Directly into the periodontal ligament and then into the bone 4, Around the circular fibers into the interdental bone Which of the following is likely to occu the epithelial attachment is removed during subgingival curettage? 1, The pocket will become deeper after therapy. 2. The patient will experience severe postoperative pain. 3, The pocket will become shallower. 4, The periodontal ligament will be severely damaged. 28. When performing subgingival curettage, which Of the following is necessary to assure successful treatment? 1, Removal of the free marginal gingiva 2, Removal of the pocket epithelium 3, Removal of the cementoename! junction 4, Placement of a periodontal pack |. Which of the following procedures should be done routinely, atleast once per year, on recall of treated periodontal patients? Charting, including probing Health history review ‘Occlusal examination Fluoride treatment ‘Oral hygiene evaluation and review 1. (3), (0), (c) and (4) 2 (a), (b), (c) and (e} 3. (a), (d) and (e) 4: {b), (e), (d) and fe) 5. All of the above The accumulation of large numbers of which of the following cells suggests that an immunologic response to plaque in the sulcus ‘occurs in inflammatory periodontal disease? Mast cells Macrophages (¢) Plasma cells Monocytes ‘Neutrophils Lymphocytes (a) and (b) bp, (d) and (e) 5. (6) and (1) {ele ana) )'and (f) After applying disclosing solution to the teeth, which of the following should a patient use for effective removal of plaque? fa) A good light, ‘A strong mouthwash (c) A soft bristle brush i} An interproximal cleaner (interproximal brush, Perio Aide®, seve os (e) ‘Avatar rigating device 1, fa), ft) and (d) 2. {a), (b) and (e) 3. (a), (c) and (d) 4, Gana ta (d) and (e) 5. (b), 6: (c), (d) and (e)31. 29. A patient should be encouraged to reduce the Frequency of his sucrose intake to 0 fc) _ stop new plaque formation. (4) eliminate periodontal disease. 1 ana ey 2 (a) and (a) 3. fb) and (e) 4: (b} and (d) 5. (e) and (d) “The organisms which are incorporated in the dental plaque in the first two days after prophylaxis are mostly (a) rods. b) cocci. fe) filaments, Following root planing, to insure 2 more ‘coronal gingival attachment after subgingival ‘curettage, itis essential that the {3} gingival inflammation be eliminated. {2} epi aachent be emeved (c) calculus and necrotic cementum be removed. (4) crevicular epithelium be preserved, 1. (a), (b) and (¢) 2 (a'and (c) 3. (b) and (e) 4, (o) and (a) 5. All of the above ‘The objectives of scaling and root planing are to remove plaque. calculus. rough cementum. ‘revicular epithelium. epithelial attachment. L xs fi 2 (a), (b) and (a) ey | é 4 tb), a SO na (a) help to slow new plaque accumulation, decrease caries activity in his mouth. 35. 37. Cervical abrasion of the tooth is usually the result of . sulcular fluids, 2: sulcular brushing. cervical plaque activity |. Stillman toothbrushing technique. 5. none of the above. veepe ‘The condition occurs most often between 12 and 20 years of age. A sudden drifting of teeth has taken place. Bone loss and pocket Formation are more extensive on some teeth ‘compared with neighboring teeth. The above is diagnostic of ingivosis. periodontosis, gingival recession. marginal periodontitis. 5. acute necrotizing gingivitis. Sulcular brushing is best accomplished with a 1, brush with square-cut bristle ends and a medium texture 2. brush with angular-cut bristle ends and a soft texture. 3, soft 2 or 3 row brush with rounded bristle tips. 4. natural bristle brush 5. None of the above Periodontal pockets which offer the best Besslity for bone regeneration are 1. suprabony pockets. 2, one-wall infrabony pockets. 3, twowwallinfrabony pockets, 4, three-wallinfrabony pockets. Most failures in maintaining adequate plaque removal result from failures in patient recalls. training. education. ‘motivation. dexterity and skill. ‘The portion of a toothbrush which functions ‘most efficiently in removing plaque is the 1. tip of the brush. 2. heel of the brush. 3. tips of the bristles. 4, sides of the bristles. 5. whole brush.39, 40. at. 42, ‘A Gyear-old boy has an exquisitely painful ‘mouth of four days duration. Three days prior to the onset of the local symptoms, he had palpable, tender, submandibular lymph nodes and a temperature of 101.2°F. Oral ‘examination reveals a generalized inflammation ‘of the attached gingiva and alveolar mucosa. Loose white debris covers the free gingival ‘margins and fills the interproximal embrasure. iscrete areas of ulceration within rings of intense inflammation are noted on the buccal ‘mucosa and the palate. The interdental papillae are intact. ‘The salivary flow is heavy and viscous. There are no lesions on the ‘extremities. The condition described is moniliass erythema multiforme. . acute herpetic gingivostomatitis, necrotizing ulcerative ging ‘The most harmful premature occlusal contacts usually exist on the 1. working side, the facial incline of the maxillary facial cusps, of the lingual incline of the mandibular lingual cusps. 