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Saber Pro Odontología study materials
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Saber Pro Odontología practice questions

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Question 1Caries activity, mineral balance and restorative material mechanisms

What is the micromechanical bonding purpose of enamel acid conditioning in an appropriate resin adhesive system, without specifying one concentration or exposure time for every product?

  1. Selectively dissolving hydroxyapatite crystals to create micro-porosities for resin tag micromechanical retention Correct answer.
  2. Completely dissolving the collagen network within the dentin matrix
  3. Sterilizing the cavity floor to eliminate anaerobic pulp bacteria
  4. Forming a covalent chemical bond between calcium phosphate and composite monomers

Explanation

Acid etching of enamel with 35-37% phosphoric acid selectively dissolves prism cores or prism peripheries, creating high-energy micro-porosities (depth of 10-30 micrometers). Fluid resin bonding agents penetrate these micro-irregularities by capillary action, polymerizing to form micromechanical resin tags.

Question 2Caries activity, mineral balance and restorative material mechanisms

In contemporary adhesive systems, what defines the 'hybrid layer' originally described by Nakabayashi?

  1. The micromechanical interdiffusion zone formed by resin monomers polymerizing within demineralized dentin collagen fibrils Correct answer.
  2. The chemical bond between glass ionomer polyacrylic acid and hydroxyapatite
  3. The layer of residual cutting debris compacted into dentinal tubules (smear plug)
  4. The interface formed between the glass filler particles and silane coupling agent

Explanation

The hybrid layer (zone d'hybridation) is formed when adhesive hydrophilic monomers (e.g., HEMA, Bis-GMA) infiltrate the exposed collagen fibril meshwork produced by acid demineralization of dentin and polymerize in situ, creating a molecular-level mechanical interlocking between tooth structure and restorative resin.

Question 3Caries activity, mineral balance and restorative material mechanisms

During a routine clinical examination under clean, dry conditions with adequate lighting, a clinician observes an opaque, chalky white spot lesion (mancha blanca) on the cervical third of the facial surface of tooth 11. What is the fundamental histological characteristic of this non-cavitated early carious lesion?

  1. Total cavitary collapse of the outer enamel with exposed infected tubular dentin
  2. Subsurface demineralization with an intact, relatively hypermineralized external surface layer Correct answer.
  3. Complete pulp chamber obliteration by secondary reparative dentin
  4. Extensive bacterial colonization of the odontoblastic layer with micro-abscess formation

Explanation

Histologically, the incipient enamel carious lesion (white spot lesion) is characterized by subsurface demineralization (body of the lesion exhibiting 5% to 25% pore volume) beneath a relatively intact and well-mineralized outer surface zone (~30-50 micrometers thick), maintained by constant surface remineralization dynamics from saliva.

Question 4Endodontic diagnosis, disinfection, and structural prognosis

What does a conventional electric pulp test primarily assess?

  1. Neural response rather than direct pulpal blood flow Correct answer.
  2. The amount of calcium in root dentin
  3. The exact number of living pulp cells
  4. The diameter of the apical foramen

Explanation

Electric pulp testing elicits a sensory response and must be interpreted with other findings because it does not directly demonstrate pulpal circulation.

Question 5Endodontic diagnosis, disinfection, and structural prognosis

A recently traumatized immature permanent incisor does not respond to a sensibility test. What is the best interpretation?

  1. The tooth necessarily has a vertical root fracture
  2. Immediate extraction is required in every case
  3. The result proves that apical growth has stopped permanently
  4. One negative test alone does not establish pulp necrosis Correct answer.

Explanation

After trauma and in immature teeth, neural responsiveness may be unreliable; diagnosis should integrate history, serial testing, examination, and imaging.

Question 6Periodontal diagnosis, risk, and long-term stability

What finding most directly distinguishes periodontitis from plaque-induced gingivitis on an otherwise intact periodontium?

  1. Redness limited to the gingival margin
  2. Bleeding after gentle probing alone
  3. Loss of periodontal attachment attributable to periodontal disease Correct answer.
  4. Visible supragingival plaque alone

Explanation

Periodontitis involves destruction of the tooth-supporting attachment apparatus; bleeding and redness alone can occur with reversible gingival inflammation.

