OPERATIVE DENTISTRY -MOSBY

1. Which of the following statements regarding caries risk assessment is true?


A. The presence of restorations is a good indicator of 

current caries activity.

• The presence of restorations is a good indicator of 


past caries activity. 


• The presence of plaque biofilm is a good indicator 


of current caries activity. 


• The presence of pit-and-fissure sealants is a good 


indicator of current caries activity. 


2. Which of the following statements about indirect pulp 


caps is false?

A. Some leathery caries may be left in the 

preparation.

• A liner is generally recommended in the 


excavation. 


• The operator should wait at least 6 to 8 weeks 


before reentry (if then). 


• The prognosis of indirect pulp cap treatment is 


poorer than that of direct pulp caps. 


3. Smooth-surface caries refers to _____. 


A. Facial and lingual surfaces B. Occlusal pits and grooves C. Mesial and
distal surfaces D. AandC 


4. The use of the rubber dam is best indicated for ______. A. Adhesive
procedures

B. Quadrant dentistry

C. Teeth with challenging preparations 

D. Difficult patients 

E. All of the above 

 5. For a dental hand instrument with a formula of 10-8.5- 

8-14, the number 10 refers to the ______.

A. Width of the blade in tenths of a millimeter B. Primary cutting edge angle
in centigrades C. Blade length in millimeters

D. Blade angle in centigrades 


6. When placement of proximal retention locks in class II amalgam preparations

is necessary, which of the following statements is not correct?

A. One should not undermine the proximal enamel.

• One should not prepare locks entirely in the axial 


wall. 


• Even if deeper than ideal, one should use the axial 


wall as a guide for proximal lock placement. 


• One should place locks 0.2 mm inside the DEJ to ensure that the
proximal enamel is not 

undermined. 


7. Which of the following statements about class V 


amalgam restorations is not correct?

A. The outline form is usually kidney-shaped or 

crescent-shaped.

B. Because the mesial, distal, gingival, and incisal 

walls of the tooth preparation are perpendicular to 


the external tooth surface, they usually diverge

facially.

C. Using four corner coves instead of two full-length

grooves conserves dentin near the pulp and may reduce the possibility of a mechanical
pulp exposure.

D. If the outline form approaches an existing proximal restoration, it is better to leave a

thin section of tooth structure between the two restorations (<1 mm) than to join the
restorations.

8. In the conventional class I composite preparation, retention is achieved by which of the

following features?

1. Occlusal convergence
2. Occlusal bevel

3. Bonding

4. Retention grooves A. 2and4

B. 1and3

C. 1and4

D. 2and3

9. Many factors affect tooth/cavity preparation. Which of the following would be the least
important factor?

A. Extent of the defect

B. Size of the tooth

C. Fracture lines

D. Extent of the old material


10. Which of the following statements about an amalgam

tooth/cavity preparation is true?


A. The enamel cavosurface margin angle must be 90

degrees.

B. The cavosurface margin should provide for a

90-degree amalgam margin.


C. All prepared walls should converge externally.

D. Retention form for class V preparations can be

placed at the DEJ.


11. Causes of postoperative sensitivity with amalgam res-

torations include all of the following except one. Which one is the exception?

A. Lack of adequate condensation, especially lateral

condensation in the proximal boxes B. Voids

C. Extension onto the root surface

D. Lack of dentinal sealing


12. When carving a class I amalgam restoration, which of

the following statements is false?


A. Carving may be made easier by waiting 1 or 2

minutes after condensation before it is started.


B. The blade of the discoid carver should move paral- lel to the margins resting totally on
the partially set
amalgam.

C. Deep occlusal anatomy should not be carved.

D. The carved amalgam outline should coincide with

the cavosurface margins.


13. The setting reaction of dental amalgam proceeds pri-

marily by _____.

• Dissolution of the entire alloy particle into mercury 


• Dissolution of the copper from the particles into 


mercury 


• Precipitation of tin-mercury crystals 


• Mercury reaction with silver on or in the alloy 


particle 


14. Restoration of an appropriate proximal contact results 


in all of the following except one. Which one is the exception?

A. Reduction or elimination of food impaction at the 

interdental papilla

• Provides appropriate space for the interdental 


papilla 


• Provides increased retention form for the 


restoration 


15. D. Maintenance of the proper occlusal relationship 


16. Major differences between etch-and-rinse (previously known as total-etch)

and self-etching primer adhesive systems include all of the following except
one. Which one is the exception? 

