牙體牙髓習題集與答案

1、一、 選擇題1. 對牙髓最具有破壞性的是A. Nd 激光B. CO2激光 C. 紅激光 D. 光固化燈E. 牙髓活力電測定儀2. 感染根管常見的優(yōu)勢菌不包括A. 普氏菌 B. 放線菌 C. G細菌 D. 真桿菌 E. 梭形桿菌3.備洞時易損傷牙髓的因素不包括A. 施力大 B. 用冷卻劑 C. 持續(xù)常時間鉆磨 D. 制備深的窩洞 E. 不用冷卻劑 4.與頑固性根尖周病變和竇道經(jīng)久不愈可能有關的細菌為A. 普氏菌 B. 放線菌 C. G細菌 D. 真桿菌 E. 梭形桿菌5. 判斷牙髓活力最可靠的檢查方法是A. 熱診B. 冷診 C. 牙髓活力電測定 D. 試驗性備洞 E. X線檢查6診斷殘髓炎最準確

2、的依據(jù)是A. 叩診B. 牙髓活力測試C. 病史D. 癥狀E. 探查治療后根管有痛覺7急性根尖周膿腫最佳的排膿途徑A. 從牙周間隙排膿B. 從頰、舌側(cè)粘膜或皮膚排出C. 經(jīng)根管從齲洞排膿D. 從上頜竇或鼻腔排膿E. 以上都不對 8感染侵入牙髓組織的途徑A. 深齲B. 深牙隱裂C. 深牙周袋 D. 重度磨耗E. 以上都有可能9根尖周炎疼痛最劇烈的階段是A. 粘膜下膿腫期 B. 骨膜下膿腫期C. 漿液期D. 根尖膿腫期 E. 瘺管形成期10上頜第一磨牙的根管形態(tài)特點是：cA. 多數(shù)是2根管，即1個頰根管和1個腭根管B. 多數(shù)是3根管，即1個近頰、1個遠頰和1個腭根管C. 多數(shù)是4根管，即2個近頰、1

3、個遠頰和1個腭根管D. 多數(shù)是4根管，即1個近頰、2個遠頰和1個腭根管E. 多數(shù)是4根管，即1個近頰、1個遠頰和2個腭根管1115號標準根管銼的銼尖直徑和刃部末端直徑分別是：dA. 0.10mm和0.47mmB. 0.10mm和0.45mmC. 0.15mm和0.45mmD. 0.15mm和0.47mmE. 以上都不對12彎曲根管預備的常見并發(fā)癥是：aA. 根管臺階B. 藥物性根尖周炎C. 牙周組織壞死D. 皮下氣腫E. 誤戲和誤咽13根管預備的工作長度是指：dA. 牙的實際長度B. 從牙冠參照點到牙本質(zhì)牙釉質(zhì)界C. 從牙冠參照點到解剖根尖孔D. 從牙冠參照點到生理根尖孔E. 從牙冠參照點到距

4、生理根尖孔0.51mm14根管成形的標準是：aA. 根管比原來直徑至少擴大3個器械號B. 根尖預備到20號標準器械C. 根管內(nèi)無大量滲出D. 根管沖洗無混濁液體E. 根管內(nèi)無嚴重氣味15下列哪一項不是牙髓切斷術的潛在并發(fā)癥：eA. 根髓感染B. 根管鈣化C. 內(nèi)吸收D. 牙髓壞死E. 髓室穿孔16下列哪一項描述不是玻璃離子粘固劑修復術窩洞預備的特點 （）CA. 玻璃離子粘固劑與牙體組織有化學粘接，對固位形的要求可放寬B. 不必作倒凹、鳩尾等固位形C. 去除齲壞牙本質(zhì)，必須作預防性擴展D. 窩洞的點、線角圓鈍E. 洞緣釉質(zhì)不作斜面17深齲患者激發(fā)痛較重，洞底軟齲能夠徹底去凈，治療方法應選擇（ ）

