Endodontics Question Bank

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1. Clinical manifestations of facial fractures include all of the following except:

The exception is narrowing of the intercanthal distance; midface trauma (e.g., naso-orbito-ethmoid fractures) typically causes widening (telecanthus), not narrowing, of the intercanthal distance. Battle's sign, floor-of-mouth ecchymosis, and cranial nerve impairment are genuine signs of facial fractures.

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2. Xerostomic drugs include all of the following except:

All of the listed drug classes, antihistamines, antihypertensives, antidepressants, sedative/hypnotics, antiseizure, antiparkinson agents, and proton pump inhibitors, can cause xerostomia, so all of the above is correct.

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3. All of the following are useful in treating patients with xerostomia except:

Alcohol-based mouthwashes worsen xerostomia by drying the oral mucosa, so they are not useful for treating dry mouth; sugar-free gum/mints, supplemental fluoride, and pilocarpine (a salivary stimulant) are all helpful, making the alcohol-based rinse the exception.

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4. Which of the following salivary stimulants are approved by the FDA to be used for the relief of xerostomia?

The salivary stimulants FDA-approved for xerostomia are the cholinergic agonists pilocarpine HCl and cevimeline HCl, which stimulate residual functional salivary tissue. Bromhexine and anethole trithione are not FDA-approved for this use.

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5. Pilocarpine use is a relative contraindication in patients with which of the following systemic conditions?

Pilocarpine is a cholinergic (muscarinic) agonist, so it is relatively contraindicated in cardiovascular disease, asthma, and chronic pulmonary disease, because cholinergic stimulation can worsen bronchospasm and cardiac/respiratory conditions. Thus all of the above apply.

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6. What complication is commonly seen if codeine is taken during the third trimester of pregnancy?

Codeine (an opioid) taken in the third trimester can cause neonatal respiratory depression (breathing difficulties) and withdrawal, because opioids cross the placenta and depress the fetal/neonatal respiratory drive.

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7. Which of the following is the most common multilocular radiolucency found in the jaws?

The odontogenic keratocyst (keratocystic odontogenic tumor) is the most common multilocular radiolucency of the jaws, frequently presenting with a multilocular, expansile appearance, especially in the posterior mandible.

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8. Which of the following typically presents as a radiopaque lesion associated with the root of a non-vital tooth?

Focal sclerosing osteomyelitis (condensing osteitis) presents as a localized radiopacity around the apex of a tooth with pulpal pathosis (often a non-vital or chronically inflamed pulp), representing a reactive bone sclerosis in response to low-grade inflammation.

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9. Choose the correct statement that best describes pemphigoid and/or pemphigus?

The keyed correct statement is that pemphigoid rarely affects the oral cavity. [REVIEW: keyed answer may be incorrect - mucous membrane pemphigoid commonly involves the oral cavity (desquamative gingivitis), so 'pemphigoid rarely affects the oral cavity' is questionable; pemphigus alters desmosomes and shows a positive Nikolsky sign, which are the more reliably correct facts.]

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10. Necrotizing sialometaplasia is a self limiting, neoplastic, inflammatory condition of unknown etiology. Treatment is via radiation.

The first statement is true: necrotizing sialometaplasia is a self-limiting, benign (pseudoneoplastic) inflammatory condition of unknown cause that heals spontaneously. The second is false: it is not treated with radiation; it resolves on its own, so treatment is supportive.