Question 7Periodontal diagnosis, risk, and long-term stability

A site has a probing depth of 4 mm and gingival recession of 2 mm from the cementoenamel junction. What is its clinical attachment level?

  1. 8 mm
  2. 6 mm Correct answer.
  3. 4 mm
  4. 2 mm

Explanation

With the gingival margin apical to the cementoenamel junction, clinical attachment loss is the probing depth plus recession.

Question 8Restore function while respecting structure and supporting tissues

How do retention and resistance form differ for a conventional crown preparation?

  1. Retention opposes removal along the path of insertion; resistance opposes other dislodging forces Correct answer.
  2. Retention is the same as pulpal vitality
  3. Both refer only to the shade of ceramic
  4. Resistance means the tooth has no caries

Explanation

Preparation geometry should help resist both withdrawal and functional tipping; these related mechanical requirements are distinct from esthetics or the biological state of the tooth.

Question 9Restore function while respecting structure and supporting tissues

What is the purpose of a ferrule in restoring a structurally compromised endodontically treated tooth?

  1. It makes every root fracture repairable
  2. The ferrule sterilizes the root canal
  3. A band of remaining coronal tooth structure helps resist functional fracture stresses Correct answer.
  4. A post automatically replaces the need for sound tooth structure

Explanation

A ferrule uses remaining tooth structure encircled by the restoration to improve stress management; prognosis still depends on the overall tooth and restorative design.

Question 10Surgical assessment, anatomy, bleeding, and complications

Which sensory deficit most directly suggests inferior alveolar nerve involvement after mandibular surgery?

  1. Altered sensation of the lower lip and chin Correct answer.
  2. Loss of vision in one eye
  3. Loss of shoulder abduction
  4. Isolated numbness of the forehead

Explanation

The inferior alveolar nerve continues through the mental nerve to supply the lower lip and chin, making these areas useful for sensory assessment.

Question 11Surgical assessment, anatomy, bleeding, and complications

Which structure is particularly relevant to altered general sensation of the tongue after lower third-molar surgery?

  1. Phrenic nerve
  2. Greater occipital nerve
  3. Lingual nerve Correct answer.
  4. Optic nerve

Explanation

The lingual nerve supplies general sensation to the anterior tongue and lies near the mandibular third-molar region, creating a recognized surgical risk.

Question 12Describe lesions, construct differentials, and obtain a diagnosis

A persistent indurated ulcer on the lateral tongue has no clear traumatic explanation. What is the most appropriate next diagnostic priority?

  1. Observation indefinitely without documentation
  2. Prompt specialist assessment and biopsy planning Correct answer.
  3. Repeated polishing of adjacent intact teeth as definitive management
  4. Reassurance that all painless ulcers are harmless

Explanation

A persistent unexplained indurated ulcer is a concerning finding; a timely tissue diagnosis or appropriate referral takes priority over unsupported reassurance.

Question 13Describe lesions, construct differentials, and obtain a diagnosis

What does the clinical term leukoplakia describe?

  1. A predominantly white oral patch diagnosed after excluding other definable causes Correct answer.
  2. Any white material that wipes off the mucosa
  3. A guaranteed benign response to spicy food
  4. A histologic diagnosis of invasive carcinoma in every case

Explanation

Leukoplakia is a clinical exclusion diagnosis for a white lesion; histopathology is needed when indicated to evaluate dysplasia or another underlying process.

Question 14Care for the developing dentition with risk-based decisions

Why does the frequency of fermentable carbohydrate exposure matter in caries risk assessment?

  1. Repeated acid challenges can limit the time available for remineralization Correct answer.
  2. Only the color of the food affects caries
  3. Frequency has no effect if total daily intake is unchanged
  4. All carbohydrates permanently sterilize plaque

Explanation

Caries risk reflects the balance of repeated demineralizing challenges and protective factors, so exposure pattern is relevant alongside quantity, fluoride, and biofilm control.

Question 15Care for the developing dentition with risk-based decisions

What is the main anticaries purpose of topical fluoride varnish?

