Pulp & Periapical Lesions (including osteomyelitis)
1- Which statement is true for dry socket ?
A) Traumatic extraction is the main cause
B) Stimulation of fibrinolysins
C) Contraceptives and pre-surgical infections
D) All of the above
2- Which of the following lesions if not treated most likely to cause periapical lesion ?
A) Internal resorption
B) Reversible pulpitis
C) Chronic hyperplastic pulpitis
D) Acute suppurative pulpitis
3- Which lesion in the oral cavity that can be complicated to a radicular cyst if untreated ?
A) Periapical granuloma
B) Periodontal abscess
C) Periapical abscess
D) All of the above
4- An acute periapical abscess is usually due to......
A) Periapical pocket
B) Occlusal interference
C) Necrotic pulp
D) Chronic gingivitis
5- Classification of pulpitis include the following except.....
A) Focal reversible pulpitis
C)Chronic pulpitis
B) Acute hyperplastic pulpitis
D) Acute pulpitis
6- The chief cells seen in acute periapical abscess are......
A) Macrophages
B) Lymphocytes
C) Multinucleated giant cells
D) Polymorphnuclear leukocytes
7- Radiographic examination of a tooth involved in acute periapical abscess shows.....
A) Well-circumscribed radiolucency
B) Well-circumscribed radiopacity
C) Mixed radiopaque and radiolucent lesion
D) Slight widening of the periodontal ligament space
8- A child complaining from a mass in his lower first molar which showed hyposensititivity in thermal and electric response.
A) Acute Pulpitis
B) Pulp hyperemia
C) Chronic hyperplastic pulpitis
D) Periapical granuloma
9- A patient presents with a painful tooth which he feels high in the oral cavity. The tooth was extremely sensitive to percussion. Regional lymphadenopathy was also present. The most likely diagnosis is .......
A) Periapical granuloma
B) Acute periapical abscess
C) Pulp polyp
D) Pulp hypermia
10- Dull aching type of pain is characteristic feature of .......
A) Focal reversible pulpitis
B) Pulp polyp
C) Chronic pulpitis
D) Acute Pulpitis
11- Cholesterol clefts may be found in histological examination of.........
A) Periapical granuloma
B) Periapical Abscess
C) Chronic pulpitis
D) Acute suppurative Pulpitis
12-Which of the following statements is false about focal reversible pulpitis?
A) Application of ice results in pain which doesn't subside with removal of the thermal stimulus.
B) Responds to electric pulp testing at a lower level of current than contralateral teeth.
C) Sensitivity to percussion is absent.
D) Dilatation of pulpal vessels.
13-Chronic hyperplastic pulpitis (pulp polyp) is essentially:
A) Necrotizing lesion.
B) Suppurative lesion.
C) Proliferation of inflamed pulp tissue.
D) Very sensitive and painful lesion.
14-The earliest response of pulpitis is:
A) Cyst formation.
B) Calcification.
C) Hyalinization.
D) Formation of dental granuloma.
