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WorksheetsOP 3
Total questions: 90
Worksheet time: 45mins
When placing a rubber dam, selecting and securing the clamp is an important step. Which of the following criteria indicates that a clamp has been positioned correctly?
The clamp fits snugly around the cervical area of the tooth, is stable, and does not injure the gingiva
The larger the clamp size, the better for easier manipulation
The clamp only needs to touch the tooth lightly without fully gripping it
The clamp is placed deeply below the gingival margin to ensure absolute isolation
Symptomatic apical periodontitis is characterized by:
Strong positive response to pulp testing
Normal response to vertical percussion
Radiographs
Pain on percussion or biting
Sign of a tooth with pulp necrosis but no periapical (AP) lesion
prolonged pain with cold test
facial swelling
painful to percussion
unresponsive to pulp testing, non-tender to percussion
According to the sequence of cavity preparation steps, which of the following belongs to the 'Final cavity preparation stage'?
Creating the primary resistance form
Creating the primary retention form
Establishing the outline form and initial depth
Pulp protection if needed
Mechanical retention in cavity preparation is mainly achieved by which factor?
Using etchants and bonding agents
Creating small retention grooves in dentin
Creating small retention grooves in enamel
Using pins in dentin
Which sign raises suspicion of a root fracture within the alveolar bone?
The tooth is not mobile
The tooth is very sensitive to cold
No gingival bleeding observed
The crown appears grey in color
Why is GIC preferred as a base (lining) material?
Easy to manipulate
Chemical adhesion and fluoride release
Fast setting
High esthetics
The histological characteristic of asymptomatic apical periodontitis is:
acute inflammation
chronic granulation tissue
pulpal abscess
polymorphonuclear leukocytes (PMNs) predominate
What is the most common cause of symptomatic apical periodontitis?
irreversible pulpitis or necrosis
occlusal trauma (or traumatic occlusion)
periodontitis
tooth wear (or dental abrasion/erosion)
Why is moisture control necessary when restoring a tooth with composite?
To reduce air bubbles
To reduce material shrinkage
To enhance esthetics
To increase adhesion
Condensing osteitis is commonly associated with:
Acute trauma
Reversible pulpitis
Unknown cause
Chronic apical periodontitis
According to Andreasen, the best healing outcome for a root fracture is:
Connective tissue
Calcified tissue (calcified callus)
Granulation tissue
Bone
A patient has a high risk of early caries around orthodontic brackets. What is the most appropriate detection method?
QLF – Quantitative Light-induced Fluorescence
Panoramic radiograph
Probing
Staining
What is the main objective of the 'Patient Evaluation' stage?
Scheduling follow-up appointments
Collecting patient data
Taking radiographs
Starting treatment
Asymptomatic irreversible pulpitis:
Never needs treatment because it is painless
Always has spontaneous pain
No pain, but shows chronic histopathologic changes
Pulp testing is always negative
Why is reversible pulpitis usually painful?
Mild inflammation – increased intrapulpal pressure
Due to apical periodontitis
Due to pulp necrosis
Complete interruption of the pulp’s blood supply
Symptomatic irreversible pulpitis is typically characterized by:
Pain that persists after the stimulus is removed
Pain increases when drinking cold
No thermal response
Pain decreases with heat
Which of the following injuries does not cause loss of tooth structure?
Enamel–dentin fracture
Enamel–dentin–pulp fracture
Enamel fracture
Enamel crack
When placing the Tofflemire universal matrix band, the U-shaped part of the retainer should face which side of the tooth?
Mesial side
Occlusal side
Distal side
Gingival side
When preparing a Class I cavity for Amalgam, which of the following statements about the retention form is correct?
The buccal and lingual walls converge toward the occlusal surface
The buccal and lingual walls converge toward the gingival surface
The mesial and distal walls converge toward the occlusal surface
All walls are perfectly parallel
Why is a pulp polyp usually not painful?
Pulp exposure – reduced intrapulpal pressure
Vascular obstruction – less pain
Pulp necrosis – less pain
Loss of nerve supply – less pain
What is the physiological splinting time for subluxation?
1 week
2 weeks
No splinting needed
4 weeks
Symptomatic irreversible pulpitis commonly leads to:
Asymptomatic apical periodontitis (AP) immediately
Symptomatic apical periodontitis (AP)
Chronic apical abscess
No periapical changes
If a tooth does not respond to both electric and cold testing, what is the most likely diagnosis?
