1991 Case A 1.

During the child's first visit, the dentist requested that the parents wait in the reception room. The child cried moderately, but tearfully, throughout the dental examination and prophylaxis. The dentist "gave her permission" to cry while he/she worked and then took no notice of her crying. Her crying diminished in intensity over time and then stopped. With respect ONLY to the crying behavior, the dentist has A. B. C. D. used positive reinforcement. used negative reinforcement. extinguished the behavior. ignored the problem.

2. Which of the following is the LEAST likely to contribute to this patient's dental phobia? A. B. C. D. Her age Her gender Her mother's dental phobia Her prior dental experience

3. At a subsequent visit, the child's behavior worsened. The dentist decided to use pharmacologic anxiety control. Which of the following represents the most appropriate drug for this purpose? A. B. C. D. E. Chlorpromazine (Thorazine) P.O. Hydroxyzine (Vistaril) P.O. Meperidine (Demerol) P.O. Ketamine (Ketelar) I.M. Pentobarbital (Nembutal) P.O.

4. After the permanent mandibular left first molar has further erupted, placement of which of the following is indicated for managing the space that is mesial to this tooth? A. B. C. D. A band and loop space maintainer A distal shoe space maintainer A passive mandibular lingual holding arch A space-regaining appliance

5. Which of the following describes the most appropriate treatment for the lingually-erupting permanent mandibular right central incisor? A. Extracting the primary right central incisor immediately, and then moving the lingually-erupted tooth labially with an appliance. B. Waiting for the primary right central incisor to exfoliate, and then moving the lingually-erupted tooth labially with an appliance. C. Extracting both primary mandibular central incisors immediately, and then observing the eruption of the permanent central incisors.

D. Observing the primary mandibular central incisors until they exfoliate, and then allowing the permanent incisors to move labially on their own. 6. Which of the following best describes the radiolucency seen at the furcation of the mandibular right second primary molar? A. B. C. D. It is of pulpal origin. It is of periodontal origin. It is of combined pulpal and periodontal origin. It is a normal feature of the mixed dentition.

7. Which of the following represents the most appropriate treatment for the primary mandibular right second molar? A. B. C. D. An indirect pulp treatment A pulpotomy followed by a Class II amalgam restoration A pulpotomy followed by a steel crown restoration An extraction

8. Which of the following represents the most appropriate treatment for the primary mandibular left first molar? A. B. C. D. MO and DO amalgam restorations An MOD amalgam restoration A stainless steel crown restoration An extraction

9. Which of the following best describes the number of radiographs that accompany this case? A. B. C. Case B 1. During the first dental office visit, this child cooperated for the examination, prophylaxis, and radiographs. Which of the following should be performed during the next appointment? A. B. C. D. Restoration of the primary mandibular left first and second molars Extraction of the erupted malformed tooth Restoration of the primary maxillary right first and second molars As much restorative treatment as the child will allow Insufficient Appropriate Excessive

2. Which of the following best describes this child's primary molar relationship? A. Class II

B. C. D.

Distal step Mesial step Flush terminal plane

3. Which of the following represents the most appropriate treatment for this child's primary mandibular molars? A. B. C. D. Sealants Amalgam restorations Steel crown restorations Reinforced zinc oxide-eugenol restorations

4. How much additional systemic sodium fluoride should this child ingest per day? A. B. C. D. E. None 0.25 mg 0.5 mg 1.1 mg 2.2 mg

5. The presence of which of the following can be confirmed from the available radiographs and photographs? A. B. C. D. E. A peg-shaped lateral incisor Multiple supernumerary teeth A chronic periapical infection Congenitally-missing permanent premolars A normal complement of teeth for the child's age

6. The peg-shaped tooth in the maxillary left incisor area will most likely result in which of the following? A. B. C. Loss of arch length (perimeter) in the mixed and permanent dentitions Ectopic eruption of the permanent maxillary incisor(s) The development of an odontogenic cyst or tumor and subsequent infection

7. Which of the following represents the most appropriate treatment for the tooth that has erupted into the maxillary left incisor space? A. B. C. D. Restoring it with a composite resin crown Allowing it to resorb and exfoliate Observing it at six-month intervals Extracting it

8. If one or more of this child's teeth were to be extracted, which of the following should be prescribed?

A. Erythromycin, 1 g PO 1 hour preoperatively, and 500 mg PO 6 hours later B. Penicillin V, 2 g PO 1 hour preoperatively, and 1 g PO 6 hours later C. Penicillin V, 1 g PO 1 hour preoperatively, and 500 mg PO 6 hours later D. Penicillin V, 1 g PO, 1 hour preoperatively, and 500 mg PO every 6 hours for 8 doses E. Vancomycin, 500 mg IN. 1 hour preoperatively 9. For this child, which of the following represents the maximal dose (per treatment session) of 2% lidocaine 1: 100,000 epinephrine that can be injected? A. B. C. D. 40-80 mg 90-130 mg 140-180 mg 190-230 mg

10. When the dentist removed the caries in the primary maxillary right first molar, the pulp became exposed. Which of the following represents the treatment-of-choice for this tooth? A. B. C. D. E. Case C 1. Which of the following BEST represents this patient's dental age? A. B. C. D. 6 years 8 years 10 years 12 years A pulpotomy and an amalgam restoration A pulpotomy and a stainless-steel crown restoration An extraction and the subsequent placement of a space maintainer An indirect pulp treatment and a reinforced zinc oxide-eugenol restoration A direct pulp cap with calcium-hydroxide and an amalgam restoration

2. The patient's midline relationship is most likely to be the result of A. B. C. D. a mandibular functional shift. asymmetric growth of the mandible. crowding in the mandibular arch. blocked-out maxillary lateral incisors.