15. The phenomenon by which bacteria circulating in blood accumulate at the site of pulpal inflammation is called as
(a) Chemotaxis
(b) Retrograde pulpitis
(c) Anachoretic pulpitis
(d) Aerodontalgia
16. Most accepted explanation for anachoretic pulpitis is
(a) Increased capillary permeability
(b) Increased vascular pressure
(c) Presence of large number of dilated capillaries
(d) Lack of collateral blood supply
17. The more accepted terminology for pulp hyperemia is
(a) Focal irreversible pulpitis
(b) Focal reversible pulpitis
(c) Subtotal pulpitis
(d) Pulpitis clausa
18. Focal reversible pulpitis is most commonly seen in all of the following cases except
(a) Large metallic restorations
(b) Shallow carious lesions
(c) Deep carious lesions
(d) Restorations with defective margins
19. Pain which increases in intensity as the patient lies down is characteristic of
(a) Focal reversible pulpitis
(b) Acute pulpitis
(c) Chronic hyperplastic pulpitis
(d) Chronic pulpitis
20. Microabscess formation within inflamed pulp is characteristic of
(a) Acute pulpitis
(b) Focal reversible pulpitis
(c) Chronic pulpitis
(d) Pulp hyperemia
21. Sensitivity to electric pulp vitality tester in acute pulpitis is lost in later stages because of
(a) initial Necrosis of pulp
(b) Reduction in inflammatory exudate
(c) Increase in the size of capillaries locally
(d) Decreased secretion of prostaglandins
22. Which amongst the following characteristics is not associated with chronic hyperplastic pulpitis?
(a) Open carious lesion
(b) Occurs in children and young adults
(c) Occurs in people with high tissue resistance
(d) Occurs around margins of a restoration
23. Which teeth are most commonly involved by chronic hyperplastic pulpitis?
(a) Deciduous anteriors and permanent canines
(b) Deciduous molars and permanent 1st molars
(c) Deciduous canines and permanent incisors
(d) Exclusively deciduous molars
24. All of the following except _______ are common radiological features associated with a periapical granuloma.
(a) Thickening of PDL around root apex
(b) Well-defined radiopacity
(c) Root resorption of involved tooth
(d) Well-defined radiolucency with sclerotic borders
25. Foam cells within periapical granulomas are ______ cells that have ingested lipids.
(a) Polymorphonuclear leukocytes
(b) Langerhans cells
(c) Macrophages
(d) Plasma cells
26. Apical periodontal cyst usually occurs as a sequela of
(a) Acute pulpitis
(b) Periodontal abscess
(c) Osteomyelitis
(d) Periapical granuloma
27. Which amongst the following is not a predisposing factor of osteomyelitis?
(a) Trauma to bone
(b) Radiation damage to bone
(c) Paget’s disease
(d) Fibrous dysplasia
28. Condensing osteitis is another name for
(a) Chronic suppurative osteomyelitis
(b) Chronic focal sclerosing osteomyelitis
(c) Chronic diffuse sclerosing osteomyelitis
(d) Garre’s osteomyelitis
29. In which type of osteomyelitis will you find focal gross thickening of periosteum with peripheral reactive bone formation?
(a) Chronic focal sclerosing osteomyelitis
(b) Chronic diffuse sclerosing osteomyelitis
(c) Florid osseous dysplasia
(d) Garre’s osteomyelitis
30. If a periapical abscess drains intraorally through a sinus tract after perforating the buccal cortical plate and surface epithelium it forms a mass of granulation tissue known as
(a) Phoenix abscess
(b) Residual cyst
(c) Parulis
(d) Lateral radicular cyst
31. Chronic apical periodontitis is another name of
(a) Phoenix abscess
(b) Periapical abscess
(c) Periapical granuloma
(d) Periapical cyst
32- In the radiographic picture of acute osteomyelitis which statement is true ?
A) Early osteomyelitis may show a normal radiographic appearance
B) Late osteomyelitis may show a normal radiographic appearance
C) Acute osteomyelitis doesn't appear radiographically
D) None of the above
33- Garre's osteomyelitis is characterizied clinically by ..........
A) Endosteal bone formation
B) Periosteal bone formation
C) Resorption of cortical bone
D) Resorption of medullary bone
34- In diffuse sclerosing osteomyelitis........
A) An inflammatory reaction in the mandible in response to a microorganism of low virulence
B) Show well defined radiolucency
C) Localized to deciduous teeth
D) All of the above
35- Onion skin appearance is a radiographic feature seen in ......
A) Acute pyogenic osteomyelitis
B) Chronic pyogenic osteomyelitis
C) Garrie's osteomyelitis
D) Diffuse sclerosing osteomyelitis
36- The radiographic examination of diffuse sclerosing osteomyelitis shows......
A) Onion skin appearance
B) Moth-eaten appearance
C) Multiple diffuse radiolucencies
D) Cotton wool appearance
37- The dead bone separated from the vital bone is defined as........
A) Involucrum
B) Sequestrum
C) Cloacae
D) A&B
38- Expansion of jaw bones is seen in:
A) Garre's Osteomyelitis
B) Chronic Diffuse sclerosing osteomyelitis
C) Chronic Focal sclerosing osteomyelitis
D) Chronic Suppurative osteomyelitis
39- Focal Sclerosing Osteomyelitis is:
A) Due to excessive periosteal bone formation
B) An extremely painful condition
C) Due to low grade chronic infection
D) A common sequel following sequestrectomy
40-Which of the following conditions is often associated with a vital pulp?
