American Student Dental Association

National Board Dental Examinations

TEST PACKET ll-M

Compiled, released items from approximately 2000-2008

American Student Dental Association

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Important Notice and Disclaimer Concerning These Materials

These materials are distributed by the American Student Dental Association (ASDA) with permission from the American Dental Association Joint Commission on National Dental Examinations. All of these released items are the copyrighted property of the American Dental Association. You may not copy for any purpose this publication, or any part of it, in print, electronic or other format without prior express written permission from the American Dental Association. This collection of examination materials includes questions compiled from examinations administered by the Joint Commission on National Dental Examinations from approximately 2000 to 2008. The Joint Commission periodically releases items no longer in use to familiarize candidates, educators and others with the general format and content of its examinations. A content outline of the current examination may be found in the Guide. The same information is available online at www.ada.org or on request from the Joint Commission office. The American Student Dental Association and the Joint Commission on National Dental Examinations do not guarantee that the information in released National Board examinations is accurate, current or relevant. Released materials may no longer be consistent with the current content specifications, content emphasis or examination structure. Because ofthe dynamic nature of dental practice and the biomedical sciences, these materials may be outdated. The Joint Commission communicates and emphasizes the following cautions to examination candidates and others. All released items are the copyrighted property of the American Dental Association. These materials are intended for the personal, non-commercial use of the purchaser and may not be reproduced in any format, whether paper or electronic, without the express written permission of the ADA Joint Commission on National Dental Examinations. WARNING: All test material, items or questions currently in use in the National Board examination programs are considered "unreleased" items. Examination regulations prohibit the sharing or use of unreleased items under any circumstances, including efforts to remember and reconstitute exam items. Individuals who breach the confidentiality of an examination may face serious consequences, including voiding of National Board scores and notification to state boards of dentistry.

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TABLE OF CONTENTS

Part II Released Items Case A Questions Case B Questions Case A.. Case B Answer Key

5 23 24 26 31 36

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A patient has pain over the left pre-auricular area; this patient can open approximately 45 mm and has a "pop-and-click" in the joint area. The most likely diagnosis is A. B. C. D. myofascial pain dysfunction syndrome. internal derangement with reduction. auriculotemporal syndrome. coronoid hyperplasia.

6.

A 2-day-old developing plaque consists primarily of A. B. C. D. E.

: Treponema species Bacteroides species. filamentous organisms. gram-positive cocci and rods. a structureless, non-mineralized pellicle. -r

Erythromycin is responsible for numerous drug interactions, some of which are fatal. This is because erythromycin A. B. C. D. E. increases the absorption of many drugs. decreases the absorption of many drugs. decreases cytochrome P-450 metabolism of other drugs. increases renal reabsorption of many drugs. decreases distribution of many drugs.

Each of the following is an electromagnetic radiation EXCEPT one. Which one is the EXCEPTION? A. B. C. D. E. Radar X rays Alpha rays Gamma rays Visible light

Which of the following is NOT a complication of radiation therapy? A. B. C. D. Mucositis Xerostomia Osteoradionecrosis Granuloma

The penetrating quality of x-ray beams is influenced by which of the following? A. B. C. D. E. Kilovoltage Milliamperage Exposure time Focal-film distance Filament temperature

Each of the following is known to contribute to orofacial clefting EXCEPT one. Which one is the EXCEPTION? A. B. C. D. Valium Poor diet Acetaminophen Vitamin deficiency or excess

Contraction ofthe lateral pterygoid muscle moves the articular disk in which of the following directions? A. B. C. D. E. Anteriorly and medially Posteriorly and medially Anteriorly and laterally Posteriorly and laterally Anteriorly, laterally, and interiorly

10.

Which of the following physical signs indicates severe CNS oxygen deprivation? A. B. C. D. Dilated pupils with increased light reflex Pinpoint pupils with increased light reflex Dilated pupils with an absence of light reflex Pinpoint pupils with an absence of light reflex

A decrease in which of the following causes an increase in radiographic density? A. B. C. D. E. Milliamperage (mA) Kilovoltage peak (kVp) Object-film distance Source-film distance Exposure time

11.

Subconjunctival hemorrhage is most commonly found in which of the following fractures? A. B. C. D. E. Nasal LeFort I Frontal sinus Zygomatic arch Zygomaticomaxillary complex

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12.

Which o f t h e following drug groups increases intraocular pressure and is, therefore, contraindicated in patients with glaucoma? A. B. C. D. Catecholamines Belladonna alkaloids Anticholinesterases Organophosphates

17.

An analgesic compound #3 contains how many mg of codeine?

A, B. C. D.

7.5 15 30 60

18.

Acute pyogenic bacterial infections produce A. B. C. D. E. leukopenia. lymphopenia. neutropenia. leukocytosis. lymphocytosis.

13.

Which o f t h e following best describes a vestibuloplasty? A. B. C. Bone is added to the mandible to augment its height. Osseointegrated dental implants are placed to support prosthesis. Soft tissue is repositioned in order to increase the area on which the denture may be supported. The chin is augmented to enhance esthetics. Periodontal tissue is removed from around a tooth to establish a biologic width.

19.

D. E.

A 35-year-old woman has an acute dentoalveolar abscess. Which of the following conditions will be the most likely to complicate the management of this patient? A. B. C. D. Asthma Epilepsy Chemotherapy Hypertension

14.

On a new patient's initial appointment, the dentist should do which o f t h e following first? A. B. C. D. Establish rapport Inform Gather information Evaluate

20.

Which o f t h e following is indicated to correct a condition of atropine poisoning evidenced by rapid heart rate, dry mouth and gastrointestinal inactivity?

15.

An elderly patient has worn a maxillary complete denture against 6 mandibular anterior teeth for an extended period of time. In examining the edentulous mouth of this patient, the dentist would probably see which of the following? A. B. C. D. Intrusion of the mandibular anterior teeth Flabby ridge tissue in the posterior maxillary arch Loss of osseous structure in the anterior maxillary arch Cystic degeneration of the foramina of the anterior palatine nerve

A. B. C. D. E.

Nicotine Homatropine Epinephrine Pilocarpine Physostigmine

21.

If a patient suddenly becomes unconscious during treatment, the practitioner should immediately assess the patient's A. B. C. D. airway and pulse, airway and blood pressure, pulse and blood pressure, color and pupils.

16.

The use of study casts in orthognathic surgery does each of the following EXCEPT one. Which one is the EXCEPTION? A. B. C. D. E. Constructs splints Performs model surgery Determines the postoperative occlusion TM Identifies the type of skeletal deformity Aids in explaining the surgical procedure to the patient

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22.

Gingival overgrowth, hirsutism, coarsening of facial features, lymph gland hypertrophy, cognitive deficits, and fetal abnormalities are side effects associated with which of the following antiepileptic drugs? A. B. C. D. E. Phenobarbital GX Carbamazepine (Tegretol1 ^) Valproate (Depakene) Phenytoin (Dilantin) Ethosuximide (Zarontin)

27.