3. Which of the following has most likely caused the patient's right posterior crossbite? A. B. C. D. A tongue-thrust habit A thumb-sucking habit A unilateral constriction of the maxillary right posterior teeth A bilateral symmetrical constriction of the maxillary posterior teeth

4. From the panoramic radiograph, the dentist can determine that the maxillary permanent canines are erupting A. B. C. D. ectopically. normally. facially. palatally.

5. Which of the following describes an appropriate procedure for initiating this patient's orthodontic treatment? A. B. C. D. Expanding the maxillary arch Correcting the crossbite of the maxillary lateral incisors Extracting the primary mandibular canines Removing the primary maxillary first molars

6. The mixed-dentition arch-length analysis reveals a 1.5 mm deficiency in the mandibular arch. These results support which of the following alternatives? A. B. C. D. Expanding the mandibular arch Leaving the mandibular arch as it is Extracting the mandibular primary canines Initiating a serial-extraction procedure

7. This patient's mother requests a prescription for systemic sodium fluoride supplements. Which of the following represents the appropriate daily supplemental dosage? A. B. C. D. None 0.5 mg 1.1 mg 2.2 mg

8. Which of the following represents the most appropriate periodontal diagnosis for this child? A. B. C. Case D 1. The evidence gathered from this patient's oral and radiographic examinations, as well as from his medical and dental histories, suggests that his plaque flora contain elevated percentages of which of the following? A. B. Bacteroides gingivalis Streptococcus mutans Periodontal health Generalized marginal gingivitis Localized prepubertal periodontitis

C. D.

Eikenella corrodens Actinobacillus actinomycetemcomitans

2. The practitioner has determined that Tooth #31 is the source of the patient's pain. This tooth is sensitive to percussion. Vitality tests elicit no response. These signs and symptoms are consistent with a diagnosis of which of the following? A. B. C. D. E. Pulpal hyperemia Reversible pulpitis Suppurative pulpitis Acute apical periodontitis Chronic apical periodontitis

3. In order to alleviate this patient's pain from Tooth #31, the dentist should do which of the following? A. B. C. D. E. Adjust the occlusion Prescribe an antibiotic Perform an indirect pulp cap Initiate root canal treatment Perform a pulpotomy

4. The practitioner has relieved the patient's pain, conducted a thorough examination, and designed a complete treatment plan. Which of the following represents the most appropriate next step? A. Controlling the caries in Teeth #'s 3, 18, 19, and 30 B. Placing a temporary crown on Tooth #3 and restoring all remaining carious lesions with amalgam C. Placing a full crown on Tooth #3 D. Extracting Teeth #'s 3 and 31 5. Tooth #3 has a vertical root fracture. The dentist determines that this tooth is nonrestorable. Which of the following replacements represents the most appropriate choice? A. A resin-bonded fixed partial denture that uses Teeth #'s 2 and 4 as abutments B. A conventional fixed partial denture that incorporates three-quarter-crown retainers on Teeth #'s 2 and 4 C. A single-tooth osteointegrated implant D. A cast-metal removable partial denture that has appropriate clasps and rests 6. Which of the following materials is the most appropriate for restoring Teeth #'s 18, 19, and 20? A. B. C. Amalgam Cast gold Resin bonded composite

D.

Intermediate restorative material

7. The restorative treatment of Tooth #19 required indirect pulp capping. After completing this portion of the treatment, the dentist should proceed by A. B. C. D. grinding the tooth out of occlusion. relieving the occlusion in the opposing tooth. taking an additional periapical radiograph of the tooth. instructing the patient in home-care maintenance for this tooth.

8. An oral lesion can be seen in the photograph. What is the most likely clinical diagnosis? A. B. C. D. Lichen planus Verruca vulgaris Actinic cheilitis Fibroma

9. Which of the following represents the treatment-of -choice for the lesion seen in the photograph? A. B. C. D. E. Observation only Incisional biopsy Excisional biopsy Intra-lesional steroid injection Topical application of anti-inflammatory agents

10. During a subsequent afternoon visit that is scheduled for additional dental treatment, the patient becomes pale, sweaty, and tremulous. Administration of which of the following represents the most appropriate course of action for this patient's condition? A. B. C. D. Regular insulin A sugar-containing drink Intravenous glucose Oxygen

11. The decision has been made to extract the impacted third molars. When should they be removed? A. B. C. D. Immediately After the teeth cause problems After the roots are 50%-developed After the roots are fully developed

12. While the dentist is performing root canal therapy on Tooth #31, the patient develops an infection. Which of the following is the most appropriate antibiotic for treating this infection?

A. B. C. D.

Erythromycin Tetracycline hydrochloride An extended-spectrum penicillin An increase in the patient's minocycline

13. After performing root canal treatment, the dentist plans to restore Tooth #31. Which of the following represents the most appropriate restorative treatment for this tooth? A. B. C. D. Case E Amalgam core and cast full crown Prefabricated post-retained amalgam and cast onlay Pin-retained amalgam Resin-bonded composite