5、CA. 雙層墊底，一次完成充填治療B. 局麻下開髓失活，行牙髓治療C. 先做安撫治療，待12周復診時癥狀消除后，再以雙層墊底充填治療D. 實行活髓切斷術E. 間接蓋髓、雙層墊底，一次完成充填治療18臨床上不易查出的繼發(fā)齲可用下列哪些方法幫助診斷（）CA. 探診B. 溫度測驗C. X線D. 染色法E. 麻醉法19深齲備洞時，下列哪項措施是錯誤的（）AA. 洞底平、側(cè)壁直，兩相垂直B. 去盡腐質(zhì)C. 保護牙髓D. 洞緣線圓鈍E. 盡量保留健康牙體組織20復合樹脂充填后脫落的原因如下，除了（）AA. 制備了固位形B. 牙齒表面未注意清潔C. 酸蝕后的牙面接觸唾液D. 未制備洞斜面E. 充填體過薄21

6、下列哪項不是窩洞的基本固位形(B)A. 側(cè)壁固位B. 釘?shù)拦涛籆. 倒凹固位D. 鳩尾固位E. 梯形固位22制備倒凹是為了：(B)A. 獲得良好的抗力形B. 獲得良好的固位形C. 便于墊底D. 便于充填E. 便于放置蓋髓劑23V類洞充填備洞時，要求：(A)A. 適當?shù)墓涛恍蜝. 嚴格的抗力形C. 必須做鳩尾D. 口小底大E. 底平壁直24右下頜第一恒磨牙頰面齲洞破壞越過邊緣嵴至咬合面窩溝是：(A)A. I 類洞B. II 類洞C. III 類洞D. IV 類洞E. V 類洞25墊底的部位為：(D)A. 僅在髓壁B. 僅在軸壁C. 僅在側(cè)壁D. 僅在髓壁和軸壁E. 任何壁均可墊26下列說法正確的

7、是 BA. 男性患齲率略高于女性B. 齲病流行率主要隨社會經(jīng)濟模式而變化C. 齲病流行模式依靠地理環(huán)境而改變D. 遺傳因素對齲病的發(fā)生和發(fā)展產(chǎn)生重要的影響E. 環(huán)境因素對齲病的發(fā)生和發(fā)展無影響27釉質(zhì)齲損害的4個區(qū)不包括 A A. 壞死區(qū)B. 透明帶C. 暗帶D. 損害體部E. 釉質(zhì)表面層28牙本質(zhì)齲損在光鏡下可看到微生物滲透至牙本質(zhì)小管的區(qū)域是 B A. 壞死區(qū)B. 感染層C. 牙本質(zhì)脫礦區(qū)D. 硬化區(qū)E. 修復性牙本質(zhì)層29靜止齲屬于 B A. 急性齲B. 慢性齲C. 繼發(fā)齲D. 牙釉質(zhì)齲E. 牙骨質(zhì)齲30病程進展快，多數(shù)牙在短期內(nèi)同時患齲的急性齲稱為 EA. 濕性齲B. 慢性齲C. 干性

8、齲D. 繼發(fā)齲E. 猛性齲31 Which is the best way of pain control for endodontic treatmentA. Local anestheticsB. DevitalizationC. AnalgesicsD. Occlusal reductionE. Incising and drainage32 Which one is not the reason for use of rubber damA. Protect aspiration or swallowing of instruments or irrigantsB. Eliminate

9、 the dental fear of patientsC. Improve visibilityD. Reduced risk of cross-contamination E. Legal considerations33 The following statements are correct exceptA. Nearly all canals exhibit a certain degree of curvature.B. There may be more than one canals within one root. C. The apical foramen usually

10、opens at the anatomical apex.D. Apical constriction occurs at 0.51mm from the apical foramen.E. Lateral and accessory canals might be the cause of treatment failure.34 Which one is wrong regarding the principle of access cavityAStraight-line accessBConservation of tooth structureCUnroofing of the ch