  1. Change primary teeth into permanent teeth
  2. Support remineralization and reduce susceptibility to demineralization Correct answer.
  3. Remove every established cavitated lesion
  4. Replace all need for plaque control

Explanation

Topical fluoride supports mineral balance at the tooth surface, but its use complements risk reduction and does not mechanically restore a cavitated defect.

Question 16Diagnose the cause before selecting mechanics or appliances

What biological process permits orthodontic tooth movement under controlled force?

  1. Remodeling of the periodontal ligament and adjacent alveolar bone Correct answer.
  2. Permanent dissolution of all root cementum
  3. Immediate stretching of enamel into a new shape
  4. Movement of the crown while the root remains fixed forever

Explanation

Orthodontic force produces tissue responses in the periodontal ligament and surrounding bone, allowing movement through coordinated remodeling rather than reshaping enamel.

Question 17Diagnose the cause before selecting mechanics or appliances

What does anchorage describe in orthodontic mechanics?

  1. The color of the brackets
  2. Resistance to unwanted movement of supporting teeth or structures Correct answer.
  3. A guarantee that no tooth will move
  4. The amount of fluoride in a mouth rinse

Explanation

Anchorage planning controls where reaction forces are expressed, helping achieve intended movement while limiting undesirable displacement of the supporting unit.

Question 18Imaging justification, geometry, and responsible interpretation

What is the principal justification for prescribing dental imaging?

  1. Replacement of history taking
  2. A clinical question for which the expected diagnostic benefit outweighs the imaging risk Correct answer.
  3. The patient's request for the largest image volume regardless of need
  4. A fixed need for every possible image at every visit

Explanation

Imaging selection follows clinical assessment and a defined diagnostic purpose, rather than indiscriminate exposure or a belief that more images always improve care.

Question 19Imaging justification, geometry, and responsible interpretation

When CBCT is indicated, what field of view should generally be chosen?

  1. The smallest field sufficient to answer the clinical question Correct answer.
  2. A field that intentionally excludes the lesion
  3. The largest available field for every patient
  4. A field selected only by the patient's height

Explanation

Field selection balances diagnostic coverage against unnecessary exposure, while still including the anatomy required to answer the specific clinical question.

Question 20Read evidence and design programs for the population

What does the prevalence of untreated caries describe in a defined survey population?

  1. Only new cases arising during future follow-up
  2. The probability that treatment will succeed
  3. The number of restorations placed per clinician
  4. The proportion with untreated caries at the specified assessment time Correct answer.

Explanation

Prevalence describes existing disease within a defined population and time frame, so its interpretation depends on the case definition and who was assessed.

Question 21Read evidence and design programs for the population

What does disease incidence measure in a longitudinal study?

  1. All cases ever diagnosed without a time reference
  2. Only the severity of disease at baseline
  3. The percentage of participants satisfied with the clinic
  4. New cases developing among the population at risk over a defined period Correct answer.

Explanation

Incidence concerns the occurrence of new disease over time among people initially at risk, distinguishing it from the burden of existing cases.

Question 22Prevent infection and prepare for physiological deterioration

Why can pulse oximetry alone be insufficient to detect early hypoventilation during sedation?

  1. Oxygen saturation may remain acceptable while ventilation deteriorates, especially with supplemental oxygen Correct answer.
  2. The monitor replaces continuous clinical observation
  3. Pulse oximetry directly measures exhaled carbon dioxide
  4. Normal saturation proves the airway cannot obstruct

Explanation

Oxygenation and ventilation are different physiological functions, so monitoring plans must not assume that a saturation reading provides a complete assessment of breathing.

Question 23Prevent infection and prepare for physiological deterioration

What information does capnography principally provide during procedural sedation?

  1. A direct measurement of pulpal blood flow
  2. The exact depth of dental caries
  3. The total number of viable oral bacteria
  4. Exhaled carbon dioxide patterns that help assess ventilation Correct answer.

Explanation

Capnography provides breath-related carbon dioxide information and waveform trends, supporting recognition of ventilatory problems alongside other monitoring and direct patient assessment.

Question 24Caries activity, mineral balance and restorative material mechanisms

A 45-year-old reports pain in a heavily restored 36 that occurs when biting a grain and is worst on release of pressure. Cold does not linger. The historia clínica has no nocturnal spontaneous pain. Which diagnostic impression is most likely?