What space management treatment should be planned for a child age 4. missing both primary mandibular first molars with no primate space present? A. B. C. D. E. Lingual arch Distal shoe(s) Nance holding arch Band-and-loop space maintainer(s) Observation; no space maintainer necessary.

28. 23. Which of the following should be performed first for a collapsed or unconscious victim of illness or accident? A. B. C. D. Open the airway Establish unresponsiveness Establish pulselessness Examine the victim for bleeding and fractures 29. 24. A patient presents with facial lacerations that have irregular or devitalized wound edges. In excising the wound elliptically, a practitioner takes into account each of the following EXCEPT one. Which is the EXCEPTION? A. B. C. D. Excision is perpendicular to the natural skin tension lines. Length to width ratio of the excision is at least 3 to 1. Excision is done as conservatively as possible. The wound is undermined prior to closure.

Each of the following characterizes an impending insulin shock EXCEPT one. Which one is the EXCEPTION? A. B. C. D. Weakness Convulsions Mental confusion Cold perspiration

An unconscious patient is suspected of having an obstructed airway. How should this patient be managed? A. B. C. D. Protrude the tongue, clear the pharynx, extend the neck, and protrude the mandible Extend the neck, clear the pharynx, protrude the tongue, and protrude the mandible Extend the neck, protrude the mandible, protrude the tongue, and clear the pharynx Clear the pharynx, extend the neck, protrude the mandible, and protrude the tongue

30.

A tender swelling in the soft tissue of the submandibular triangle is most likely caused by A. B. C. D. lipoma. lymphadenopathy. an obstruction of Stensen's duct. an infected thyroglossal duct cyst.

25.

Which of the following represents the major route of excretion of penicillin V? A. B. C. D. Secretion in the bile and into the feces Excretion in the urine as inactive metabolites Total metabolism by the liver and excretion in the feces Secretion not metabolized in the urine

31.

Which of the following is the least helpful in determining the anatomical integrity of the temporomandibular joint? A. B. C. D. E. Arthrography Arthroscopy Panoramic films Computerized tomography Magnetic resonance imaging

26.

Which of the following systemic conditions lowers resistance, impairs healing, and indicates early use of antibiotics for infections? A. B. C. D. Vitamin C deficiency Diabetes mellitus Polycythemia vera Systemic lupus erythematosus
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32.

A freshly condensed Class II amalgam restoration has a deficient margin at the proximogingival cavosurface angle. This might have been caused by which of the following? A. B. C. D. Overtightening the matrix band Neglecting to wedge the matrix band Neglecting to contour the matrix band Using too large an initial increment of amalgam

36.

Which of the following is a local contraindication for the surgical removal of an impacted tooth? A. B. C. D. E. A nonvital tooth Fever of unknown origin A history of bleeding disorder An undiagnosed ulcer in the oral cavity Pale gingiva with a confirmed history of anemia

37. 33. Each o f t h e following measures can minimize fractures of the maxillary alveolar process EXCEPT one. Which one is the EXCEPTION? A. B. C. D. E. Use of controlled force when using forceps and elevators Removal of buccal bone and/or sectioning of teeth A thorough presurgical analysis and planning alterations in the surgical approach Use of the maxillary pinch grasp to detect expansion of the alveolar bone Use of forceps with beaks that grasp the roots more firmly

Which of the following properties increases when the intermediate chain of a local anesthetic drug is lengthened? A. B. C. D. Potency Allergenicity Solubility in water Rate of biotransformation

38.

Which o f t h e following is NOT an advantage of chemical vapor sterilization? A. B. C. D. E. Cycle time is short. It will not char fabrics. It will not cause corrosion. There is no need for special ventilation. Instruments are dry at the end of the cycle.

34.

Ethyl alcohol is a good antidote for methanol poisoning because A. B. C. D. E. it inhibits methanol metabolism. it competes successfully with methanol for alcohol dehydrogenase. it prevents formation of formaldehyde. it prevents damage to the optic nerve. All of the above.

39.

The most common cause of fracture at the isthmus of a Class II restoration is A. B. C. D. E. delayed amalgam expansion. a sharp axio-pulpal line angle. isthmus width too narrow. moisture contamination o f t h e amalgam during placement. lack of interproximal contact.

35.

Each of the following nonsedating antihistamines would be contraindicated in an individual taking cimetidine for heartburn EXCEPT one. Which one is the EXCEPTION? A. B. C. D. E. Astemizole (Hismanal) Diphenhydramine (Benadryl) Fexofenadine (Allegra) Hydroxyzine (Vistaril) Terfenadine (Seldane)

40.

Alveoplasty following closed extraction is usually performed with

A. B. C. D.

a bur. fingers. a rongeur. a bone file

41.

The periosteal elevator is used to do each of the following EXCEPT one. Which one is the EXCEPTION? A. B. C. D. Luxate the teeth Retract the soft tissue flap Elevate the interdental papillae Provide protection to the soft tissue flap

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42.

The fenestration technique for mandibular vestibuloplasty is based on the premise that the mucosal attachment will A. B. C. D. not cross the skin graft. not cross the mucosal graft. not cross a fibrous scar band. be maintained in its lowered position by the new denture.

48.

How does the growth of the cranial base generally relate in time to the growth of the jaws? A. B. C. D. E. Follows Precedes Unrelated Accompanies Initially follows, then accompanies

49. 43. Which of the following represents a constitutional symptom? A. B. C. D. Tinnitus Chills Xerostomia Dysphagia

Aplastic anemia is a serious toxic effect associated most frequently with which of the following antibiotics? A. B. C. D. Streptomycin Tetracycline Chloramphenicol Chlortetracycline

44.

Which of the following is the most commonly used surgical procedure to correct maxillary retrognathia? A. B. C. D. C-osteotomy Le Fort I osteotomy Inverted L-osteotomy Anterior maxillary osteotomy

50.

The therapeutic index of a given drug indicates the relative A. B. C. D. E. safety. potency. efficacy. duration. solubility.

45.

In the preauricular approach to the TMJ, which of the following anatomic structures, if damaged, presents the potential for greatest morbidity? A. B. C. D. E. Facial nerve Parotid gland Auriculotemporal nerve Superficial temporal vein Facial artery

51.

Which of the following flap designs allows the best surgical access to the apical aspect of a tooth root with the least reflection of soft tissue? A. B. C. D. Envelope Semilunar Vertical release Rotation pedicle

52. 46. Which of the following is most clearly associated with the appearance of "moon fades"? A. B. C. D. Hyperthyroidism Regular corticosteroid use Diabetes mellitus Pancreatic insufficiency

Each of the following is a disadvantage of oral sedation EXCEPT one. Which one is the EXCEPTION? A. B. C. The administrator has little control over the ultimate clinical actions ofthe drug(s). There can be significant differences in the bioavailability of oral drugs. With most oral drugs, there is a relatively slow onset of clinical activity and a prolonged duration of action. Oral anxiolytic drugs are effective in relieving anxiety in the hours immediately preceding the dental appointment.

47.

Osteomyelitis of the mandible is most likely to develop because of A. B. C. D. failure of pus to localize. a resistant strain of bacteria. low resistance of the patient. TM lack of drainage from the infected area.

