AGD Endodontic Diagnosis and Treatment 2 — Questions and Answers
Question 1: A patient presents with a tooth that is tender to percussion but has no response to cold testing. Radiographically, there is a periapical radiolucency. What is the most likely diagnosis?
- Acute apical abscess
- Pulp necrosis with symptomatic apical periodontitis (Correct answer)
- Irreversible pulpitis
- Chronic hyperplastic pulpitis
Correct answer: Pulp necrosis with symptomatic apical periodontitis
Pulp necrosis with symptomatic apical periodontitis presents with no pulp vitality response, percussion sensitivity, and periapical changes on radiograph.
Question 2: Which instrument is used to determine the working length electronically during root canal treatment?
- Endodontic explorer
- Electronic apex locator (Correct answer)
- Gutta-percha cone
- Spreader
Correct answer: Electronic apex locator
Electronic apex locators measure impedance differences to identify the apical foramen and determine accurate working length.
Question 3: During canal preparation, a file separates within the apical third of a curved canal. What is the FIRST recommended step?
- Immediately refer the patient to an endodontist
- Attempt ultrasonic retrieval if trained (Correct answer)
- Pack gutta-percha around the fragment and obturate
- Extract the tooth immediately
Correct answer: Attempt ultrasonic retrieval if trained
Ultrasonic techniques can often retrieve separated instruments from the coronal and middle thirds; the decision to refer depends on fragment location and operator skill.
Question 4: Sodium hypochlorite is used as an irrigant during root canal treatment primarily because of its ability to:
- Lubricate canal walls
- Dissolve organic tissue and kill bacteria (Correct answer)
- Smear layer removal
- Prevent file breakage
Correct answer: Dissolve organic tissue and kill bacteria
Sodium hypochlorite is the gold standard endodontic irrigant due to its potent antimicrobial action and ability to dissolve pulpal remnants.
Question 5: A tooth diagnosed with a chronic apical abscess most commonly presents with:
- Severe spontaneous pain and swelling
- A sinus tract draining to the mucosa (Correct answer)
- Marked sensitivity to cold
- No radiographic findings
Correct answer: A sinus tract draining to the mucosa
Chronic apical abscess is characterized by a sinus tract (parulis) that allows continuous drainage, often making the tooth asymptomatic.
Question 6: Which root canal sealer is classified as a bioceramic material and is known for its excellent biocompatibility?
- AH Plus
- Pulp Canal Sealer
- EndoSequence BC Sealer (Correct answer)
- Roth 811
Correct answer: EndoSequence BC Sealer
EndoSequence BC Sealer is a premixed calcium silicate-based bioceramic sealer with high biocompatibility and excellent sealing ability.
Question 7: In a patient with a fully formed apex, which obturation technique uses thermoplasticized gutta-percha injected into the canal?
- Cold lateral condensation
- Single-cone technique
- Warm vertical compaction
- Thermafil technique (Correct answer)
Correct answer: Thermafil technique
The Thermafil technique uses a plastic carrier coated with alpha-phase gutta-percha that is heated and injected into the prepared canal.
AGD Endodontic Diagnosis and Treatment 2
A patient presents with a tooth that is tender to percussion but has no response to cold testing.
Radiographically, there is a periapical radiolucency.
What is the most likely diagnosis?