  1. Symptomatic irreversible pulpitis
  2. Cracked tooth (cracked-tooth syndrome) Correct answer.
  3. Pulp necrosis with acute apical abscess
  4. Referred pain from maxillary sinusitis

Explanation

Pain on biting, especially on release, in a restored posterior tooth is the classic historia of a crack. Thermal tests may be normal or briefly sharp, unlike lingering irreversible pulpitis. The odontólogo general should look for a crack with transillumination and bite testing rather than jumping to endodontics or sinus disease.

Question 25Caries activity, mineral balance and restorative material mechanisms

A 40-year-old reports morning jaw stiffness. Exam shows matching flat occlusal wear on opposing posterior teeth, shiny wear facets, and masseter hypertrophy. There are no erosive palatal cups. Which process in the sistema estomatognático is the best diagnostic impression?

  1. Attrition from bruxism Correct answer.
  2. Erosion from gastric acid
  3. Abrasion from a coarse cervical scrubbing habit only
  4. Abfraction as a standalone diagnosis without occlusal wear

Explanation

Attrition is tooth-to-tooth wear. Matching facets, hypertrophy, and morning stiffness from the historia clínica indicate bruxism. Erosion from gastric acid typically cups palatal enamel of maxillary incisors and is not “matching opposing flats.”

Question 26Caries activity, mineral balance and restorative material mechanisms

A 65-year-old on multiple xerogenic medications has a sudden rise in cervical and root caries despite lifelong low caries. Which oral–systemic mechanism should the odontólogo general recognize?

  1. Hyposalivation reducing buffering and clearance of sugars Correct answer.
  2. Excess saliva flooding the mouth with minerals
  3. Fluorosis appearing for the first time at age 65
  4. A new Angle Class III relationship caused by tablets

Explanation

Drug-induced hyposalivation is a major oral–systemic pathway to rampant cervical caries in older adults. The historia clínica of polypharmacy plus new root caries is more informative than blaming “old age” alone. Prevention must address saliva, fluoride, and diet, not only restorations.

Question 27Caries activity, mineral balance and restorative material mechanisms

A 45-year-old with chronic heartburn has cupped, glazed palatal enamel on the maxillary incisors and first molars. Occlusal wear facets are not matching. Which oral–systemic process is most likely?

  1. Attrition from nocturnal bruxism only
  2. Abrasion from a pipe stem
  3. Abfraction from toothbrushing the palate
  4. Dental erosion associated with gastroesophageal reflux Correct answer.

Explanation

Gastric acid preferentially erodes palatal surfaces of maxillary teeth. GERD in the historia clínica plus non-matching cupped enamel is an oral–systemic diagnosis. The odontólogo general should coordinate with medical care, not only restore enamel.

Question 28Caries activity, mineral balance and restorative material mechanisms

A 19-year-old has a smooth, opaque white spot on the facial of 11 that does not cavitate when probed gently. Which basic treatment by the odontólogo general is most appropriate?

  1. Immediate full-crown preparation
  2. Extraction of 11
  3. Root canal treatment
  4. Noninvasive management with plaque control and topical fluoride rather than a surgical Class V preparation Correct answer.

Explanation

Noncavitated (white-spot) lesions are managed by disrupting biofilm and applying fluoride to promote remineralization. Drilling a smooth white spot is not first-line basic treatment. The odontólogo general matches intervention intensity to lesion activity and cavitation.

Question 29Caries activity, mineral balance and restorative material mechanisms

A 4-year-old with ECC has several cavitated posterior lesions. The odontólogo general considers 38% silver diamine fluoride. Which preventive-consent point is essential?

  1. SDF never changes tooth color
  2. SDF can arrest caries but stains arrested lesions black; informed consent must include this Correct answer.
  3. SDF replaces the need to ever restore or extract abscessed teeth
  4. SDF is an antibiotic for cellulitis

Explanation

SDF arrests many dentin lesions and is a useful pediatric/community preventive-restorative tool, but it blackens carious tooth structure. Parents must be informed. SDF does not treat a spreading odontogenic infection or a necrotic abscessed molar as the only therapy.