D.

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53.

Principles for managing a localized alveolar osteitis after extraction of a mandibular first molar include each of the following EXCEPT one. Which one is the EXCEPTION? A. B. C. D. Flushing out debris with normal saline solution Curetting the boney wall to promote bleeding Placing a sedative dressing in the socket to protect exposed bone Administering mild analgesic drugs as an adjunct to local treatment

56.

You are doing some preprosthetic surgery on a patient in preparation for a new denture. Which of the following statements about removal of her moderate-sized mandibular lingual tori is correct? A. B. The tori should be removed using a large pear-shaped acrylic bur. The tori should be removed by grooving the superior surface then shearing the torus off with a mono-beveled chisel. The area is then smoothed with a bone file. The tori should be removed by grooving the superior surface of the torus with a bur, then shear the torus off with a bibeveled chisel. The tori should be removed by inserting a rongeurs vertically under a lingual flap and "snipping off' the tori.

C.

54.

When is the most appropriate time to permanently modify/alter the occlusion of an acute TMD patient? A. B. C. During the first visit, while the patient has the acute symptoms Prior to initiating splint therapy, one week after the first visit Only after the patient is sympton-free and has shown improvement during splint therapy Never, until definitive orthodontic treatment has been started 57.

D.

Which of the following statements about the flap for the removal of a palatal torus is correct? A. The most optimal flap uses a midline incision which courses from the papilla between teeth #8 and 9 posteriorly to the junction of the hard and soft palates. The most optimal flap is a reflection of the entire hard palate mucoperiosteum back to a line between the 2 first molar teeth. The most optimal flap uses a midpalatal incision that courses from the palatal aspect of tooth #3 across to the palatal aspect of tooth #14. The most optimal flap is shaped like a "double-Y", with a midline incision and anterior and posterior side arms extending bilaterally from the ends of the midline incision.

D.

B.

55.

Which of the following best defines the term "Temporomandibular Disorders"? A. B. A clinical condition related to dysfunction of the temporomandibular joint and disk A collective term for a heterogenous group of musculoskeletal disorders of varying etiologies, that present with similar signs and symptoms A clinical condition caused by disharmony between the occlusal proprioceptors and masticatory muscles A group of clinical conditions that arise from excessive loads being placed on the TM joints by muscle spasms, resulting in disk displacement on one or both sides

C.

D.

C.

58.

D.

Which of the following statements about maxillofacial bone grafts is INCORRECT? A. B. C. Xenografts are frequently used in mandibular reconstruction. The most common source of autologous bone is the iliac crest. Allogeneic banked bone is often used as a carrier, supplemented with an autogenous graft. An example of isogeneic bone grafting is transplanting bone marrow in the treatment of such diseases as leukemia.

D.

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59.

Your patient was referred to an oral and maxillofacial surgeon for an implant, and you were advised that she was going to need a sinus lift procedure with placement of an autogenous bone graft. What is the definition of that graft? A. B. C. D. The graft will use an artificial, bone-like material. The graft uses bone from another human being. The graft uses the patient's own bone, taken from another site. The graft uses bovine bone, or bone from another animal species.

62.

Each of the following statements concerning the administration technique of inhalation sedation is correct, EXCEPT one. Which one is the EXCEPTION? A. If the patient is wearing contact lenses, they should be removed prior to administration of the sedation. The patient should be seated in an upright (85-90 degree) position in the dental chair. The initial flow rate of oxygen should be at least 6 L/min via the nasal hood. As the flow of nitrous oxide through a mixing dial style unit is increased, the flow rate of oxygen is reduced, so the correct percentage of each is delivered at a constant flow rate.

B. C. D.

60.

A complete denture patient returns for a 24-hour post-op appointment after insertion of new dentures. The patient points to a sore area on top of the mandibular ridge crest on the posterior right side but no sore spot is visually evident. Which of the following is the first procedure the dentist should perform? A. Reduce the centric contacts on all posterior teeth on the right side of the mandibular denture. Using a large acrylic bur, grossly reduce the internal surface of the denture. Reduce all eccentric contacts on the right side of the maxillary and mandibular dentures. Apply pressure indicator paste to the internal surface of the mandibular denture and check for pressure spots. Tell the patient this is normal for the first day of wearing new dentures and to return in one week for another post-op check.

63.

Each of the following is a common cause of postsurgical atelectasis (decreased expansion of the alveoli) EXCEPT one. Which one is the EXCEPTION? A. B. C. D. E. Shallow inspirations Pain-limiting movement Inactivity after surgery Preoperative respiratory infection Narcotic analgesic that depress the respiratory drive

B. C.

D.

64.

Cavity liners should have a minimal thickness of

E.

A. B. C. D.

1 mm. 1.5 mm. 15 mm. 125 mm

61.

When a patient bites on a hard object on the left mandibular molar, the interarticular pressure of the right temporomandibular joint is A. B. C. D increased. decreased. remains unchanged. varied but it is unpredictable.

65.

Each of the following statements is correct regarding phenytoin EXCEPT one. Which one is the EXCEPTION? A. B. Causes gingival hyperplasia Corrects certain cardiac dysrhythmias

C.
D. E.

Is ineffective when administered orally

Causes toxic effects related to the cerebellum and vestibular system Exerts antiseizure activity at doses which do not cause general CNS depression

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66.

A properly executed posterior superior alveolar nerve block will anesthetize each of the following structures EXCEPT one. Which one is the EXCEPTION? A. B. C. D. Maxillary sinus membrane in the molar region Second and third molar teeth and a portion of the first molar tooth Buccal alveolar bone, soft tissue and periodontium in the posterior maxilla Soft palate mucosa on the side of the injection

71.

Which of the following is the most serious result of digoxin intoxication? A. B. C. D. E. Bradycardia Renal failure Atrial tachycardia Atrial fibrillation Ventricular fibrillation

72.

Each of the following represents an advantage of oral sedation EXCEPT one. Which one is the EXCEPTION? A. B. C. Need for specialized training and equipment High incidence and severity of adverse reactions Erratic and incomplete absorption of drugs from the Gl tract Short duration of action

67.

Which areas should be avoided for an IM injection before a child can walk? A. B. C. D. Gluteal muscles Ventrogluteal Vastus lateralis Deltoid area 73.

D.

The depth of light penetration into the tooth or restoration before it is reflected outward is the A. B. C. D. metamerism. degree of translucency. color perception. value.

68.

Adrenal insufficiency during major stress results in A. B. C. D. gingival hyperplasia. cardiovascular collapse. hypotension. ketoacidosis. 74.

69.

A patient that is having general anesthesia using an IV barbiturate rapidly passes through
A. B. C. D. Stage Stage Stage Stage I. II. III. IV

In young patients, stains are usually more prominent in which areas of the teeth?
A. B. C. D.

Incisal
Occlusal Cervical Facial

75. 70. Which of the following antibiotics has been implicated in the vast majority of cases of oral

The character and individuality of teeth are largely determined by

contraceptive failure during antibiotic use?

A. B. C. D. E. Penicillin

A.
B. C.

translucency.
surface texture, color,

Rifampin
Keflex Erythromycin Tetracycline

D.

shape.

