EXAM 2

Question 1

1. In the contemporary order of tooth preparation, which of the following principles of tooth preparation should be accomplished first?
   a. Outline form
   b. Convenience form
   c. Caries removal
   d. Resistance form

Answer 1

b. Convenience form

Question 2

2. In the contemporary order of tooth preparation, outline form, resistance form, and retention form become irrelevant.
   a. True
   b. False

Answer 2

b. False

Question 3

3. Minimally invasive dentistry is meant to halt or delay the typical restorative cycle.
   a. True
   b. False

Answer 3

a. True

Question 4

4. It is more important to remove the central caries prior to removal of the peripheral caries.
   a. True
   b. False

Answer 4

b. False

Question 5

5. Demineralized tooth structure cannot remineralize.
   a. True
   b. False

Answer 5

b. False

Question 6

6. It is more important to decrease sucrose quantity intake than to decrease sucrose frequency intake.
   a. True
   b. False

Answer 6

b. False

Question 7

7. When preparing a posterior tooth for a slot preparation, one should:
   a. Pay little or no attention to retentive form.
   b. Primarily consider silver amalgam to be the restorative material of choice.
   c. Critically examine the fissures and central groove of the tooth, and ensure no caries.
   d. Always use a three in one bonding system as the adhesive.

Answer 7

c. Critically examine the fissures and central groove of the tooth, and ensure no caries.

Question 8

8. The outline form of a cavity preparation incorporates aspects of all of the following, except:
   a. Depth of the caries removal.
   b. Final margin of the preparation
   c. Peripheral extent of the lesion.
   d. Should be smooth and flowing, following the anatomy and contour of the tooth.

Answer 8

a. Depth of the caries removal.

Question 9

9. The outline if a cavity preparation is defined as:
   a. The shape or form the preparation assumes after the retention form has been completed
   b. The shape or form of the cavity on the surface of the tooth - (?)
   c. That form the cavity takes to resist the forces of mastication
   d. The shape or form of the preparation after carious dentin has been excavated
   e. That form the cavity takes to resist dislodgement or displacement of the restoration

Answer 9

d. The shape or form of the preparation after carious dentin has been excavated

Question 10

10. In general, using minimally invasive principles, undermined enamel does not need to be removed.
    a. True
    b. False

Answer 10

b. False

Question 11

11. Aspects that influence the outline form of a tooth preparation include:
    a. The lateral spread of the decay at the DEJ
    b. The type of restorative material to be used
    c. The tooth and its relative position in the arch
    d. All of these

Answer 11

d. All of these

Question 12

12. Bacterial plaque and biofilm are synonymous terms.
    a. True
    b. False

Answer 12

a. True

Question 13

13. The direct causes of carious lesions commonly forming in similar sites on the tooth are influenced by all of the following, except:
    a. Hydroxyl ions, left unbuffered, percolate into the enamel laminar pores.
    b. Biofilm is markedly thicker in some locations than others.
    c. Demineralization outweighs remineralization at the ionic level.
    d. Multiple biofilm ecosystems in the same mouth.

Answer 13

a. Hydroxyl ions, left unbuffered, percolate into the enamel laminar pores.

Question 14

14. Dental biofilm forms on tooth surfaces, and can be considered to have evolved, as humans have evolved, to be a benign and even beneficial part of the oral ecosystem. In hunter-gatherer populations what is the most probable beneficial effect of biofilm?
    a. Biofilm has the capacity to prevent colonization of the tooth surface with acidogenic bacteria that have been transmitted from other individuals
    b. Biofilm has the capacity to protect tooth surfaces against dissolution by occasional contact with acid foods
    c. Biofilm has the capacity to prevent small fractures in the enamel through mechanical reinforcement
    d. Biofilm has the capacity to prevent occlusal wear by abrasive foods through increased lubrication during mastication

Answer 14

b. Biofilm has the capacity to protect tooth surfaces against dissolution by occasional contact with acid foods

Question 15

15. Dental corrosion differs from dental caries in several key respects. Which of the following statements best describes these differences?
    a. Corrosion can be reversed by treatment of the tooth surface with matrix proteins and fluoride; caries cannot be reversed and must be restored with filling materials.
    b. Caries softens the tooth surface, making it more liable to wear away during tooth-brushing or chewing hard foods; corrosion occurs most commonly in pits, fissures and other surface defects.
    c. Caries can be treated by substituting drugs that increase salivary flow with those that decrease salivary flow; corrosion can be treated by substituting drugs that decrease salivary flow with those that increase salivary flow.
    d. Corrosion is caused by acids in foods and drinks, or by gastric acid; caries is caused by acids produced by bacterial metabolism of simple sugars within [the biofilm]