A. Time necessary to apply the materials B. Amount of smear layer removed

C. Bond strengths to enamel

D. Need for wet bonding 

 17. A casting may fail to seat on the prepared tooth owing to all of the following
factors except one. Which one is the exception?

• Temporary cement still on the prepared tooth after 


the temporary restoration has been removed 


• Proximal contacts of casting too heavy or too 


tight 


• Undercuts present in prepared tooth 


• The occlusal of the prepared tooth was 


underreduced 


18. All of the following reasons are likely to indicate the 


need for restoration of a cervical notch except one. Which one is the exception?

A. Patient age

B. Esthetic concern 

C. Tooth is symptomatic 

D. Deeply notched axially 


19. All of the following statements about slot-retained 


complex amalgams are true except one. Which one is the exception?

A. Slots should be at least 1.5 mm in depth.

B. Slots should be 1 mm or more in length. 

C. Slots may be segmented or continuous.

D. Slots should be placed at least 0.5 mm inside 

the DEJ. 


20. Which one of the following acids is generally recom- 


mended for etching tooth structure? A. Maleic acid

B. Polyacrylic acid

C. Phosphoric acid 

D. Tartaric acid

E. Ethylenediaminetetraacetic acid 


20. Triturating a dental amalgam _____.


A. Reduces the size of the alloy particles B. Coats the alloy particles with mercury C.
Reduces the crystal sizes as they form D. Dissolves the alloy particles in mercury
21. Which of the following materials has the highest linear coefficient of thermal
expansion?

A. Amalgam

B. Direct gold

C. Tooth structure

D. Composite resin

22. A cervical lesion should be restored if it is _____.

A. Carious

B. Very sensitive

C. Causing gingival inflammation D. All of the above

23. Compared with amalgam restoration, composite res- torations are _____.

A. Stronger

B. More technique-sensitive

C. More resistant to occlusal forces

D. Not indicated for class II restorations


24. The one constant contraindication for a composite res-

toration is _____.

A. Occlusal factors

B. Inability to isolate the operating area C. Extension onto the root surface

D. Class I restoration with a high C-factor

25. Which of the following statements regarding the choice between doing a composite or
amalgam restoration is true?

A. Establishing restored proximal contacts is easier

with composite.

B. The amalgam is more difficult and technique-

sensitive.

C. The composite generally uses a more conservative

tooth/cavity preparation.

D. Amalgam should be used for class II restorations.

26. Match each condition of tooth loss with the most closely linked type of tooth loss.

Section 2 • Operative Dentistry 77

• Mechanical wear secondary to abnormal forces (s.a. toothbrushing) ___ 


Abfraction
 • 

Normal tooth wear ___ Attrition

• Wear secondary to chemical 




Erosion
presence ___

• Tooth loss in the cervical area 


Abrasion
secondary to biomechanical loading ___ 


1. Abfraction

2. Attrition 3. Erosion

4. Abrasion

27. From the following list, select the reasons to consider the restoration of abraded or
eroded (noncarious) cer- vical lesions. (Choose four.)

A. Caries develops in the lesion.

B. The defect is shallow and does not compromise the structural integrity of the tooth.

C. Intolerable sensitivity exists and is unresponsive to conservative desensitizing

measures.

• The defect contributes to a phonetic problem. 


• The area is to be involved in the design of a remov- 


able partial denture. 


• Teeth are endodontically treated. 


G. The patient desires an esthetic improvement.

28. From the following list, select the reasons associated with replacement of existing
restorations. (Choose four.)

• Marginal ridge discrepancy that contributes to 


food impaction 


• Existing restoration has significant discrepancies 


and is a negative etiologic factor to adjacent teeth 

 or tissue 


• Light marginal staining not compromising esthet- 


ics and judged noncarious 


• Poor proximal contour or a gingival overhang that 


contributes to periodontal breakdown 


• Recurrent caries that can be adequately treated by 


a repair restoration 


• Presence of shallow ditching around an amalgam 


restoration 


• For tooth-colored restorations, unacceptable 


esthetics 


29. Match each pulpal condition with the most closely

linked recommended pulp therapy.

30. Place the following steps for the application of an etch- and-rinse (total-etch) three-
step dental adhesive in correct sequence.