Question 30Caries activity, mineral balance and restorative material mechanisms

Two patients eat similar weekly amounts of sugar. Patient A consumes it in two meals; Patient B sips sweet drinks all day. Which preventive interpretation is most accurate?

  1. Total weekly grams are the only number that matters; frequency is irrelevant
  2. Patient B’s all-day sipping creates more acid attacks and higher caries risk despite similar weekly sugar Correct answer.
  3. Patient A is always higher risk because meals are “worse” than sipping
  4. Neither patient needs fluoride if sugar totals match

Explanation

Stephan-curve logic: each exposure drops plaque pH. Grazing and sipping multiply demineralization cycles. The odontólogo general therefore targets frequency, not only a weekly sugar total. Fluoride remains indicated by risk, not by matching grocery receipts.

Question 31Periodontal diagnosis, risk, and long-term stability

A 52-year-old smoker’s historia clínica lists bleeding on brushing for years. Probing depths are 5–6 mm with 3–4 mm clinical attachment loss on several posterior teeth and bleeding on probing. There is no pain. Which diagnosis of the periodontium is most accurate?

  1. Plaque-induced gingivitis without attachment loss
  2. Periodontitis based on clinical attachment loss and probing depth Correct answer.
  3. Necrotizing ulcerative gingivitis
  4. Pericoronitis of a partially erupted third molar

Explanation

Periodontitis is diagnosed when inflammation is accompanied by detectable clinical attachment loss, not by bleeding alone. The historia clínica of chronic bleeding plus 3–4 mm CAL and 5–6 mm pockets places this patient beyond gingivitis. Smoking is a risk modifier but does not change the core periodontal diagnosis.

Question 32Periodontal diagnosis, risk, and long-term stability

A 26-year-old in the second trimester reports gingival bleeding that began after she became pregnant. The historia clínica shows previously stable gums. Exam reveals generalized erythematous, swollen papillae with plaque and no attachment loss. Which impression diagnostic is most likely?

  1. Desquamative gingivitis from mucous membrane pemphigoid
  2. Drug-induced gingival overgrowth from nifedipine
  3. Leukemic gingival infiltrate
  4. Pregnancy-associated gingivitis of the sistema estomatognático Correct answer.

Explanation

Pregnancy-associated gingivitis is a plaque-induced inflammatory response amplified by hormonal change, typically without new attachment loss. The historia clínica that bleeding started in pregnancy and the absence of CAL support this impression. The odontólogo general still treats plaque; hormones explain the exaggerated response, they do not replace biofilm control.

Question 33Periodontal diagnosis, risk, and long-term stability

A 22-year-old student who smokes and has slept little presents with sudden, severe gingival pain and foul breath. Exam shows punched-out interdental papillae covered by a grayish pseudomembrane and spontaneous bleeding. Which diagnosis is most consistent with this historia clínica?

  1. Chronic periodontitis Stage II
  2. Pregnancy gingivitis
  3. Necrotizing ulcerative gingivitis Correct answer.
  4. Primary herpetic gingivostomatitis limited to attached gingiva of 16 only

Explanation

Necrotizing ulcerative gingivitis is an acute, painful infection with necrosis of papillae, fetor oris, and bleeding, classically in young adults under stress who smoke. It is a clinical diagnosis from the historia clínica and exam. It is not the same as slowly progressive periodontitis.

Question 34Periodontal diagnosis, risk, and long-term stability

A 55-year-old with type 2 diabetes has generalized periodontitis. Which oral–systemic statement should guide the odontólogo general’s diagnostic interview?

  1. Diabetes and periodontitis have a bidirectional relationship: poor glycemic control worsens periodontitis, and periodontitis is associated with poorer glycemic control Correct answer.
  2. Diabetes protects against attachment loss
  3. Periodontitis cannot occur in people with diabetes
  4. Oral health is unrelated to HbA1c

Explanation

The diabetes–periodontitis link is bidirectional. Hyperglycemia increases periodontal destruction; periodontal inflammation is associated with higher HbA1c, and nonsurgical therapy has shown modest HbA1c reductions in reviews. The historia clínica must include diabetes control, not only pocket depths.