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76.

When the dentist enters the operatory, the patient, who is new to the office, stands close to the wall, has his arms folded, and is looking at the floor. The dentist should initiate communication by saying which of the following? A. B. C. D. E. Let's get going, I've got a lot to do. What are you angry about? Didn't my assistant get you seated? You seem uncomfortable; did you have a bad dental experience? Hi, I'm Doctor Wilson, what brings you here today?

81.

The outstanding advantage of phenytoin over phenobarbital in the treatment of epilepsy is that phenytoin A. B. C. D. does not bring about dependence. has a longer duration of action. is effective against both grand and petit mal. produces less sedation for a given degree of motor cortex depression.

82.

The main function o f t h e liner used in a casting ring is to A. B. C. D. E. provide venting of the mold. help prevent shrinkage porosity. provide easy divesting of the casting. provide additional water to the investment mix. allow uniform and uninhibited setting expansion o f t h e investment.

77.

Which o f t h e following antibiotics is the substitute of choice for penicillin in the penicillin-sensitive patient? A. B. C. D. Cephalexin Erythromycin Tetracycline Clindamycin 83.

78.

The phenomenon whereby various light sources produce different perceptions of color is called A. B. C. D. E. fluorescence. incandescence. opalescence. translucency. metamerism.

The use of a rubber dam is considered an essential component of endodontic armamentarium. Exception to its use in a given situation is acceptable if the patient is informed and consents. A. B. C. D. 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.

79

A 4-year-old child has a history of frequent spontaneous pain in a primary mandibular second molar. This molar has a necrotic pulp. Which of the following represents the treatment of choice? A. B. C. D. Pulpectomy Pulpotomy Extraction Pulp cap

84.

The Occupational Safety and Health Administration's (OSHA) "Bloodborne Pathogens Standard" deals with each of the following EXCEPT one. Which one is the EXCEPTION? A. B. C. D. E. Disposal of medical waste Exposure Control Plan Hepatitis B vaccination Instrument sterilization and storage Material Safety Data Sheets (MSDS)

80.

Which o f t h e following is an outstanding advantage of phenytoin over phenobarbital in the treatment of grand mal epilepsy? A. B. Exerts less sedation for a given degree of motor cortex depression Is effective in a greater percentage of cases

C.
D. E.

Needs to be given much less frequently

Does not cause gastric distress Has a longer duration of action
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85.

A 20-year-old patient presents with an upper maxillary centra) incisor previously treated for endodontic fractures at the level of the alveolar crest. Which of the following represents the first necessary step to restore and maintain the tooth's esthetics? A. B. C. D. Orthodontically extrude remaining tooth structure Extract remaining tooth structure Fabricate FPD over the remaining root Fabricate RPD over the remaining root

90.

Back pressure porosity is A. B. C. the same as occluded gas porosity. the result of using an oxidizing flame. most likely when the wax pattern is positioned very close to the open end of the ring. often evidenced by rounded margins on the casting, the same as suck-back porosity.

D.

91.

86.

Shrinkage porosity in a gold casting is associated with A. B. C. D. E. the use of excessive flux. the use of no flux. sprue diameter. alloy oxidation. excessive burnout time.

Which of the following explains why a properly designed rest on the lingual surface of a canine is preferred to a properly designed rest on the incisal surface? A. B. C. D. The enamel is thicker on the lingual surface. Less leverage is exerted against the tooth by the lingual rest. The visibility of, as well as access to, the lingual surface is better. The cingulum of the canine provides a natural surface for the recess.

87.

Which of the following is an acronym for a marketing strategy to use for reluctant patients? A. B. C. D. SUCCESS RECRUIT OPTIMEM EIEIO

92.

The most potent antitubercular drug is A. B. C. D. isoniazid. vancomycin. trimethoprim. sulfamethoxazole.

88.

Spontaneous gingival hemorrhage or acute stomatitis, observed in a pediatric patient under treatment for absence seizures, indicates withdrawal of which ofthe following anticonvulsant drugs? A. B. C. D. E. Phenytoin Ethosuximide Carbamazepine Phenobarbital Valproic acid

93.

The main metabolite of ingested isopropyl alcohol

A. B. C. D. E.

urea. acetone. methanol. acetaldehyde. formaldehyde

94.

89.

Which of the following drugs is most likely to cause convulsions when a physically dependent person is withdrawn? A. B. C. D. E. Pentobarbital (Nembutal) Diazepam (Valium) Hydroxyzine (Vistaril) Chloral hydrate (Noctec) Chlorzoxazone (Parafon Forte)
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At the try-in appointment for a 3-unit posterior gold FPD, the proximal contacts, fit, occlusion, contour, and surface finish have been determined to b8 acceptable. Which ofthe following represents what step is accomplished next with this FPD? A. B. C. D. Soldering index Copalite preparations Temporary cementation Mix zinc phosphate cement

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95.

Larger condensers and laterally applied condensation forces are recommended to ensure complete condensation of which of the following amalgam types? A. B. C. D. E. Admixed Spherical Lathe-cut High-copper Conventional

100. With respect to temperature, the processing cycle of a denture is designed to A. B. C. D. attain development of color. prevent boiling of the monomer. prevent breakdown of the initiator. volatilize the hydroquinone inhibitor.

101 . Alcoholic euphoria results from A. B. C. D. E. increased activity of the cerebrum. increased activity of thalamic areas. increased activity of limbic synapses. decreased activity of medullary centers. removal of the inhibitory effect of the cortex.

96.

Proposed modes of action for the oral antidiabetic agents include each of the following EXCEPT one. Which one is the EXCEPTION? A. B. C. D. E. Blockade of glucagon release from pancreas Blockade of catecholamine release from adrenal medulla Stimulation of insulin release from pancreatic beta cells Action as direct receptor agonists for the insulin receptor Increase affinity of tissues for utilization of available plasma glucose

102. The portion of an artificial tooth that is found only in porcelain anterior teeth is A. B. C. D. E. the pin. the collar. the finish line. the diatoric. None of the above.

97.

Compressing the acrylic resin in a rubbery stage will probably result in A. B. C. D. an open bite or open pin. porosity of the finished acrylic. incomplete filling of the mold details. large amounts of excess that is difficult to trim.

103. The casting shrinkage of cobalt-chromium alloys is approximately A. B. C. D. 1.25% 1.75% 2.2%. 3.2%.

104. Which of the following is a disadvantage of glass ionomer cement? 98. Which of the following statements concerning ethyl alcohol is true? A. B. C. D. E. It produces a true stimulation of the central nervous system. It protects individuals against exposure to cold by preventing heat loss. It is metabolized primarily by the lungs. It is partially absorbed in the stomach. It possesses anticholinergic properties. A. B. C. D. Difficulty in mixing Irritation of the pulp Low bond strength to dentin Moisture sensitivity during initial set

105. Which of the following will result when using a thinner mix of a gypsum-bonded casting investment? A. B. C. D. E. Produce a smoother casting Increase setting expansion Decrease setting expansion Increase thermal expansion Decrease required burn-out temperature

99.