Answer 15

d. Corrosion is caused by acids in foods and drinks, or by gastric acid; caries is caused by acids produced by bacterial metabolism of simple sugars within [the biofilm]

Question 16

16. ‘Toothbrush abrasion’ is most probably due to a combination of factors. Which of the following statements describes these factors best?
    a. Hard toothbrush bristles, aided by detergents in tooth-paste, can dislodge surface crystallites of enamel if they have been weakened by exposure to soft foods.
    b. Abrasive particles in tooth-paste are usually softer than the surface of normal enamel, but are harder than the surface of acid-softened enamel.
    c. Excessive brushing due to fear of periodontal disease is most commonly associated with excessive wear of tooth surfaces.
    d. Brushing using small, circular motions of the brush head is more likely to wear away tooth enamel than is brushing that moves the brush head backwards and forwards in the mouth.

Answer 16

b. Abrasive particles in tooth-paste are usually softer than the surface of normal enamel, but are harder than the surface of acid-softened enamel.

Question 17

17. Where, in relation to the contact area between two teeth, is a proximal carious lesion most likely to first develop?
    a. At the contact area
    b. At and immediately below the contact area
    c. At and immediately above the contact area
    d. 1.0 to 1.5 mm below the contact area

Answer 17

b. At and immediately below the contact area

Question 18

18. Sensitivity of teeth to cold is a good indicator both of active corrosion by acids and of the presence of exposed dentine. Why is this so?
    a. Because acids diffuse through exposed dentine to induce pulpal inflammation, which increases sensitivity of pulpal nerve endings.
    b. Because acids coagulate the proteins inside dentinal tubules, thereby increasing the sensitivity of pulpal nerve endings.
    c. Because acids prevent the precipitation of pellicle and smear layer which would otherwise close open dentinal tubules.
    d. Because acids prevent the mineralization of pellicle and smear layer, which would otherwise close open dentinal tubules.

Answer 18

d. Because acids prevent the mineralization of pellicle and smear layer, which would otherwise close open dentinal tubules.

Question 19

19. There are characteristic differences in patterns of tooth structure loss through corrosion between intrinsic gastric acids and extrinsic food- or drink-derived acids. Which of the following statements best describes these differences?
    a. Intrinsic acids tend to result in the loss of the lingual surfaces of upper teeth, while extrinsic acids tend to result in the loss of the occlusal surfaces of lower teeth.
    b. Intrinsic acids tend to result in the loss of the lingual surfaces of lower teeth, while extrinsic acids tend to result in the loss of the occlusal surfaces of upper teeth.
    c. Intrinsic acids tend to result in the loss of the occlusal surfaces of upper teeth, while extrinsic acids tend to result in the loss of the facial surfaces of lower teeth.
    d. Intrinsic acids tend to result in the loss of the occlusal surfaces of upper teeth, while extrinsic acids tend to result in the loss of the lingual surfaces of lower teeth.

Answer 19

a. Intrinsic acids tend to result in the loss of the lingual surfaces of upper teeth, while extrinsic acids tend to result in the loss of the occlusal surfaces of lower teeth.

Question 20

20. The dentine and pulp are closely associated with each other physically. Which of the following statements best describes their relationship in biological terms?
    a. The dentine is hard tissue, the pulp is soft tissue; they are separate and distinct biologically because of protective responses provided by the odontoblast layer.
    b. The relationship between dentine and pulp is intimate biologically; physical, chemical and bacterial insults to dentine also affect the pulp.
    c. Dentine provides an impermeable, hard and thermally insulating barrier that protects the pulp from external trauma and insult.
    d. All insults to dentine are immediately transmitted to the pulp via nerve fibers, veins and lymph vessels within the odontoblastic tubule.

Answer 20

b. The relationship between dentine and pulp is intimate biologically; physical, chemical and bacterial insults to dentine also affect the pulp.

Question 21

21. The dental pulp may be damaged by an advancing carious lesion. Which of the following is the most probable combination of symptoms as the lesion advances?
    a. Increased sensitivity to hot, cold and osmotic change when pioneer bacteria have advanced into dentine.
    b. Increased sensitivity to hot, cold and osmotic change when pioneer bacteria first reach the dentino-enamel junction.
    c. Increased sensitivity to biting pressure because of changes in the periodontal ligament in response to bacterial toxins
    d. Increased sensitivity to hot, cold and osmotic change when pioneer bacteria invade the pulp space.

Answer 21

b. Increased sensitivity to hot, cold and osmotic change when pioneer bacteria first reach the dentino-enamel junction.

