AGD Clinical Skills & Patient Care in General Dentistry 2 — Questions and Answers
Question 1: When performing a pulp vitality test, which method is considered the MOST reliable for assessing pulp status in a mature permanent tooth?
- Thermal cold test using Endo-Ice
- Electric pulp testing
- Laser Doppler flowmetry (Correct answer)
- Percussion testing
Correct answer: Laser Doppler flowmetry
Laser Doppler flowmetry measures actual blood flow and is the most reliable indicator of pulp vitality, though thermal and electric tests are more commonly used in practice.
Question 2: A patient presents with a 3 mm probing depth, no bleeding on probing, and no radiographic bone loss. How is this classified?
- Generalized chronic periodontitis
- Healthy periodontium (Correct answer)
- Gingivitis on reduced periodontium
- Stage I periodontitis
Correct answer: Healthy periodontium
A probing depth of ≤3 mm with no bleeding on probing and no bone loss indicates a healthy periodontium by the 2017 AAP/EFP classification.
Question 3: Which local anesthetic has the longest duration of action for pulpal anesthesia during an inferior alveolar nerve block?
- 2% Lidocaine with 1:100,000 epinephrine
- 3% Mepivacaine plain
- 0.5% Bupivacaine with 1:200,000 epinephrine (Correct answer)
- 4% Articaine with 1:100,000 epinephrine
Correct answer: 0.5% Bupivacaine with 1:200,000 epinephrine
Bupivacaine 0.5% provides the longest pulpal anesthesia (up to 90 minutes) and is preferred for lengthy procedures.
Question 4: During crown preparation, the ideal total occlusal convergence (taper) for a full-coverage crown is approximately:
- 2–4 degrees
- 6–12 degrees (Correct answer)
- 14–20 degrees
- 22–28 degrees
Correct answer: 6–12 degrees
A total occlusal convergence of 6–12 degrees provides optimal retention and resistance form for full-coverage crown preparations.
Question 5: A patient taking warfarin needs a simple extraction. The INR result is 2.8. What is the most appropriate course of action?
- Postpone surgery until INR is below 1.5
- Proceed with extraction using local hemostatic measures (Correct answer)
- Discontinue warfarin 7 days before extraction
- Refer to a hospital setting only
Correct answer: Proceed with extraction using local hemostatic measures
Current guidelines support proceeding with simple extractions in patients with an INR ≤3.5 using local hemostatic measures without altering anticoagulation therapy.
Question 6: Which suture material is MOST appropriate for closing a flap in an area where the patient is unlikely to return for suture removal?
- 3-0 silk
- 4-0 nylon
- 4-0 polyglycolic acid (Vicryl) (Correct answer)
- 2-0 black silk
Correct answer: 4-0 polyglycolic acid (Vicryl)
Polyglycolic acid (Vicryl) is a resorbable suture that eliminates the need for a removal appointment, making it ideal for patients with poor follow-up compliance.
Question 7: When taking a bite-wing radiograph, the horizontal angulation error results in which image artifact?
- Foreshortening of teeth
- Elongation of teeth
- Overlapping of contact areas (Correct answer)
- Cone-cutting of the image
Correct answer: Overlapping of contact areas
Incorrect horizontal angulation causes the X-ray beam to strike the contact areas obliquely, producing overlapping (superimposition) of proximal surfaces.
AGD Clinical Skills & Patient Care in General Dentistry 2
When performing a pulp vitality test, which method is considered the MOST reliable for assessing pulp status in a mature permanent tooth?