The most likely cause of failure in the pre-ceramic soldering technique is A. B. C. D. E. underheating the parts to be joined. overheating the parts to be joined. using an incompatible solder. using phosphate as the soldering TM investment. preheating the soldering assembly.

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1 0 6 . Which of the following oral bacteria have been implicated as periodontal pathogens? A. B. C. D. Porphyromonas gingivalis, Eubacterium sp., and Campylobacter recta Streptococcus gordonii, Streptococcus mutans, and Gemella sp. Lactobacillus casei and Veillonella sp. Streptococcus mitior, Streptococcus gordonii and Bacteroides gracilis

112. Allowing the ultrasonic-sealer tip to remain on the tooth surface too long will A. B. C. D. damage the tooth surface. dull the tip of the instrument. burnish the calculus onto the tooth surface. cause irreversible pulpal damage.

113.

The most important anticoagulant effect of heparin is to interfere with the conversion of A. B. C. D. E. PTA to PTC. PTC to Factor VIII. fibrinogen to fibrin. prothrombin to thrombin. proaccelerin to accelerin.

107.

The base of the incision in the gingivectomy technique is located A. B. C. D. E. in the alveolar mucosa. at the mucogingival junction. above the mucogingival junction. coronal to the periodontal pocket. at the level of the cementoenamel junction.

114.

Dental phobias are very hard to eliminate because they A. B. C. D. are ego-syntonic. cannot be seen. become habitual. are self-reinforcing.

108

Which of the following is the most important factor affecting pulpal response? A. B. C. D. Heat Depth to which dentinal tubules are cut Desiccation Invasion of bacteria

115. Which of the following describes a material with high compressive strength but low tensile strength?

109

Primary herpetic gingivostomatitis is most likely to occur in which o f t h e following age groups? A. B. C. D. E. 1 -5 years 6-10 years 11-15 years 16-20 years 21-25 years

A. B. C. D.

Resilient Brittle Ductile Malleable

116. The Occupational Safety and Health Administration (OSHA) is concerned with regulated waste within the office. OSHA regulates the transportation of waste from the office. A. B.
C.

110. Which of the following filling materials is least desirable for use as Preventive Resin Restoration? A. B. C. D. Microfilled resin Amalgam Hybrid resin
Glass ionomer

Both statements are true. Both statements are false.

T h e first s t a t e m e n t i s l i u e , the s e c o n d i s

D. 111. Each o f t h e following osseous defects would be classified as infrabony EXCEPT one. Which one is the EXCEPTION? A. B. C. D. A trough A dehiscence A hemiseptum An interdental crater
TM

false. The first statement is false, the second is true.

117.

One can accelerate the setting time of zinc oxideeugenol impression pastes by adding a small amount of A. B. C. D. water, glycerin, petrolatum, plaster of paris.

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118. What percentage ofthe U.S. population does not

have dental insurance? A. B. C. D. 35-40% 45-50% 55-60% 65-70%

122. The drug of choice to treat overdosage with tricyclic antidepressants is A. B. C. D. E. atropine. phenytoin. physostigmine. pentobarbital. an amphetamine.

119. A patient works at a nuclear power plant. He is

frequently exposed to a small amount of radiation, although the dose he receives is below the occupational limits. Which of the following best explains why this patient need not wear his employee film badge while he is having dental radiographs made? A. B. C. D. His badge records only gamma-radiation, not x rays. His film badge must be used only to measure occupational doses. It is unlikely that the current dose will rise above his occupational limit. The dose from the dental radiographs is too low to be measured accurately by the badge. 123. Chlortetracycline acts by interfering with A. B. C. D. cell wall synthesis. nucleic acid synthesis. protein synthesis on bacterial but not mammalian ribosomes. protein synthesis on mammalian but not bacterial ribosomes.

124. The toxic impurity that can theoretically be found in

nitrous oxide gas is A. B. C. D. E. ozone. helium. methane. nitric oxide. cyclopropane

120. A 5-year-old child has a posterior unilateral

crossbite that is accompanied by a functional shift of the mandible. When should this crossbite be corrected? A. B. C. D. Immediately, without waiting for the eruption of permanent first molars When all the primary teeth have exfoliated After the permanent first molars have fully erupted When the child is approximately 9 years of age

125. How many hours per day should a cervical pull

headgear be worn to achieve the most effective results? A. B. C. D. E. 6 8 10 12 14

1 2 1 . When determining the appropriate dose of systemic fluoride supplement for a child, it is. most important for the dentist to consider which of the following? A. B. C. D. The fluoride content of the drinking water The child's diet and caries activity The child's age and the fluoride content of the drinking water The child's weight and the fluoride content of the drinking water

126. Drug interaction resulting in serious adverse cardiovascular events, including death, might occur between erythromycin and which of the following antihistamine drugs? A. B. C. D. E. Terfenadine (Seldane) Promethazine (Phenergan) Hydroxyzine (Atarax) Diphenhydramine (Benadryl) Chlorpheniramine (Chlor-Trimeton)

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127. A mercury spill in the laboratory or office is

appropriately cleaned up by A. B. C. D. removing the mercury, then spraying the area with BAL. scrubbing the spill area with hot water and detergent. sweeping up the mercury and disposing of it in a plastic bag. aspirating the mercury into a wash bottle trap, then dusting the spill area with sulfur powder.

132.

Which of the following cannot be used to calculate the dosage of a drug for a child?

A. B. C. D.

Clark's rule Vital signs Body surface area Body weight (mg/kg)

133.

Which of the following symptoms is the most distinct characteristic of morphine poisoning? A. B. C. D. E. Comatose sleep Pin-point pupils Depressed respiration Deep, rapid respiration Widely dilated, non-responsive pupils

128.

The concentration of which of the following ions determines the binding affinity of agonists and antagonists to the opioid receptor?

A. B. C. D. E.

Sodium Calcium Chloride Potassium Phosphate

134.

In addition to the treatment of epilepsy, phenytoin may be indicated for the treatment of A. B. C. D. E. arrhythmia, narcolepsy, hypertension, schizophrenia, panic attacks.

129. In communicating with children, which o f t h e

following should the dental team do? A. B. C. Allow the parent to answer questions asked by the child at chairside Allow both the parent and the dentist to communicate simultaneously with the child Transmit word substitutes for dental procedures and equipment during the appointment Attain voice control to build the groundwork for future instructions

135. Which o f t h e following drugs is commonly used in

the treatment of congestive heart failure?

D.

A. B. C. D. E.

Phenytoin Digitalis Quinidine Procainamide Nitroglycerin

1 3 0 . A prescription includes each o f t h e following parts EXCEPT one. Which one is the EXCEPTION? A. B. C. Superscription Inscription Subscription Transcription Conscription

1 3 6 . The mechanism of action of the muscle relaxation induced by diazepam most clearly resembles that produced by A. B. C. D. E. d-tubocurarine. meprobamate. succinylcholine. decamethonium. gallamine.