11、amber and exposure of pulp hornsDFacial surface of anterior teethEOcclusal surface of posterior teeth35 The advantages of gutta-percha as a filling material are A. It is compactible and adapts excellently to the irregularities and contour of the canalB. It is radiopaqueC. It can be easily removed fr

12、om the canal when necessaryD. It can be softened and made plastic by heat or by organic solventsE. All of the above36 Which one is incorrect about the criteria of the root canal is ready to be filled after the completion of root canal cleaning and shaping? A. The tooth is asymptomatic.B. The canal i

13、s wet.C. There is no sinus tract.D. There is no foul odor.E. The temporary filling is intact37 Which one is not the pathways of pulpal and periapical infections? A. Dentinal tubulesB. Pulp exposureC. GingivalD. Periodontal ligamentE. Anachoresis38 Tug-back is achieved and the canal is ready for fill

14、ing A. When the gutta-percha has extended beyond the apexB. When the gutta-percha is easily removed from the root canal C. When the gutta-percha placed to apical constriction exhibits resistance on removalD. After cementationE. None of above 39 Most root canal infections involve A. a single obligate

15、 anaerobic speciesB. multiple anaerobic species onlyC. mixed aerobic and anaerobic microorganismsD. multiple aerobic species onlyE. none of above40 An abnormally shaped tooth that may appear as an extra wide crown, a normal crown with an extra root, or other combinations resulting from the union of

16、two adjacent tooth germs by dentin during development is called A. fused teeth B. concresence of teeth C. geminated teeth D. dilacerations of tooth E. taurodontism41 Which isnt the non-operative treatment of dental caries in the following?A. application of fluorideB. application of APF gelC. reminer

17、alizative therapyD. enameloplasty E. pit and fissure sealing42 Which is not the aim of operative therapy on the dental caries management?A. To remove infected dentine and prohibit cariesB. To protect the pulp and avoid painC. To enhance the strength of the toothD. To facilitate plaque controlE. To r

18、estore the appearance (of teeth) and its function43 Which is the best statement about resistance form A. Resistance form is the design of a cavity in such a way that the remaining tooth substance and the restorative material can withstand masticatory stressB. The bulk required will depend on the fle

19、xural strength of restorative material. In the case of amalgam it is estimated that a minimum of 1.5-2mm thickness of the restorative material is required to withstand masticatory stressC. If a marginal ridge is found to be too weak in the cause of an occlusal cavity preparation, a Class II cavity m

20、ay have to be prepared instead, so as to eliminate the weak marginal ridge. This is particularly indicated where the ridge is only of enamel thickness and unsupported by sound dentineD. The cavity should be designed that the occlusal margins of the cavity are in areas not subjected to excessive occl

21、usal trauma, otherwise the enamel wall of the cavity and/or the margins of the restorative material may fracture. In practice, this may be achieved by placing an occlusal margins of a cavity about one-quarter (1/4) of the intercuspal distance. Note, that efforts should always be made to conserve sou

22、nd tooth tissueE. All of the above44 Which is the most danger area of tooth in dental caries occurred after you have learned dental caries? A. Pits and fissures on occlusal surfaces of molars and premolarsB. Approximal surfaces of all teeth. C. Gingival thirds of all teeth, both on facial and lingua

23、l surfacesD. Pits and fissures near the lingual of maxillary incisors and canines (lingual pits)E. Pits and fissures on the buccal of molars45 Which is not true in the following statement about dental caries and micro-organisms? A. Caries could be induced by specific bacteria, especially mutans stre

24、ptococci-group (eg. Streptococcus mutans and Strep. sobrinus). B. There are caries occurred when only fed a cariogenic (high sucrose) diet. C. In the 60s Keyes infected germ-free animals with known strains of streptococci and found that these organisms were transferred to uninfected litter mates who

25、 then became susceptible to caries. He thus demonstrated that dental caries was potentially infectious and transmissible.D. When talking about cariogenic microorganisms, we often refer to Streptococcus mutans, Lactobacillus and Actinomyces.E. Occlusal caries could be prevented using penicillin in an