Question 35Periodontal diagnosis, risk, and long-term stability

A systemically healthy adult has Stage II periodontitis. Which basic treatment is first-line for the odontólogo general?

  1. Systemic antibiotics as the only therapy, without instrumentation
  2. Immediate extraction of all teeth with 4 mm pockets
  3. Oral hygiene instruction plus scaling and root planing, then reevaluation Correct answer.
  4. Orthognathic surgery

Explanation

Cause-related periodontal therapy is plaque control plus scaling and root planing, followed by reevaluation (often around 4–8 weeks). Antibiotics are not a substitute for instrumentation in ordinary Stage II disease. Everyday general-dentist care starts here, with referral if complexity exceeds scope.

Question 36Periodontal diagnosis, risk, and long-term stability

After SRP, a patient still has 5 mm pockets with food trapping. Which home-care preventive measure should the odontólogo general add?

  1. Interdental cleaning sized to the embrasure (brushes or other aids), not only occlusal brushing Correct answer.
  2. Stop all interdental cleaning to “rest the gums”
  3. Brush only once a week
  4. Use a hard brush horizontally on exposed roots as the only method

Explanation

Periodontal maintenance fails without interdental plaque control. Aids must fit the embrasure. This preventive measure affects both oral attachment and, indirectly, systemic inflammatory burden. Hard horizontal scrubbing causes abrasion, not better periodontal health.

Question 37Endodontic diagnosis, disinfection, and structural prognosis

A 35-year-old describes spontaneous nocturnal pain in tooth 46 that lingers more than 30 seconds after cold. Ibuprofen helps only briefly. Cold testing on 46 produces a prolonged, referred ache to the ear; percussion is mildly tender. Which pulpal diagnosis best integrates this historia clínica?

  1. Reversible pulpitis
  2. Symptomatic irreversible pulpitis Correct answer.
  3. Pulp necrosis without apical involvement
  4. Cracked tooth with a vital asymptomatic pulp

Explanation

Lingering thermal pain, spontaneous or nocturnal episodes, and referred pain indicate symptomatic irreversible pulpitis. The pulp cannot be expected to return to health after a simple restoration. Percussion tenderness may add symptomatic apical periodontitis but does not reverse the pulpal diagnosis.

Question 38Endodontic diagnosis, disinfection, and structural prognosis

A 40-year-old says tooth 21 “died” after a blow two years ago and now shows a small buccal pimple that sometimes drains. The tooth is gray, not tender, and does not respond to cold; adjacent teeth respond normally. Which diagnostic impression is most accurate?

  1. Reversible pulpitis of 21
  2. Symptomatic irreversible pulpitis
  3. Acute apical abscess with cellulitis
  4. Pulp necrosis with chronic apical abscess (sinus tract) Correct answer.

Explanation

No thermal response, gray discoloration after trauma, and a draining sinus tract indicate necrosis with chronic apical abscess. Pain is often minimal because the tract decompresses the area. The odontólogo general links the trauma historia clínica to the present nonvital, draining incisor.

Question 39Endodontic diagnosis, disinfection, and structural prognosis

A 50-year-old has a 9 mm isolated probing depth on the palatal of 26 that reaches the apex, a necrotic pulp to cold, and a wide periapical radiolucency. Adjacent sites probe 3 mm. Which diagnostic impression of this combined lesion is most coherent?

  1. Primary periodontal lesion with a vital pulp
  2. Occlusal trauma without pulpal or periodontal breakdown
  3. Endodontic–periodontal lesion with a necrotic pulp and a probing path to the apex Correct answer.
  4. Reversible pulpitis with gingivitis only

Explanation

A probing path to the apex plus a nonvital pulp and apical radiolucency indicates an endodontic–periodontal lesion, often a primary endodontic lesion draining through the sulcus. Isolated deep probing unlike the rest of the mouth is a clue. The odontólogo general must not treat this as ordinary periodontitis while leaving a necrotic pulp.

Question 40Endodontic diagnosis, disinfection, and structural prognosis

A 33-year-old locates pain to the left face. Cold lingers on 36, but the patient also has morning masseter tightness. Bite testing on a Tooth Slooth is negative on 36; percussion of 36 is positive. Which finding most reliably attributes the pain to the pulp–periapex rather than to a muscular TMD complaint?