D.
E.

1 3 1 . Inhalation of amyl nitrite can result in each of the following EXCEPT one. Which is the EXCEPTION? A. B. C. D. E. Tachycardia Coronary artery dilation Peripheral arteriolar dilation A decrease in arterial blood pressure Increased motility o f t h e small bowel

137. What percent of the blood alcohol level is the most likely to produce a lethal effect in 50 per cent of the population?

A. B. C. D. E.

0.05% 0.10% 0.20% 0.30% 0.50%

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138. Prolonged use of amyl nitrite may result in A. B. C. D. E. aplastic anemia. thrombocytopenia. granulocytopenia. methemoglobinemia. hypoprothrombinemia.

142. Which of the following best describes adjunctive orthodontic treatment? A. B. C. Orthodontic therapy performed only with removable appliances Limited orthodontic treatment to align the front teeth for maximum esthetics Orthodontic treatment to enhance restorative and periodontal rehabilitation Early treatment of orthodontic problems to prevent more serious malocclusion

139. The thinnest portion of the wax pattern should be

placed A. B. C. D. against the ring for support. in the deepest part of the ring. opposite the direction of rotation of the casting arm. in the same direction as the rotation of the casting arm.

D.

143. Which of the following drug groups is currently the mainstay of treatment in depressive psychoneurotic disease? A. B. C. D. E. Amphetamines Phenothiazines Benzodiazepines Monoamine oxidase inhibitors Tricyclic (imipramine-like) antidepressants

140. Which of the following statements is true

concerning anticholinesterase? A. B. C. D. E. Agents such as DEP inhibit only plasma cholinesterase. Organophosphates are readily absorbed through the skin. Agents may cause paroxysmal supraventricular tachycardia. Reactivators such as 2-PAM reactivate ACHE which has undergone "aging". Alkaloid physostigmine has the greatest number of side effects unrelated to ACHE inhibition.

144. Each of the following is a symptom of poisoning by an organophosphate insecticide EXCEPT one. Which one is the EXCEPTION? A. B. C. D. E. Diarrhea Hot, dry skin Excessive salivation Increased lacrimation Skeletal muscle fasciculation

141. In developing a canine-protected articulation where the anterior vertical overlap is determined to be less than 2 mm, the posterior cusp height should be kept shallow because the buccal cusps of the posterior teeth will have to assist in protrusive disclusion. A. B. C. D. E. Both the statement and the reason are correct and related. Both the statement and the reason are correct but NOT related. The statement is correct but the reason is NOT The statement is NOT correct, but the reason is correct. NEITHER the statement NOR the reason is correct.

145. Digitalis should be given to patients with atrial fibrillation who require quinidine to avoid A. B. C. D. E. hypokalemia. thromboembolism. sino-atrial bradycardia. ventricular tachyarrhythmias. prolongation of P-R interval of the ECG.

146. The presence of Ag in metal-ceramic alloys contributes to which of the following? A. B. C. D. Increases melting temperature Increases alloy strength Increases alloy corrosion resistance May cause green discoloration of the porcelain

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147. Having had a complete radiographic survey made 12 months ago, an asymptomatic adult patient presents for a recall appointment. There is no clinical evidence of caries or periodontal disease. The United States Food and Drug Administration would recommend which of the following for this adult? A. B. C. D. E. No radiographs Bite-wing radiographs only Panoramic radiograph only Panoramic and bite-wing radiographs Full-mouth survey including bite-wing radiographs

151. The "S" in DMFS signifies which of the following? A. B. C. D. E. Score Standard Surfaces Simplified Significant

152. Each of the following pharmacologic effects is

produced by ethanol EXCEPT one. Which one is the EXCEPTION? A. B. C. D. E. Diuresis CNS depression Enzyme induction Cutaneous vasoconstriction Increased gastric acid secretion

148. When high gold content alloys are compared to base metal alloys, the base metal alloys exhibit A. a higher melting point, increased specific gravity, and generally higher yield strength and hardness. a higher melting point, decreased specific gravity, and generally higher yield strength and hardness. a higher melting point, generally higher yield strength and hardness, and more consistent bonding to porcelain. increased specific gravity, generally lower yield strength, and more consistent bonding to porcelain. decreased specific gravity, generally higher yield strength and hardness, and more consistent bonding to porcelain.

B.

153. The cardiac glycosides will reduce the concentration of which ion in an active heart muscle cell? A. B. C. D. E. Sodium Calcium Chloride Potassium Magnesium

C.

D.

E.

154. Which of the following antihypertensive agents acts directly on arterial smooth muscle to cause vasodilation? A. Methyldopa (Aldomet) Clonidine (Catapres) Guanethidine (Ismelin) Metoprolol (Lopressor) Hydralazine (Apresoline)

149. The central skeletal muscle relaxation produced by depressing the polysynaptic reflex arcs is brought about by all of the following drugs EXCEPT A. B. C. D. diazepam (Valium). lorazepam (Ativan). meprobamate (Equanil). d-tubocurarine (Tubarine).

B. C. D. E.

155. The combination of a Schedule II narcotic with an

antipsychotic drug produces which ofthe following? A. B. C. D. Neuroleptic analgesia Conscious sedation Dissociative anesthesia Psychotomimetic analgesia

150. Which of the following statements best describes

why L dopa eventually becomes ineffective in the

treatment of Parkinson's disease? A.

B.

L-dopa absorption slows with aging.

Dopa decarboxylase activity increases with

C. D.

E.

age. Dietary intake of pyridoxine speeds L-dopa metabolism. Patients gradually develop tolerance because L-dopa induces liver enzyme activity. Neuronal cell loss in the substantia nigra is progressive and continuous over the course TM
o f t h e disease.

156. Which ofthe following drugs is excreted primarily by renal tubular secretion? A. B. Benzylpenicillin Streptomycin Tetracycline Bacitracin Polymyxin

c.
D. E.

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157. Excessive vertical dimension of occlusion may result in which of the following? A. B. C D. E. Poor denture retention Increased interocclusal distance Drooping of the corners of the mouth Creases and wrinkles around the lips Trauma to underlying supporting tissues

162. In pursuit of what the dentist believes is best for the patient, the dentist attempts to control patient behavior. This is known as A. B. C. D. autonomy, competence, maleficence, paternalism.

158. Which of the following represents the cause of death in poisoning from an irreversible anticholinesterase, such as diisopropylfluorophosphate? A. B. C. D. E. Cardiac failure, resulting from excessive vagal stimulation Dehydration, resulting from hypermotility of the gastrointestinal tract Asphyxia, resulting from increased airway resistance Respiratory failure, resulting from paralysis ofthe intercostals and the diaphragm Central nervous system depression, following prolonged excitation

163. When 50 mg. of chlorpromazine (Thorazine) is administered to a patient, on standing the patient might experience a fall in blood pressure due to which of the following? A. B. C. D. E. Anticholinergic action Decrease in heart rate Alpha-adrenergic blockade Negative inotropic action Stimulation of autonomic ganglia

164. Which ofthe following represents an amphetamine-like drug that is widely used in the treatment of hyperkinetic children? A. B. C. D. Doxapram (Dopram) Hydroxyzine (Atarax) Theophylline (Theobid) Methylphenidate (Ritalin)

159. Treatment with sulfonamides is less likely to be accompanied by crystalluria if A. B. C. D. E. a mixture of sulfonamides is used. cortisone is administered concurrently. probenecid is administered concurrently. the urine is acidified with ammonium chloride. para-aminosalicylic acid is administered concurrently.