26、imal study.46 The advantages glass-ionomer cement includeA. high adhesion propertiesB. low abrasion properties C. use as a permanent restoration D. reduction in caries due to fluoride releasing properties E. all of the above47 Which one of the statements is error in retentive pin placementA. be avoi

27、ded bifurcation and trifurcation areas B. parallel to the external surface of the toothC. many pin holes be better placed in different planes D. the length of pin in dentine should be longer than that of in restoration E. be in the hardest dentine48 The reasons of spontaneous pain after tooth fillin

28、g include A. mistakenly judge the condition of pulp B. neglect small pulp exposureC. irritation of materials to pulpD. residual carious dentineE. all of the above49 Which of the following is a contra-indication to endodontic treatmentA. DiabetesB. PregnancyC. HIV-infected patientsD. Patient sufferin

29、g from heart attack within past 6 monthsE. Cancer50 Central cusp is most common in A. maxillary the second premolars B. maxillary the first premolarsC. mandibular the first premolarsD. mandibular the second premolarsE. maxillary the second molars51 Submerged deciduous teeth occurs most common in A.

30、primary maxillary the second molarsB. primary maxillary the first molars C. primary central incisorsD. primary mandibular the second molarsE. primary mandibular the first molars52 In clinical assessment, which is not correct? A. Spontaneous discomfort at night provide a clue as the tooth is inflamed

31、B. Vitalometer tests are very unreliableC. If the tooth is excessively mobile , it may have abnormal root resorptionD. Swelling or with a fistulous tract is indicative of a necrotic pulpE. No pain history affirmed no inflammation 53 If you mechanically expose the mesiobuccal pulp horn on the primary

32、 maxillary first molar .The carious lesion on the mesial and distal surfaces is moderate, the treatment now should be A. Pulp capping with Ca(OH)2; restor with silver amalgamB. Pulpotomy; restored with a stainless steel crownC. Pulpectomy; restored with a stainless steel crownD. Pulp capping with Ca

33、(OH)2; restored with a stainless steel crownE. Extraction and a space maintainer54 The tooth of root fracture should be treated with splint for A. 2-3 weeks B. 1-2weeks C. 3-8 weeks D. 2-3 months E. 1-2 months55 In which situation below the pulp would be exposed? A. Enamel infractionB. Enamel fraciu

34、reC. Enamel-dentin fractureD. Complicated crown fractureE. Uncomplicated crown-root fracture56 We should advocate a routine dental appointment on or before A. the ZERO birthdayB. the first birthdayC. the second birthdayD. the third birthdayE. the six birthday57 The order of susceptibility of the pri

35、mary teeth to carious attack is as follows A. Mandibular primary molar Maxillary primary incisor Maxillary primary molar mandibular primary anterior teethB. Maxillary primary incisor Maxillary primary molar mandibular primary molar mandibular primary anterior teethC. Maxillary primary incisor mandib

36、ular primary molar mandibular primary anterior teeth Maxillary primary molarD. Maxillary primary incisor mandibular primary molar Maxillary primary molar mandibular primary anterior teethE. Maxillary primary incisor mandibular primary anterior teeth mandibular primary molar Maxillary primary molar 5

37、8 A 7 years old boy with bilateral loss of the mandibular primary first and second molars, which of the following may be best A. Band and loop respectively B. Lingual arch C. Removable appliances D. Distal shoe E. None of them59 Clinical features of dental fluorosis do not include A. The lesion symm

38、etrically distributed in the mouth, but not all teeth are equally affected B. The least affected teeth are the incisors and first permanent molarsC. Changes from fine white opaque lines running across the tooth on all parts of the enamel to features where parts of the chalky white and porous outer e

39、namel become detached and discoloredD. The loss of surface enamel in the severest cases results in a loss of anatomical form of the teethE. Well-demarcated borders lesion along incremental line 60 For intrusive luxation of teeth, the most common complication is A. Pulp necrosisB. OsteitisC. Root res