Question 22

22. The pulp may be damaged by chemicals released from some restorative materials that are placed into contact with dentine. Dentine provides some level of protection against this. Which of the following is most likely to reduce this protective effect?
    a. Exothermic reactions during the setting of restorative materials, which liquefy the content of odontoblastic tubules.
    b. Excessive exposure to intense light during curing of restorative materials, which displaces tubule contents through thermal change.
    c. Heat generation during tooth cutting, which liquefies the tubule contents and displaces them, preventing chemical buffering.
    d. When there is only a thin layer of dentine remaining, because both tubule diameter and the number of tubules in a given area increases close to the pulp.

Answer 22

d. When there is only a thin layer of dentine remaining, because both tubule diameter and the number of tubules in a given area increases close to the pulp.

Question 23

23. The pulp may be damaged by bacterial microleakage around and beneath restorative materials. Which of the following is most likely to provide the best, long-term protection against bacterial microleakage?
    a. The use of fluoride-based remineralization solution prior to restoration placement, followed by acid treatment and a resin-based restorative material.
    b. The use of an ion exchange adhesive material as the restoration itself or as a base, followed by an appropriate restorative material.
    c. The use of a light-activated resin-based restorative material following acid treatment of dentine, in combination with daily use of an antibacterial mouth rinse.
    d. The use of a copal varnish, followed by direct placement of dental amalgam into the defect to be restored.

Answer 23

b. The use of an ion exchange adhesive material as the restoration itself or as a base, followed by an appropriate restorative material.

Question 24

24. The pulp may be damaged by mechanical and thermal trauma during tooth cutting. In a tooth that has not previously suffered major trauma, which of the following is most likely to be the tissue response to tooth cutting?
    a. Transient acute inflammation in the days immediately following tooth cutting, then recovery and healing over several further days.
    b. Persistent acute inflammation for several weeks following tooth cutting, followed by chronic inflammation leading to pulp death up to a year later.
    c. Chronic inflammation during the months following tooth cutting, followed by progressive decline and death at any time up to five years later.
    d. Transient acute inflammation immediately after tooth cutting, followed by chronic inflammation and progressive decline and death at any time up to ten years later.

Answer 24

a. Transient acute inflammation in the days immediately following tooth cutting, then recovery and healing over several further days.

Question 25

25. Damage to the pulp can result in inflammation and pain that may or may not resolve. Patients experiencing pulpal symptoms will want to be advised about what is likely to happen next. Reversible inflammation of the pulp, that is, inflammation that is likely to resolve in the absence of further trauma, is best confirmed in which of the following ways?
    a. Reversible inflammation of the pulp is best confirmed radiographically because it causes increased radiolucency at the root apex.
    b. Reversible inflammation of the pulp is best confirmed by percussion testing because it causes sympathetic inflammation of the periodontal ligament
    c. Reversible inflammation of the pulp is best confirmed from the patient’s symptoms because it causes increased sensitivity to temperature change.
    d. Reversible inflammation of the pulp is best confirmed by thermal and percussion testing because it causes increased sensitivity of both pulpal and periodontal nerve endings.

Answer 25

c. Reversible inflammation of the pulp is best confirmed from the patient’s symptoms because it causes increased sensitivity to temperature change.

Question 26

26. Please put in order 1-10, the steps of use for Peak Universal bond: (5 points)

_____ Rinse vigorously for 5-10 seconds

_____ Lightly dry (one second of an air blast or one second of high volume suction over the prep or blot dry with cotton)

_____ Air dry at half pressure for 10 seconds

_____ Light cure for the recommended time

_____ Lightly dry (one second of an air blast or one second of high volume suction over the prep or blot dry with cotton)

_____ Begin placement of composite resin

_____ Etch the enamel and dentin for 20 seconds

_____ Scrub for 10 seconds

_____ Apply Peak

_____ Scrub in Consepsis 2% Chlorhexidine

Answer 26

1. Etch the enamel and dentin for 20 seconds
2. Rinse vigorously for 5-10 seconds
3. Lightly dry (one second of an air blast or one second of high volume suction over the prep or blot dry with cotton)
4. Scrub in Consepsis 2% Chlorhexidine
5. Lightly dry (one second of an air blast or one second of high volume suction over the prep or blot dry with cotton)
6. Apply Peak
7. Scrub for 10 seconds
8. Air dry at half pressure for 10 seconds
9. Light cure for the recommended time
10. Begin placement of composite resin

Question 27

27. All of the following are true regarding glass ionomer, which of the following is the exception?
    a. Releases fluoride
    b. Good chemical adhesion
    c. High solubility after initial set
    d. Thermal expansion similar to tooth
    e. Good thermal insulator

Answer 27

c. High solubility after initial set

Question 28

28. Demineralized tooth structure cannot remineralize.
    a. True
    b. False

Answer 28

b. False

Question 29

29. Which type of composite resins are most commonly used today?
    a. Macrofill
    b. Microhybrids
    c. Microfill
    d. Hybrids

Answer 29

b. Microhybrids