165. Metabolism of a drug will usually result in conversion to each of the following EXCEPT one. Which one is the EXCEPTION? A. B. C. D. E. Inactive form More active compound Less active compound More water-soluble compound Less ionized compound

160. Which of the following is the most common reason for a cast crown not to seat on a patient's tooth? A. B. C. D. E. Overextended margins Excessive proximal contact Undercut areas on the preparation Casting too wide bucco-lingually Porosity within the inner surface of the crown

1 66. The disk sensitivity assay for antibiotic activity is used because A. B. C. D. the results are obtainable in a few minutes. it distinguishes between bacteriostatic and bactericidal drugs. it indicates whether or not an antibiotic has good oral absorption. it allows for routine testing of sensitivity to a range of antibiotics.

161 . Loss of a primary right molar in a 3-year-old child requires placement of a A. B. C. D. band and loop. distal shoe. removable acrylic appliance. None of the above.

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167. Which of the following agents is the least effective in producing topical anesthesia? A. B. C. D. E. Tetracaine (Pontocaine) Butacaine (Butyn) Procaine (Novocaine) Lidocaine (Xylocaine) Benzocaine

173. Nystatin (Mycostatin) is used in the treatment of infections caused by A. B. C. Peptostreptococci spp. Bacteroides spp. Candida albicans.

D.
E.

Streptococcus mutans.
Pseudomonas aeruginosa.

168. Which of the following routes of administration

exhibits the slowest rate of absorption? A. B. C. D. Oral Sublingual Subcutaneous Intramuscular

174. Which ofthe following analgesics can be given either orally or by intramuscular injection? A. B. C. D. E. Aspirin Acetaminophen (Tylenol) Ibuprofen (Motrin, Advil) Ketorolac (Toradol) Naproxen (Naprosyn, Aleve)

169. Which ofthe following sedatives is most likely to cause a dry mouth? A. B. C. D. Buspirone (BuSpar) Hydroxyzine (Vistaril) Chloral hydrate (Noctec) Phenobarbital (Luminal)

175. A cast gold restoration might be indicated for the replacement of a faulty amalgam to obtain A. B. C. D. better margins. more ideal contours. less trauma to the pulp. less removal of tooth structure.

170. Barbiturates taken in combination with very high doses of ethanol exhibit an interaction best described as which of the following? A. B. C. D. E. Potentiation Protein bumping Negative synergism Competitive inhibition Enterohepatic circulation

176. During a soldering procedure, flux serves to A. B. C. D. provide an oxidizing environment in the area to be soldered. displace gases and dissolve corrosion products. remove any debris that may remain in the area to be soldered. hold the solder in place during heating.

171. Which of the following erythromycins is both

enteric coated and long acting? A. B. C. D. ERYC E.E.S. Erythrocin llosone

177. Excessive heating of the acrylic resin during processing should be avoided to prevent A. B. C. D. E. exothermic heat buildup. acrylic resin shrinkage. evaporation of the monomer. excessive acrylic resin expansion. discoloration ofthe acrylic resin.

172. Each of the following is a characteristic of tramadol (Ultram) EXCEPT one. Which one is the EXCEPTION? A. B. C. D. E. Centrally acting analgesic Structurally similar to morphine Binds to the mu-opioid receptor Biotransformed into a more active metabolite Inhibits uptake of norepinephrine and serotonin
TM

178. Following compression of acrylic into the denture flasks, placing the flasks into the processing tanks at curing temperature is delayed to A. B. C. D. assure complete flow of acrylic into the mold. allow the monomer to permeate all polymer crystals. establish an equalized and uniform pressure in the molds. allow the flasks and the acrylic to reach a stable temperature.

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) 2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.

Case A #'s 179-187

(see page 26)
179. The plaques on this patient's lower labial mucosa
most likely represent which of the following? A. B. C. D. E. Leukoplakia Nicotinic stomatitis Chronic lip chewing Psoriasis Smokeless tobacco hyperkeratosis

184. Which of the following represents the best initial restorative treatment for tooth #4?
A. B. C. D. E. Place porcelain fused to metal crown Restore with conservative MO amalgam Treat mesial caries with composite resin Place mesial glass ionomer restoration to restore root caries lesion No treatment is necessary.

1 8 5 . Each of the following statements is true concerning impacted teeth #17 and #32 EXCEPT one. Which one is the EXCEPTION? A. B. C. D. Alveolar osteitis in the removal of bony impactions might occur (5-20%). The alveolar nerve is not likely to be injured during this extraction. Horizontally impacted teeth are considered the most difficult mandibular impactions. Asymptomatic bony impactions are not recommended for extraction in patients over 35 years-of-age.

180. Which o f t h e following represents the structure

indicated by the arrows on the radiograph? A. B. C. D. E. Innominate line Lateral border of the orbit Pterygoid plate of the sphenoid Zygomatic process of the maxilla Posterior border of the maxillary sinus

181. Prior to undergoing scaling and root planing, how

should this patient be treated? A. B. C. D. E. Amoxicillin (Amoxil), 2 gm, 1 hour prior to procedure Cephalexin (Keflex), 3 gm, 1 hour prior to procedure Clarithromycin (Biaxin), 600 mg, 1 hour prior to procedure Clindamycin (Cleocin), 2 gm, 1 hour prior to procedure No antibiotic treatment is necessary. 1 8 6 . The position of tooth #26 will complicate the design of a maxillary prosthesis. Maxillary tuberosity reduction on the patient's left side would facilitate prosthesis fabrication. A. B. C. D. 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.

182. Which of the following risk factors is most likely to

contribute to future attachment loss in this patient? A. B. C. D. E. Probing depths greater than 3 mm Insulin administration Occlusion Nutrition Smoking 1 8 7 . Prior to dental treatment using local anesthesia without sedation the patient should be instructed to take his usual dose of insulin and eat a normal diet. If the patient is to have local anesthesia with sedation, the patient should be instructed to reduce the usual dose of insulin and not eat. A. B. C. D. A. B. C. D. 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.
TM

183. There is a vertical defect on the mesial of tooth #2.

There is a crater defect between tooth #2 and tooth #3.

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.

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Case B#'s 188-200

(see page 31)
188. Which of the following is the most likely periodontal diagnosis for this patient? A. B. C. D. Plaque-induced gingivitis Chronic periodontitis Aggressive periodontitis Necrotizing ulcerative periodontitis

193. Which of the following is the most likely diagnosis

for the radiolucency distal to the apical third of the root of tooth #13? A. B. C. D. Metastatic carcinoma Lateral periodontal cyst Chronic periradicular periodontitis Extension of the maxillary sinus

194. Which of the following is the most appropriate restorative therapy for the patient's lower incisors? A. B. Splint together with composite resin Remove failing margins and rough surfaces, and place new composite restorations where indicated Place porcelain fused to metal crowns No treatment is indicated.