  1. Lingering cold response and percussion tenderness of 36 Correct answer.
  2. Bilateral masseter hypertrophy alone
  3. A history of exam stress
  4. Clicking of the left TMJ without locking

Explanation

Odontogenic pain is localized by reproducing symptoms on the suspect tooth. Lingering cold and percussion tenderness of 36 identify symptomatic irreversible pulpitis with symptomatic apical periodontitis. TMD signs can coexist and must be recorded, but they do not override a tooth that objectively reproduces the chief complaint.

Question 41Endodontic diagnosis, disinfection, and structural prognosis

Tooth 11 is gray. Cold spray on 11 produces no response; 12 and 21 respond briskly. Which interpretation of this complementary pulp test is most appropriate?

  1. 11 is definitely vital because color change proves blood flow
  2. The test shows irreversible pulpitis of 11
  3. EPT numerical values prove 11 is twice as inflamed as 12
  4. 11 is nonresponsive compared with controls, supporting pulp necrosis pending radiographic correlation Correct answer.

Explanation

Sensibility tests are interpreted against control teeth. No response on a discolored incisor with normal controls supports necrosis. Cold does not measure blood flow directly, so the odontólogo general still correlates with a periapical radiograph and history (especially trauma).

Question 42Endodontic diagnosis, disinfection, and structural prognosis

Tooth 46 is extremely tender to vertical percussion and to biting. Cold lingering is also present. Which complementary finding most supports adding symptomatic apical periodontitis to the pulpal diagnosis?

  1. A positive percussion test on 46 Correct answer.
  2. A geographic-tongue pattern on the dorsum
  3. A Class I molar relationship
  4. A torus palatinus

Explanation

Percussion and bite tests assess the periodontal ligament. Tenderness supports symptomatic apical periodontitis in addition to the pulpal diagnosis suggested by lingering cold. Anatomic variants and occlusion class do not corroborate apical inflammation.

Question 43Endodontic diagnosis, disinfection, and structural prognosis

An 8-year-old’s tooth 11 was avulsed and replanted yesterday. Today EPT and cold give no response. The tooth is slightly mobile, socket intact. Which interpretation of these complementary tests is most appropriate?

  1. Immediate pulpectomy because tests prove necrosis at 24 hours
  2. Extract 11 because a silent EPT means the tooth cannot survive
  3. Diagnose chronic apical abscess on the basis of EPT alone
  4. Treat sensibility tests as temporarily unreliable after trauma and follow vitality over subsequent visits Correct answer.

Explanation

After luxation or avulsion, neural response may be absent for weeks even if the pulp still has blood supply. A silent EPT at 24 hours does not prove necrosis. The odontólogo general combines color, mobility, radiographs, and serial testing rather than rushing to pulpectomy on one complementary test.

Question 44Endodontic diagnosis, disinfection, and structural prognosis

Deep occlusal caries in 36 approaches the pulp on a bitewing. The patient is asymptomatic. Which pair of exámenes complementarios should the odontólogo general obtain before choosing excavation, pulp capping, or endodontics?

  1. TMJ MRI and a cephalogram
  2. Only an extraoral photograph
  3. Cold sensibility testing of 36 plus a periapical radiograph Correct answer.
  4. Only transillumination of the lips

Explanation

Before treating deep caries, the clinician must know whether the pulp is responsive and whether the apex is already rarefied. Cold testing plus a periapical radiograph corroborate the restorative versus endodontic decision. Bitewings alone do not show the apex.

Question 45Endodontic diagnosis, disinfection, and structural prognosis

A 7-year-old’s newly erupted 21 has an open apex and was subluxated one week ago. EPT is silent; a cold test is equivocal. Which statement about these complementary tests is most accurate?

  1. EPT is more reliable than cold in immature teeth
  2. Cold testing is generally more reliable than EPT in immature teeth, and a silent test one week after trauma does not by itself prove necrosis Correct answer.
  3. Any silent EPT mandates immediate apexification
  4. Pulp tests are unnecessary in children

Explanation

The plexus of Raschkow is incomplete for years after eruption, so EPT is often unreliable in immature teeth. Cold is preferred, yet even thermal tests can be falsely negative after trauma. The odontólogo general follows color, radiographs, and serial exams rather than treating a number on the EPT machine.