Pulp necrosis
Reversible pulpitis
Asymptomatic irreversible pulpitis
Normal pulp
In tooth preparation, the resistance form refers to:
The ability to resist bacteria
The ability of the restoration to withstand masticatory forces without fracturing
The ability to isolate from saliva
The ability to restore tooth color
Tooth has negative pulp test, painful to percussion, X-ray shows no radiolucency:
Pulp necrosis + symptomatic apical periodontitis (AP)
Reversible pulpitis + symptomatic apical periodontitis (AP)
Normal pulp + acute apical abscess
Pulp necrosis + acute apical abscess
When preparing a Class I cavity, what is one of the most serious possible errors?
The axial wall of the cavity should not be convex
Damaging the adjacent tooth
Preparing a cavity with depth less than 2.5 mm
Not beveling the enamel at the margins
In the composite restoration procedure, after etching the enamel surface with phosphoric acid (H3PO4), what characteristic should the enamel exhibit after rinsing and drying?
Smooth and glossy
Glass-like translucency
Chalky white appearance
Shiny yellow
Which sign is NOT associated with acute apical abscess?
Fever
No pain
Pus
Severe pain
Why is resistance form necessary in cavity preparation?
To withstand occlusal forces and prevent fracture
To make the procedure easier
To improve esthetics
To reduce cost
When restoring a tooth with composite, if using a rubber dam is not possible, what should be done?
Isolate using cotton rolls + continuous saliva suction
Continuous saliva suction only
Retract the mouth using a mirror
Do nothing
A sign suggesting symptomatic irreversible pulpitis is:
Spontaneous pain
No thermal response
Quick response to cold
Not sensitive to percussion
What is the main purpose of placing pins in complex Amalgam restorations?
To prevent dislocation of the restoration
To provide retention and resistance form for the restoration
To avoid creating cracks in the tooth
To increase the compressive strength of Amalgam
What are the common mistakes when placing a GIC base?
GIC contains air bubbles
GIC does not set
All of the above
GIC does not adhere to tooth structure
What is flowable composite commonly used for during tooth restoration?
As an adhesive
Polishing the restoration
Lining the cavity floor
Final restoration
In enamel infraction, what is the primary treatment?
Endodontic treatment
Pulp capping
No intervention, monitoring
Porcelain veneer
Which of the following describes the axial wall in a Class II MOD (double) cavity preparation?
Perpendicular to the long axis of the tooth
Parallel to the long axis of the tooth
Located on the occlusal side
Located on the gingival side
Which cells are the main participants in reversible pulpitis?
Neutrophils (polymorphonuclear leukocytes)
B lymphocytes
Plasma cells
Macrophages
In a root fracture involving the apical third, which sign indicates a better prognosis?
Severe tooth mobility
Dark discoloration of the tooth
Minimal displacement of the tooth
Significant displacement of the coronal segment
A patient presents with sharp pain and sensitivity to sweets or cold drinks. The pain stops immediately after the stimulus is removed. What is the most appropriate pulp diagnosis?
Pulp necrosis
Symptomatic irreversible pulpitis
Normal pulp
Reversible pulpitis
Which matrix system is specifically designed to improve proximal contact and anatomical form for Class II composite restorations?
Tofflemire matrix
Sectional matrix system with wedge and ring
Celluloid strip
T-shaped matrix
When restoring a Class V cavity, which step is usually performed first?
Isolating the tooth with a rubber dam
Using a self-etch system
Etching the entire tooth surface with acid
Cleaning the cavity with pumice and a nylon brush
Tooth sensitive to biting, prolonged cold response, no apical radiolucency (RL), suspected diagnosis?
normal pulp
reversible pulpitis
irreversible pulpitis
asymptomatic apical periodontitis
The cavosurface angle is:
The tangent angle of the tooth surface
The angle between the external tooth surface and the prepared cavity wall
The angle of the long axis of the tooth
The angle formed by two internal walls
What is the priority treatment for extrusive luxation?
Reposition the tooth and splint it
Tooth extraction
Immediate endodontic treatment
No treatment
Chronic apical abscess is characterized by:
asymptomatic, with a sinus tract
no lesion on X-ray
acute swelling
always severely painful
In patients with a pacemaker, which test should be avoided?