40、orptionD. Alveolar process resorptionE. All of above二、 名詞解釋a) acquired pellicleb) resistance formc) indirect pulp cappingd) retrograde pilpitise) 自發(fā)痛和激發(fā)痛f) Dentine hypersensitivityg) Smear layerh) Pulpotomy i) Initial apical filej) Dental plaque三、 簡答題簡述影響根管沖洗效果的因素簡述深齲的治療特點簡述深齲的治療特點簡述窩洞的基本固位形簡述牙隱裂的病因

41、What is the sequelae of root fractures ? Please briefly describe the benefits of root canal irrigation.What is the goals of pulp therapy in children?What are the properties of the Cariogenic Bacteria?四、 問答題詳述窩洞的結(jié)構(gòu)及窩洞預備的基本原則結(jié)構(gòu)引起牙髓活力測定誤診的原因是什么？根尖周膿腫與急性牙周膿腫的鑒別要點Please discuss the purpose of root canal

42、preparation and the procedures of Step-down technique.Explain the indications and types of pulp treatment for primary and young permanent teeth.State The Principles Of Cavity Preparation on Amalgam Restoration.答案一、選擇題1CCBBD6ECEBC11DADAE16CCCAA21BBAAD26BABBE31BCDE B36CCCAD41DCEAB46EDEDA51DEBDD56BDCEA

43、二、名詞解釋1. acquired pellicle唾液蛋白或糖蛋白吸附至牙面所形成的生物膜稱獲得性膜。2. resistance form修復體和余留牙結(jié)構(gòu)獲得足夠抗力，在承受合力時不折裂的形狀稱抗力形。3. indirect pulp capping(P91)用具有消炎和促進牙髓牙本質(zhì)修復反應的制劑覆蓋于洞底，促進軟化牙本質(zhì)再礦化和修復性牙本質(zhì)形成，從而全部生活牙髓的方法叫間接蓋髓術。4. retrograde pulpitis逆行性牙髓炎：感染來源于深牙周袋，通過根尖孔或測副根管逆行入牙髓，引起跟部牙髓的慢性炎癥。5. 自發(fā)痛和激發(fā)痛自發(fā)痛是指患牙在未受到外界刺激而發(fā)生的疼痛。激發(fā)痛是指

44、患牙受到外界刺激而發(fā)生的疼痛。6.Dentine HypersensitivityDentine hypersensitivity is a form of hypersensitivity caused by the effect of thermal, tactile, osmotic or chemical stimuli on exposed dentine.7.smear layerCutting or abrading the hard tissues with rotary and hand instruments produces a little chips or parti

45、cles which attached to the tooth surface produce the smear layer8. PulpotomyIt is indicated for carious or mechanical exposures in primary teeth and to induce root closures in the young permanent dentition9.initial apical fileThe first file that binds in the canal at WL .10.dental plaqueAn adherent

46、deposits of bacteria and their products, which is not mineralized and forms on all tooth, denture restorations surfaces. It is not an accident accumulation of bacteria but develops in a sequence of steps.三、簡答題1. 簡述影響根管沖洗效果的因素1） 藥物種類2） 根管的直徑3） 沖洗的液體量4） 病變情況5） 根管內(nèi)玷污層2. 簡述深齲的治療特點1） 停止齲病發(fā)展，促進牙髓的防御性反應2）

47、保護牙髓3） 正確判斷牙髓狀況4） 治療方法：墊底充填，安撫治療，間接蓋髓術3. 簡述窩洞的基本固位形側(cè)壁固位到凹固位鳩尾固位梯形固位舉例4簡述牙隱裂的病因1）牙結(jié)構(gòu)的薄弱環(huán)節(jié)是隱裂牙發(fā)生的易感因素2）牙尖斜度愈大，所產(chǎn)生的水平分力愈大3）創(chuàng)傷性合力5. What is the sequelae of root fractures ? Healing with calcified tissue Healing with interproximal connective tissue Healing with interproximal bone and connective tissue In