A) Apical cyst
B) Apical scar
C) Condensing osteitis
D) Chronic apical periodontitis
41- Osteomyelitis begins as an inflammation of:
A) Cortical bone
B) Periosteum
C) Medullary bone
D) Periosteum and inner cortex
42- A tooth with a 3 month history of pain, which was worse when hot liquids were in mouth. After extraction, the tooth was split open. The pulp chamber was completely filled with pus. A few remnants of pulp tissue were found in apical end. The condition is:
A) Acute partial pulpitis
B) Acute total pulpitis
C) Suppurative pulpitis
D) Strangulation of pulp
43- A person experiences throbbing pain at night. It's due to:
A) Acute pulpal degeneration
B) Acute periodontal abscess
C) Chronic pulpitis
D) Cellulitis
44- Reversible pulpitis change to irreversible pulpitis primarily because of:
A) Vascular strangulation
B) Reduced host resistance
C) Invasion of microorganisms
D) An increase in microbial virulence
45- Which of the following is more prone to osteomyelitis?
A) Maxilla
B) Zygoma
C) Palatine bone
D) Mandible
46- A 30 year old patient with radiographic appearance of endosteal bone formation, sclerosed bone is likely to be suffered from?
A) Garre's osteomyelitis
B) Chronic focal sclerosing osteomyelitis
C) Acute osteomyelitis
D) Chronic osteomyelitis
47. One of the following is not a predisposing factors for a dry socket:
A) Smoking
B) Oral contraceptive pills
C) Bone pathology
D) Atraumatic extraction
48. Aerodontalgia occurs with:
A) Recently filled teeth or teeth affected by acute pulpitis
B) Recently filled teeth or teeth affected by hyperemia
C) Recently filled teeth or teeth affected by Pulp polyp
D) Recently filled teeth or teeth affected by bacteria
49. The etiology for occurrence of self-strangulation in pulpitis is: (معلش عارف إن إجابات كتير صح لكن عايز السبب المباشر اللي هيأدي للمشكلة)
A) Constricted apical foramen
B) Absence of collateral circulation
C) The pulp is enclosed within a hard dentin chamber
D) Edema on blood vessels
50. Phoenix abscess is:
A) An acute exacerbation of a chronic periapical inflammatory lesion
B) A chronic exacerbation of a acute periapical inflammatory lesion
C) Transformation of periapical granuloma to a cyst
D) Transformation of periapical abscess to periapical granuloma
51.Perforation of the surface epithelium and drain through an intraoral sinus is known as:
A) Osteomyelitis
B) Facial cellulitis
C) Gum boil
D) Sessile swelling
52.Regarding to sensation of Pulp Hyperemia, which sentence is correct:
A. The sensation due to stimulation of unmyelinated axon superficial distributed fibers .
B. The sensation due to stimulation of unmyelinated axon deep distributed fibers
C. The sensation due to stimulation of low conduction velocity fibers due to reversible pulp damage
D. The sensation due to stimulation fast conduction velocity fibers due to reversible pulp damage
53.Patient presents with episodes of pain in a tooth which occurs on ingestion of cold things and disappears as soon as the stimulus is removed. On examination, the tooth in question had large metallic restoration and responds at a lower than normal level to electric pulp tester. Most probable diagnosis is:
A. Focal reversible pulpitis
B. Acute early pulpitis
C. Chronic pulpitis
D. Periapical abscess
54.Which type of Pulpitis will develop under large unlined metal restorations:
A. Pulp Hyperemia
B. Pulp polyp
C. Acute pulpitis
D. Chronic pulpitis
55.An asymptomatic tooth has deep caries on occlusal surface. Radiograph shows a radiopaque mass at apex of the tooth; this mass is most likely to be:
A. Cementoma
B. Condensing osteitis
C. Chronic apical periodontitis
D. Acute apical periodontitis
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