Thermal testing
Laser Doppler
X-ray
Electric pulp testing
In restoring a large broken tooth, what is the purpose of using a dentin pin?
To transmit occlusal forces evenly to the root
To stimulate the pulp to form tertiary dentin for protection
To provide retention for the restoration when tooth structure is insufficient
To increase the strength and durability of the restorative material
Which of the following signs is characteristic of an "arrested" (inactive) carious lesion?
A radiolucent area on X-ray, but the enamel surface remains intact
Cavity shape with pain when stimulated by cold
A surface that is soft, rough, and chalky white
A surface that is smooth, shiny, and dark in color
What is one of the important requirements when finishing and polishing a composite restoration?
Perform the procedure in a completely dry environment for better visibility
Only use diamond burs for finishing
Always use water cooling
Apply strong pressure to finish faster
The patient experiences sharp pain when percussed vertically, and the X-ray shows widening of the periodontal ligament space. This suggests:
Symptomatic apical periodontitis
Acute apical abscess
Symptomatic pulpitis
Pulp necrosis
Asymptomatic apical periodontitis is characterized by:
Radiolucency (RL) on X-ray
Strong response to vertical percussion
Always painful
Acute gingival swelling
What is the recommended etching time with 37% phosphoric acid (H₃PO₄) for enamel and dentin?
Enamel 20–30 s, dentin 10–15 s
Enamel 10–15 s, dentin 20–30 s
Enamel & dentin: 15–15 s
Enamel & dentin: 20–30 s
If the tooth is not isolated during etching, what adverse outcome is most commonly encountered?
Effect on tooth color
No effect
Discoloration of the restoration
Contamination with saliva, leading to reduced adhesion
Which type of dentin is formed focally in response to external stimuli such as caries, abrasion, or trauma, with the main purpose of protecting the dental pulp?
Tertiary dentin (reactionary/reparative dentin)
Primary dentin
Secondary dentin
Predentin
The X-ray finding in symptomatic apical periodontitis is:
Always has gingival swelling
Always has a sinus tract
Can be entirely normal
Always radiolucent
To maximize aesthetics when preparing a Class III cavity, which surface of the tooth is usually chosen for the access opening?
From the incisal edge, opening directly into the carious area
The buccal surface, for easier visibility and manipulation
The lingual/palatal surface
The mesial or distal surface depending on the caries location
A patient presents with an early proximal caries lesion. Which diagnostic method is most appropriate?
Visual examination
Sharp explorer probing
Bitewing radiograph
Staining technique
If a liner is not placed in a deep cavity, what potential risk may occur?
Reduced restoration durability
No effect
Reduced aesthetics
Pulpitis after restoration
When a composite restoration shows marginal gaps, what could be the possible cause?
Insufficient acid etching
Contamination with moisture during bonding
All of the above
Weak curing light
Case presents with diffuse swelling, severe pain, mild fever, tooth unresponsive to pulp testing:
Reversible pulpitis
Acute apical abscess
Normal pulp
Chronic apical abscess
If a flowable composite liner is not used at the cavity floor, what consequence may occur?
Microleakage and postoperative sensitivity
No effect
Discoloration of the composite
The restoration will not be glossy
Tooth is unresponsive to pulp testing, non-tender to percussion, X-ray shows apical radiolucency (RL). Diagnosis:
Reversible pulpitis
Condensing osteitis
Pulp necrosis + Asymptomatic apical periodontitis
Chronic apical abscess
A compound cavity is a cavity involving how many surfaces?
3
1
4
2
When the pulp is necrotic but the periapical region appears normal, what does this indicate?
Bone resorption
An early stage of the disease
Chronic diseases
Periodontal disease
A patient has spontaneous night pain, prolonged episodes of pain, and relief when applying cold. What is the most likely diagnosis?
Reversible pulpitis
Asymptomatic irreversible pulpitis
Acute apical periodontitis
Symptomatic irreversible pulpitis
The objective of tooth preparation is:
To reduce the temperature inside the cavity
To change the direction of the tooth’s long axis
To increase retention and resistance to fracture
To prevent gingival infection
According to G.V. Black’s classification, a carious lesion on the proximal surface of an anterior tooth that does not involve the incisal angle belongs to which class?
Class IV
Class III
Class I
Class II
How does G.V. Black’s philosophy of “extension for prevention” fundamentally differ from the modern concept of “minimally invasive dentistry”?