Question 46Endodontic diagnosis, disinfection, and structural prognosis

A well-defined periapical radiolucency is seen at the apex of a nonvital 22. Which limitation of this complementary image must the odontólogo general respect?

  1. The film proves the lesion is a nasopalatine duct cyst
  2. The film proves the lesion is a keratocyst
  3. The film proves malignancy
  4. A radiograph cannot reliably distinguish a periapical granuloma from a radicular cyst Correct answer.

Explanation

Periapical granuloma and radicular cyst can look identical on a periapical radiograph. Size and cortication are not histologic proof. The complementary exam supports “apical periodontitis associated with a necrotic pulp,” not a cyst-versus-granuloma claim.

Question 47Endodontic diagnosis, disinfection, and structural prognosis

A root-filled 46 has a new isolated 8 mm probing depth on the buccal and a J-shaped radiolucency along the root. Which complementary interpretation is most concerning for a vertical root fracture?

  1. Isolated deep probing plus a J-shaped (halo) radiolucency on a root-filled tooth Correct answer.
  2. Generalized 3 mm probing with no bone loss
  3. A torus mandibularis on the lingual
  4. A vital response to cold on 46

Explanation

Vertical root fracture classically produces a narrow isolated pocket and a J-shaped or halo radiolucency on an endodontically treated tooth. Complementary probing and the PA pattern together raise this suspicion. A vital cold test would argue the tooth is not the typical root-filled VRF case.

Question 48Endodontic diagnosis, disinfection, and structural prognosis

A 20-year-old has a long-standing carious 46. The periapical radiograph shows a well-defined radiopacity at the apex with a remaining PDL outline; the tooth is still responsive to cold, though delayed. Which complementary radiographic diagnosis is most likely?

  1. Periapical cemental dysplasia in an edentulous site
  2. Florid cemento-osseous dysplasia of all four quadrants
  3. Condensing osteitis (focal sclerosing osteomyelitis) associated with chronic pulpal inflammation Correct answer.
  4. Garrè (proliferative) periostitis of the maxillary sinus

Explanation

Condensing osteitis is a localized apical radiopacity at a tooth with chronic pulpitis, often a mandibular first molar in a young adult. The tooth may still respond. Complementary imaging plus vitality testing separate this from cemento-osseous dysplasia, which is not centered on a grossly carious vital-to-inflamed molar in this way.

Question 49Endodontic diagnosis, disinfection, and structural prognosis

An immunocompetent adult has symptomatic irreversible pulpitis of 46, no swelling, no fever. Definitive treatment is available today. Which treatment plan is most consistent with current antibiotic-stewardship evidence used in general dentistry?

  1. Seven days of amoxicillin as the only treatment, leaving the pulp closed
  2. Clindamycin “just in case” without pulp therapy
  3. Watchful waiting for six months
  4. Urgent pulpotomy or root canal treatment (and analgesia); do not use systemic antibiotics as a substitute for source control Correct answer.

Explanation

The 2019 ADA guideline recommends against antibiotics for symptomatic irreversible pulpitis in immunocompetent adults when definitive conservative dental treatment is available. Source control (pulpotomy or RCT) plus pain control is the basic treatment. Antibiotics do not treat an inflamed pulp inside a closed tooth.

Question 50Endodontic diagnosis, disinfection, and structural prognosis

When is ART (tratamiento restaurador atraumático) not an appropriate basic treatment?

  1. A cavitated dentin lesion without pulp symptoms, swelling, or fistula, in a community setting
  2. A tooth with irreversible pulpitis, swelling, or a draining fistula Correct answer.
  3. A small dentin cavity in a cooperative child with no pulp involvement
  4. A preventive ART sealant on a high-risk fissure

Explanation

ART restores cavitated dentin lesions with hand excavation and glass ionomer when the pulp is not irreversibly involved. Swelling, fistula, or irreversible pulpitis need pulpal treatment or extraction, not a GIC plug over an abscessed pulp. Knowing the contraindication is part of everyday general-dentist decision making.