File breakage in Endodontics

# Which of the following describes the BEST management strategy for a separated instrument AFTER cleaning and shaping has occurred?
A. Do not attempt to remove and proceed to obturation
B. Place calcium hydroxide
C. Attempt to bypass the instrument

The correct answer is A. Do not attempt to remove and proceed to obturation.

If an instrument separates at the filling/obturation stage, the instrument does NOT require removal because the etiology of the problem has already been resolved
through cleaning and shaping of the canals.

The prognosis for the tooth will be
considered more favorable if the infected
dentin has already been debrided from the
canal.

The prognosis for the tooth will also be
considered more favorably the more apical
the instrument separation occurred.

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Causes of Pulpal Necrosis

# Which of the following types of trauma is LEAST likely to result in pulpal necrosis?
A. Lateral luxation
B. Avulsion
C. Subluxation
D. Concussion
E. Extrusion 

The correct answer is D. Concussion. 

Concussion - An injury to the tooth supporting structures without increased

mobility or displacement of the tooth, but

can present with pain to percussion.

Pulpal necrosis can occur following a

serious tooth trauma, especially if the the

apical blood vessels are severed.

Subluxation- An injury to the tooth supporting structures resulting in increased

mobility, but without displacement of the

tooth. Bleeding from the gingival sulcus confirms the diagnosis.

Extrusion- The partial displacement of the

tooth out of its socket.

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Flap design for periodontal surgery

# When designing a flap for a periodontal surgery, which of the following findings is most influential?
A. Probing depth
B. Frenum attachment level
C. Vestibular depth
D. Quantity of attached gingiva
E. Presence of intrabony defect

Attached gingiva maintains a tight contact
with the periosteum of the bone and certain
areas of the tooth root.

Its function is to keep the free gingiva in
close contact with the tooth while also
protecting the soft and free moving alveolar
mucosa.

Insufficient attached gingiva makes the
mucosa more prone to trauma during
function and compromises the periodontal
support of teeth.

In order to avoid periodontal problems after surgery, the width of the attached gingiva must be preserved.

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Paracetamol is contraindicated in:

# Paracetamol is contraindicated in:
A. Nephritis
B. Chronic hepatitis
C. Bleeding disorders
D. Pregnancy

The correct answer is B. Chronic Hepatitis. 

Most prominent toxic effect associated with acetaminophen use is hepatic necrosis. 

Paracetamol (Acetaminophen) has only analgesic and antipyretic action without any anti inflammatory action. Hypersensitivity reactions to paracetamol are rare and can be given to patients to whom aspirin is contraindicated. The most serious acute adverse effect of overdose of acetaminophen is a potentially fatal hepatic necrosis. Renal tubular necrosis and hypoglycemic coma may also occur. 

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