5
A. Apply adhesive ___

B. Rinse etchant and leave surface wet ___
 3

C. Complete tooth preparation ___
1
4
D. Apply two to three layers of primer ___

E. Etch enamel and dentin with phosphoric acid for

10 to 15 seconds 2___ F. Light-cure ___

6

31. Place the following steps for a class II amalgam restora- tion in correct sequence.

A. Check occlusion of restoration and adjust if neces-

sary ___

6
2
B. Place matrix and wedge ___

C. Carve amalgam material ___
5
D. Mix amalgam material ___
3
E. Complete tooth preparation1___ F. Condense amalgam material ___
4
32. From the following list, select the functions of skirts in gold onlay tooth preparations.
(Choose two.)

A. Increase retention form

B. Provide bracing

C. Increase resistance form D. Enhance esthetics


E. Provide pulp protection F. Improve draw
Match each pulpal condition with the most closely linked recommended pulp therapy.
• Mechanical pulp exposure, noncarious (<1.0 mm) ___ 
 pulp capping
Direct

• Remaining dentin thickness greater than



 therapy required
No pulp
2.0 mm over vital pulp ___

• Carious pulp exposure (>1.0 mm) with purulent exudate ___ 


Endodontics

• Residual questionable dentin near pulp, asymptomatic tooth ___ 
 pulp capping
Indirect

1. Endodontic therapy 


2. No pulp therapy required 


3. Direct pulp cap 


4. Indirect pulp cap 


Operative Dentistry
1. A good preventive and treatment strategy for dental caries includes ____.

A. Limiting cariogenic substrate

B. Controlling cariogenic flora 

C. Elevating host resistance 

D. All of the above 


2. Which of the following statements regarding caries 


risk assessment is correct?

A. The presence of restorations is a good indicator of 

current caries activity.
 • The presence of restorations is a good indicator of 

past caries activity. 


• The presence of dental plaque is a good indicator 


of current caries activity. 


• The presence of pit-and-fissure sealants is a good 


indicator of current caries activity. 


3. Which of the following is considered a reversible 


carious lesion?

A. The lesion surface is cavitated.

• The lesion has advanced to the dentin 


radiographically. 


• A white spot is detected on drying. 


4. D. The lesion surface is rough or chalky. 


5. Which of the following statements about indirect pulp caps is false?

• Some leathery caries may be left in the 


preparation. 


• A liner is generally recommended in the 


excavation. 


• The operator should wait at least 6 to 8 weeks 


before reentry (if then). 


• The prognosis of indirect pulp cap treatment is 


poorer than the prognosis of direct pulp caps. 


6. Smooth surface caries refers to ____. 


A. Facial and lingual surfaces B. Occlusal pits and grooves C. Mesial and
 distal surfaces D.BothAandC 


7. How many blades does a finishing bur have compared with a cutting bur?

A. Fewer blades

B. Same number of blades 

C. More blades 

D. Number of blades is unrelated to the bur type 


8. The use of the rubber dam is best indicated for ____. 


A. Adhesive procedures

B. Quadrant dentistry

C. Teeth with challenging preparations D. Difficult patients

E. All of the above 


9. A rubber dam is inverted to ____.


A. Prevent the dam from tearing

B. Prevent the underlying gingiva from accidental 

trauma 


C. Provide a complete seal around the teeth

D. All of the above


9. For a dental hand instrument with a formula of 10-8.5-

8, the number 10 refers to ____.


A. The width of the blade, in tenths of a millimeter B. The primary cutting-edge angle, in
centigrades C. The blade length, in millimeters

D. The blade angle, in centigrades

10. The tooth preparation technique for a class I amalgam on a mandibular first molar
does not include which of the following?

A. Maintaining a narrow isthmus width

B. Initial punch cut placed in the most carious pit


C. Establishment of pulpal depth of 1.5 to 2 mm

D. Orientation of bur parallel to the long axis of the

tooth

11. When placement of proximal retention locks in class

II amalgam preparations is necessary, which of the following is not correct?


A. One should not undermine the proximal enamel. B. One should not prepare locks
entirely in the
axial wall.

C. Even if deeper than ideal, one should use the axial

wall as a guide for proximal lock placement.


D. One should place locks 0.2 mm inside the denti- noenamel junction (DEJ) to ensure
that the proxi-

mal enamel is not undermined.


12. When the gingival margin is gingival to the cementoe-

namel junction (CEJ) in a class II amalgam prepara- tion, the axial depth of the
axiogingival line angle should be ____.

A. 0.2 mm into sound dentin

B. Twice the diameter of a No. 245 carbide bur


C. 0.75 to 0.80 mm

D. The width of the cutting edge of a gingival marginal

trimmer

13. Which of the following statements about class V

amalgam restorations is not correct?


A. The outline form is usually kidney-shaped or

crescent-shaped.