189. Which ofthe following is the strongest radiographic evidence that tooth #10 requires endodontic treatment? A. B. C. D. Pulp chamber calcification Periodontal bone loss coronally Extent of coronal restoration Widened apical periodontal ligament space

C. D.

195. Which of the following approaches would be best

190. Which of the following is the best, most conservative restorative treatment for teeth #6 and #11? A. B. C. D. All-ceramic crowns Porcelain fused to metal crowns Restore proximal surfaces as needed with composite resin Apply fluoride in determining why the patient has had infrequent dental care in the past? A. "Why haven't you gone to the dentist more often? The more you avoid the dentist the worse your dental fear will become." "It is costly to have two daughters in college, you should go to the dentist more often or you will need expensive dental treatment." "Can you tell me why someone with a medical history as bad as yours has stayed away from the dentist for so long?" "You have had many dental problems in the past. If you had seen the dentist regularly as you should have you wouldn't have had as many. What could possibly have kept you away?" "Could you tell me more about your past dental experiences and present dental concerns?"

B.

C.

1 91 . Which of the following treatments will achieve the best esthetic results for teeth #7, #8, #9 and #10? A. B. Place all-ceramic crowns on all four teeth Place ceramic crown on tooth #7, and place composite resin restorations on teeth #8 #10 Place all-ceramic crowns on teeth #7 and #9, replace MI composite resin restoration on tooth #8, remove facial caries on tooth #10 and restore with composite Restore caries on the facial surface of tooth #7, polish composite resin restorations on teeth #8 and #9, and place crown on tooth #10 Place porcelain fused to metal crowns on teeth #7, #9, and #10. and restore the mesial surface of tooth #8 with composite

D.

E.

C.

D.

196. Following root canal therapy on tooth #10, which of

the following foundation options, prior to crown preparation, is most appropriate? A. B. C. D. Bonded composite resin Pin retained composite resin Prefabricated post and composite resin core Composite resin into canal continuous with core

E.

192. Which ofthe following is the best means to evaluate the pulpal vitality of tooth #13? A. B. C. D. Application of cold to teeth #12 and #13 Percussion testing on teeth #5 and #13 Electric pulp testing of teeth #12 and #13 Palpation in the buccal vestibule from teeth #12-#14
TM

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2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.

197. Which of the following options is the best to replace the missing mandibular teeth? A. B. C. D. Mandibular removable partial denture Fixed partial denture teeth #20 to #22 and removable partial denture Fixed partial denture teeth #28 to #31 and removable partial denture Fixed partial denture teeth #18 to #22 and fixed partial denture #28 to #31

198. Which of the following is the best diagnosis for the radiolucency apical to teeth #23-#26? A. B. C. D. E. Mental fossa Coalesced periapical granulomas Periapical cemental dysplasia Central giant cell granuloma Traumatic bone cyst

199. Following initial therapy, oral hygiene is good and there is a 1 mm reduction in probing depths. Periodontal treatment ofthe mandibular anterior teeth would include A. B. C. D. E. another round of scaling and root planning. flap surgery. soft tissue grafting. regenerative therapy. periodontal maintenance therapy only.

200. In addition to oral hygiene instructions and scaling and root planing, which ofthe following course of actions is most appropriate during initial periodontal therapy? A. B. C. D. Systemic tetracycline administration for 10 days Subgingival irrigation with 0.12% chlorhexidine Consultation with physician concerning diabetes mellitus Tooth grinding for occlusal adjustment and equilibration ofthe dentition

TM

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CASE A Age Sex Height Weight B/P

Chief Complaint

Dental History

Sporadic visits for emergency extractions.

N3 O O CD

>
3
CD

38 YRS EH MaleD Female 5' 10" 154 LBS 125/78 "I don't like the spaces in my upper teeth."

7)
CD
</)

o
CD

0)
C D Q.

o
o 3
en

Medical History

5'

D
(I

Diabetes Patient had a hang-gliding accident 3 years ago with r esultant knee replacement. He smokes 1 pack of cigarettes per day and uses chew ng tobacco.
Current Medications

Social History

CD O O
CD

Bartender

o
(A CD CO

insulin (Hur Tiulm R )

a c
Q.

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CASE A
o o
CD

ADULT CLINICAL EXAMINATION

5
Probe 555 444 434

>
3
CD

6
333

9
facial

10

1 1

12

13

14

15

16

Current Oral Hygiene Status

Fair

333 323 223 333

O
CD

Cfl

o o

R
o
3"

O o 3 3

Supplemental Oral Examination Findings 1. Diffuse irregular white patches on lower labial mucosa.

Probe,1
2. o'

655 544

434

333

433 333 323 334

Probe

534 433 333 434 I 535 I 545 I 543 I 554 I 444 323 I 334

o
CD

m x

o'

Q
CO

Clinically visible carious lesion

^en

Clinically missing tooth

Probe 32 31

545 I 4 3 3 7 333 30 29 28

facial 434 I 545 I 545 \ 5451 554 I 434

TM

323T335 21 20 19 18 17

Probe 1: Probe 2:

Furcation "Through and through" furcation initial probing depth probing depth 1 month after scaling and root planing

27

26

25

24

23

22

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Q
LA

fc

<
ULi CO

<

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en

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i 2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.

Q
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hI

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) 2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.

CASEB Age Sex Height Weight B/P

Chief Complaint

Dental History

Patient has had infrequent dental care. 50 YRS KIMaleD Female 6'0" 210 LBS 130/80 "I'm not happy with my front teeth. They feel rough."

Medical History

Patient says he had a "mild stroke" 3 years ago. arrythmias diabetes mellitus Type II hypertension

Social History

Patient is a building contractor with two daughters in college.

Current Medications

metformin (Glucophage*) metoprolol (Lopressor*) aspirin

TM

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CASE B

ADULT CLINICAL EXAMINATION

1 Probe 2 2 3 4 5 6 7 8 9 10 11 12 13 14 15 667 16

5 P 3
CD

>

Current Oral Hygiene Status

Fair

755 576

646 545 444 434 [555 I 545 I666 I 544 445 566
facial

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Supplemental Oral Examination Findings

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Probe 1: Probe 2:

Furcation "Through and through' furcation initial probing depth probing depth 1 montn after scaling and root planing

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2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.

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2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.

PART 2 KEY The key below may be used to determine correct and incorrect answers; howevnr, for this item set, it is not possible to convert a raw score numher correct to a standard score or associated pass/foil status 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 B D R C B B D A C D B B D C C D A B B B E C B C B E B E A A D E C E A C C E A D B A B C B D C D B B 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 E A C D C A C B A B B A C D B C A D B A C C C D E A D A C E E B B A B B E D B B C C E B D D A B D E 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 C D D E A A E D A B D D C D E D C A B A A B C D B B C D E D A E D C C A A B D C A A C B E C B A B C

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50

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A A D D

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D C C E B C A C D C D C E A D B A D B D B D B C D E E C D A D B B A C B B A B C B C A

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2009. American Dental Association, Joint Commission on National Dental Examinations. All rights reserved.