Minimally invasive dentistry only treats early carious lesions using advanced modern methods.
Black’s concept is not applicable to anterior teeth.
Minimally invasive dentistry does not allow the use of Amalgam material.
Black’s concept requires extending the cavity preparation into adjacent pits and fissures, whereas minimally invasive dentistry does not.
Tooth has strong positive pulp test, painful to biting, but no radiolucency:
Pulp necrosis
Symptomatic apical periodontitis (AP)
Acute apical abscess
Asymptomatic apical periodontitis (AP)
Among all tooth isolation methods, which one is considered the gold standard for achieving a dry and clean working field?
Surgical suction tip
Cotton rolls and saliva ejector
Antisialogogue medications
Rubber dam
What is the main purpose of applying glycerin to the surface of a composite restoration and then light-curing again at the final step?
To make the restoration easier to finish and polish
To improve bonding and adhesion
To prevent the formation of the oxygen-inhibition layer
To polish the restoration
According to G.V. Black’s principles of cavity preparation, what is the primary objective of creating “resistance form”?
To extend the cavity so that areas are easier to clean and prevent recurrent caries
To prevent the restoration from dislodging
To facilitate placement of the restorative material
To enable the tooth and restoration to withstand masticatory forces without fracture
The Stephan Curve describes the change of which factor in dental plaque after exposure to fermentable carbohydrates?
Temperature
pH
Viscosity of saliva
Number of bacteria
Why is intrusive luxation considered one of the most severe dental injuries?
Very susceptible to infection from the oral environment
Always causes associated crown fractures
Causes severe damage to the periodontal ligament and neurovascular bundle at the apex
Causes immediate tooth discoloration
At which step is glycerin applied to isolate the surface of the composite restoration from oxygen in the air?
After polishing
Before placing packable composite
After occlusal adjustment
Before finishing/adjusting the restoration
The characteristic sign of a subluxation injury is:
Slight mobility without displacement
Metallic sound on percussion
Tooth displacement
Tooth completely intruded into the socket
What is one of the main limitations of composite resin?
Poor biocompatibility
Polymerization shrinkage
Cannot be used for posterior teeth
Very slow setting
Why does pulp inflammation easily progress to pulp necrosis?
Due to increased vascular proliferation in the pulp
Due to demineralization caused by caries
Because the pulp is poisoned by bacteria
Because of lack of oxygen and increased intrapulpal pressure
A characteristic of reversible pulpitis is:
Brief, sharp pain in response to cold
No response to pulp testing
Prolonged pain after stimulation
Spontaneous pain
Acute apical abscess is characterized by
always has a sinus tract
localized or diffuse swelling
insensitive to percussion
no pain
What is the optimal time to manage a pulp exposure in a crown fracture (< 24 hours) in order to preserve pulp vitality?
48 hours
72 hours
1 hour
24 hours
When examining a tooth that appears pink in color, what condition should be suspected?
Internal resorption
External resorption
Pulp calcification
Abscess
What is the purpose of placing a wedge during cavity preparation in the proximal area?
To change the occlusion
To create separation (slight space) for easier manipulation
To widen the periodontal ligament space
To control gingival tissues
Crown-root fractures typically have which characteristic?
Fracture line is oblique and usually exposes the pulp
Extraction is the only option
Occur only in posterior teeth
Never involve pulp exposure
What is a characteristic of pulp necrosis?
Occurs only in teeth with closed apices
No response to pulp vitality testing
Always responds to thermal testing
Never causes apical periodontitis
To check the tightness of the proximal contact and any excess restorative material in the gingival area after restoring Class II, III, or IV cavities, which instrument should be used?
Finishing bur
Explorer
Handpiece bur
Dental floss
According to the levels of caries prevention, the patient education on proper diet and toothbrushing technique belongs to which level of prevention?
Primary prevention
Tertiary prevention
Secondary prevention
Active care
Compare the bond strength to enamel and dentin when placing composite. Which statement is the most accurate?
Dentin > Enamel
Depends on the primer
Enamel > Dentin
Enamel = Dentin
Which characteristic is commonly seen in lateral luxation?
Periodontal ligament space is uniform
Tooth is locked in the socket; percussion yields a metallic sound
Tooth is very mobile
No bleeding from the gingival sulcus