B. Because the mesial, distal, gingival, and incisal walls

of the tooth preparation are perpendicular to the

external tooth surface, they usually diverge facially. C. Using four corner coves instead of
two full-length grooves conserves dentin near the pulp and may reduce the possibility of a
mechanical pulp

exposure.

D. If the outline form approaches an existing proximal

restoration, it is better to leave a thin section of tooth structure between the two
restorations (<1 mm) than to join the restorations.

14. When preparing a class III or IV composite tooth preparation, which of the following
statements regard- ing placement of retention form is false?

A. Placement of retention form often involves gingival

and incisal retention.

• Placement of retention form is placed at the axio- gingival line angle regardless of
the depth of the axial wall. 

• Placement of retention form may be needed in large preparations. 


• Placement of retention form is usually prepared with a No. 14 round bur. 


15. In the conventional class I composite preparation, retention is achieved by

which of the following features?

1. Occlusal convergence 

2. Occlusal bevel

3. Bonding

4. Retention grooves A. 2and4

B. 1and3

C. 1and4

D. 2and3 


16. The success of an amalgam restoration depends on all of the following features
of tooth and cavity prepara- tion except one. Which one is the exception?

A. Butt-joint cavosurface margin that results in a 

90-degree margin for the amalgam

• Adequate tooth removal for appropriate strength of 


the amalgam 


• Divergent (externally) preparation walls 


• Adequate retention form features to lock the 


amalgam mechanically in the preparation 


17. Many factors affect tooth/cavity preparation. Which of the following would be
the least important factor? 

A. Extent of the defect

B. Size of the tooth

C. Fracture lines

D. Extent of the old material 


18. Which of the following statements about an amalgam tooth/cavity preparation

is true?

A. The enamel cavosurface margin angle must be 90 

degrees.
 • The cavosurface margin should provide for a 

90-degree amalgam margin. 


• All prepared walls should converge externally. 


• Retention form for class V amalgam preparations 


can be placed at the dentinoenamel junction 

(DEJ). 


19. A “skirt” feature for a gold onlay preparation ____. 


A. Has a shoulder gingival margin design 


B. Is prepared by a diamond held perpendicular to the

long axis of the crown


C. Is used only for esthetic areas of a tooth

D. Increases both retention and resistance forms

20. Causes of postoperative sensitivity with amalgam res- torations include all of the
following except one. Which one is the exception?

A. Lack of adequate condensation, especially lateral

condensation in the proximal boxes B. Voids

C. Extension onto the root surface

D. Lack of dentinal sealing


21. Factors that affect the success of dentin bonding

include all of the following except one. Which one is the exception?

A. Dentin factors such as sclerosis, tubule morphol-

ogy, and smear layer


B. Tooth factors such as attrition, abrasion, and

abfraction

C. Material factors such as compressive and tensile

strengths

D. C-factor considerations

22. Which of the following statements regarding carving a class I amalgam restoration is
false?

A. Carving may be made easier by waiting 1 or 2
minutes after condensation before it is started.

B. The blade of the discoid carver should move parallel to the margins resting on the
partially set amalgam.

C. Deep occlusal anatomy should not be carved.


D. The carved amalgam outline should coincide with

the cavosurface margins.


23. The generally accepted maximum thickness of a com-

posite increment that allows for proper cure is ____. A. 1to2mm


B. 2to4mm

C. 4to6mm

D. There is no maximum thickness restriction.


24. The setting reaction of dental amalgam proceeds pri-

marily by ____.

A. Dissolution of the entire alloy particle into mercury B. Dissolution of the copper from
the particles into

mercury

C. Precipitation of tin-mercury crystals

D. Mercury reaction with silver on or in the alloy

particle

25. What is the half-life of mercury in the human body?

A. 5 days B. 25 days C. 55 days D. 85 days E. 128 days

26. Restoration of an appropriate proximal contact results in all of the following except
one. Which one is the exception?

A. Reduces or eliminates food impaction at the inter-

dental papilla

B. Provides appropriate space for the interdental

papilla

C. Provides increased retention form for the

restoration

D. Maintains the proper occlusal relationship

27. The best way to carve amalgam back to occlusal cavo- surface margin is to ____.

A. Use visual magnification

B. Use a discoid-cleoid instrument guided by the

adjacent unprepared enamel

C. Make deep pits and grooves

D. Use a round finishing bur after the amalgam

has set

28. Major differences between total-etch and self-etching 


primer dentin bonding systems include all of the fol- lowing except one. Which
one is the exception?