2. non-working side, the facial incline of the maxillary lingual cusps, or the lingual incline of the mandibular facial cusps. 3, lingual surface of the maxillary anteriors. 4, labial surface of the mandibular anteriors. Histologic examination of the tissues in desquamative gingivitis would reveal 1. hyperkeratosis, 2 elongation of rete pegs. 3, loss of basement membrane. 4, no inflammatory response. 5. aggregations of giant cells. Undermining resorption or resorption occurring from the marrow space toward the periodontal ligament is associated with 1. unerupted teeth. 2 nutritional disturbances. 3. an overactive parathyroid gland. 4. overzealous use of toothpicks or interdental stimulators. 5. necrosis causing resorption of bone on the pressure side in occlusal traumatism. 45. 47. 48. {is generally accepted that the primary cause of inflammatory periodontal disease is 1. dental plaque. 2. open contacts. 3. food impaction. 4: calculus. 5. lysosomal enzymes. The instrument best suited for definitive oot planing is the hoe file scaler. chisel, curet. 5. None of the above is best in all instances. It depends upon the tooth in question. “The oceurrence of keratinization on the human gingiva is 1. dependent upon the functional stimulation the attached gingiva receives. 2. areflection of inflammation in the Underlying gingival connective tissue. 3. a variable factor directly related to age. 4, lacking in the gingival crevice. In the treatment of a patient with periodontal disease, prognosis is poor when malocclusion is present. 2. the patient is uncooperative. . severe gingival inflammation is present. |. periodontal pockets $ mm. in depth exist. ‘The purpose of the periodontal dressing isto 1. prevent overgrowth of granulation tissue by forming a matrix over the wound. 2. make the patient more comfortable after periodontal surgery. 3. protect the wound from foreign material. 4, All of the above To successfully treat periodontitis, itis ‘most essential to 1. reduce the occlusal trauma. 2 reduce pocket depth to 1 or 2 mm, 3. make adequate dietary and nutritional adjustments. 4, remove the colonized masses of ‘microorganisms and calculus and prevent their recolonizing.49. The most frequent type of osseous lesion in periodontitis is 1. crater 2 hemiseptum. 3. buttressing bone. 4, inconsistent margi 5. exostosis. ‘The most important objective in equilibrating natural dentition is to 1, allow greater excursive movement of the jaw. 2. restore the occlusal table to a more ideal plane. 3. improve oral hygiene by preventing food impaction. 4, increase the shearing action in mastication, 5. achieve a more favorable distribution of ‘masticatory and non-masticatory forces. Generalized fibrotic gingivat hyperplasia is best treated by |. gingivectomy. flap surgery. }- root planing and curettage. split thickness flap surgery. 5. an apically-positioned flap. ‘One common radiographic finding in clinical in 1. vertical bone loss. Z normal bone pattern 3. horizontal bone loss. 4. increase in bone density. ‘The main result of trauma from occlusion is 1. mobility of teeth. 2 pain on percussion of a tooth. 3, faceting of the cusps of the teeth. 44 pain on drawing cold air into the mouth. 5. a widened periodontal space on radiographic examination. ‘An emotional factor is often part of the etiology in 1. periodontitis. Z chronic gingivitis. 3. acute periodonta abscess. 4. acute herpetic gingivostomatit 5. acute necrotizing ulcerative gingivitis. Each of the following conditions isan indication for mucogingival surgery EXCEPT infrabony defects a high frenum pull with frenum attachment into the gingival margia. a localized gingival cleft extending to the mucogingival junction . insufficient attached gingiva a shallow vestibule. ‘Trauma from occlusion is least likely to affect 1. bone 2. cementum, 3, the epithelial attachment, 4, the periodontal ligament Items 57-59 consist of two statements. Which of the following describes each item? 1. Both statements are TRUE. 2. Both statements are FALSE. 3. The first statement is TRUE; the second is FALSE. 4, The first statement is FALSE; the second is TRUE. Trauma from occlusion causes proliferation of the epithelial attachment. This predisposes to bone loss of the horizontal type. Primary occlusal traumatism can generally be treated by selective grinding and occlusal adjustment, However, secondary occlusal ‘raumatism can rarely'be treated by the above. ‘An “ideal” functioning stomatognathic system Is characterized by harmonious and ‘well-synchronized muscle contraction patteras. However, psychic tension, pain and occlusal

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