48、terproximal inflammatory tissue without healing6.Please briefly describe the benefits of root canal irrigation. Gross debridement Frequency and volume of irrigant Intracanal placement of delivery needle Elimination of microbes Dissolution of pulp remnants Removal of the smear layer Lubricating instr

49、ument7. What is the goals of pulp therapy in children?Allowing the tooth to remain in the mouth in a nonpathologic stateMaintenance of arch length and tooth spaceRestoration of comfort with the ability to chewPrevention of speech abnormalities and abnormal habits8.What are the properties of the Cari

50、ogenic Bacteria? Acidogenic: they are able to produce acid rapidly from fermentable carbohydrates. Aciduric: They thrive under acid conditions.Adherent: Able to adhere to the tooth surface because of their ability to synthesize sticky extracelluar polysaccharides from dietary sugars.四、問答題1. 詳述窩洞的結(jié)構(gòu)及

51、窩洞預備的基本原則結(jié)構(gòu)1） 洞壁：測壁，髓壁（軸壁）2） 洞角：線角，點角，軸髓線角3） 洞緣：洞緣角4） 抗力形：洞深，盒狀洞形，階梯結(jié)構(gòu)，窩洞的外形，去除無基釉和避免形成無基釉，薄壁弱尖的處理5） 固位形：側(cè)壁固位，倒凹固位，鳩尾固位，梯形固位原則1） 去凈齲壞組織2） 保護牙髓組織3） 盡量保留健康牙體組織2. 引起牙髓活力測定誤診的原因是什么？ 引起假陽性反應的原因探頭或電極接觸了大面積的金屬修復體或牙齦，使電流流向了牙周組織；未充分隔濕或干燥受試牙，以至電流泄漏至牙周；液化性壞死的牙髓有可能傳導電流至根尖周，當電流調(diào)節(jié)到最大刻度時，患者可能會緩慢抬手示意；患者過度緊張和焦慮，以致在探

52、頭剛接觸牙面或被問知感受時即抬手。引起假陰性反應的原因患者事先用過鎮(zhèn)痛劑、麻醉劑或酒精飲料等，使之不能正常地感知電刺激；探頭或電極未能有效地接觸釉質(zhì)，以致妨礙了電流到達牙髓；根尖尚未發(fā)育完全的新萌出牙，其牙髓通常對電刺激無反應；根管內(nèi)過度鈣化的牙，其牙髓對電刺激通常無反應，常見于一些老年患牙；剛受到外傷的患牙可能對電刺激無反應。3根尖周膿腫與急性牙周膿腫的鑒別要點 急性根尖周膿腫急性牙周膿腫感染來源感染根管牙周袋病史較長期牙體缺損史牙痛史牙髓治療史長期牙周炎史牙體情況深齲洞近髓的非齲疾病修復體一般無牙體疾病牙髓活力多無多有牙周袋無深，迂回曲折膿腫部位靠近根尖部中心位于齦頰溝附近較近牙齦炎膿腫范

53、圍較彌漫局限于牙周袋壁疼痛程度重相對較輕牙松動度相對輕，病愈后牙恢復穩(wěn)固明顯，消腫后仍很松動叩痛很重相對較輕X片無明顯異常表現(xiàn)，若患牙為慢性根尖周炎急性發(fā)作者，根尖周牙槽骨顯現(xiàn)透射影像牙槽骨脊破壞，可有骨下袋病程相對較長，膿液自根尖周向外排除的時間約需56天相對較短，一般34天可自潰4.State The Principles Of Cavity Preparation.1) Removal Of Dental CariesA. Hard standard B. Stained standard2) Protect pulpA. Use sharp instrumentB. Cold the

54、operating tooth by waterC. Discontinuity cutting or shapingD. Never press to the pulpE. Anatomy acknowledges3) Cavity preparation is as conservative as possibleA. Cavity preparation is as conservative as possible B. Cavity size and shape are dictated mainly by the extent of the carious lesion. C. The cavosurface only extend to the sound dental tissues ,not for prevention4) Establishing resistance and retention formA. Resistance form is the design of a cavity in such a way that the remaining tooth substance and the restorative ma