A. The time necessary to apply the material

B. The amount of smear layer removed 

C. The bond strengths to enamel 

D. The need for wet bonding 


29. Which of the following statements is not true regard- 


ing bonding systems?

• Although dentin bonding occurs slowly, it results 


in a stronger bond than to enamel. 


• Enamel bonding occurs quickly, is strong, and is 


long-lasting. 


• One-bottle dentin bonding systems may be simpler 


but are not always better. 


• Dentin bonding is still variable because of factors 


such as sclerosis, tubule size, and tubule location. 


30. A casting may fail to seat on the prepared tooth because of all of the following
factors except one. Which one is 

the exception?

• Temporary cement still on the prepared tooth after 


the temporary restoration has been removed 


• Proximal contacts of casting are too heavy or too 


tight 


• Undercuts present in prepared tooth 


 • The occlusal of the prepared tooth was 

underreduced 


31. For a gold casting alloy, which of the following is added 


primarily to act as a scavenger for oxygen during the casting process?

A. Copper

B. Palladium 

C. Silver 

D. Zinc 


32. All of the following are likely to indicate the need for 

restoration of a cervical notch except one. Which one is the exception?

A. Patient age

B. Esthetic concern 

C. Tooth is symptomatic 

D. Tooth is deeply notched axially 


33. When comparing pin retention with slot retention for 


a complex amalgam restoration, which of the following statements is false?

A. Slots are used where vertical walls allow opposing 

retention locks.

• Slots provide stronger retention than pins. 


• Slots and grooves can be used interchangeably. 


• Pin retention is used primarily where there are few 


or no vertical walls. 


34. All of the following statements about slot-retained 


complex amalgams are true except one. Which one is the exception? 


A. Slots should be 1.5 mm in depth.


B. Slots should be 1 mm or more in length.

C. Slots may be segmented or continuous.

D. Slots should be placed at least 0.5 mm inside the

dentinoenamel junction (DEJ).


35. Bonding of resins to dentin is best described as involv-
ing ____.

A. Mechanical interlocking B. Ionic bonding

C. Covalent bonding

D. van der Waals forces

36. Which one of the following acids is generally recom- mended for etching tooth
structure?

A. Maleic acid

B. Polyacrylic acid

C. Phosphoric acid

D. Tartaric acid

E. Ethylenediamine tetraacetic acid

37. The principal goals of bonding are ____.


A. Sealing and thermal insulation

B. Strengthening teeth and esthetics

C. Esthetics and reduction of postoperative

sensitivity

D. Sealing and retention

E. Retention and reduction of tooth flexure

38. Triturating a dental amalgam ____.


A. Reduces the size of the alloy particles B. Coats the alloy particles with mercury C.
Reduces the crystal sizes as they form D. Dissolves the alloy particles in mercury

39. Which of the following is a primary contraindication for the use of a composite
restoration?

A. Occlusal factors

B. Inability to isolate the operating area

C. Nonesthetic areas

D. Extension onto the root surface


40. Which of the following materials has the highest linear

coefficient of expansion? A. Amalgam


B. Direct gold

C. Tooth structure

D. Composite resin

41. Which of the following is the most common pin used

in restorative procedures? A. Friction-locked pin


B. Cemented pin

C. Amalgam pin
 With regard to the mercury controversy related to the use of amalgam restorations,
which of the following statements is not correct?

D. Self-threaded pin

42. A cervical lesion should be restored if it is ___Scientific evidence is lacking that
amalgam poses health risks to humans except for rare allergic reactions. 


• Alternative amalgamlike materials with low or no mercury content have promise. 


• True allergies to amalgam rarely have been reported. 


• Efforts are under way to reduce the environmental mercury to which people are
exposed to lessen their total mercury exposure. 


44. Compared with amalgam restorations, composite res- torations are ____.

A. Stronger

B. More technique-sensitive 

C. More resistant to occlusal forces 

D. Not indicated for class II restorations 


45. Whichofthefollowingstatementsregardingthechoice between doing a composite

or amalgam restoration 

is true?

A. Establishing restored proximal contacts is easier 

with composite.

• The amalgam is more difficult and technique- 


sensitive. 


• The composite generally uses a more conservative 


tooth/cavity preparation. 


• Only amalgam should be used for class II 


restorations. 


46. Eburnated dentin has which of the following charac- 


teristics? (Choose all that apply.)

A. Is sclerotic dentin

B. Indicates recent poor hygiene

C. Usually appears as a white patch D. Is firm to the touch of an explorer E. Is
usually seen in older patients 

 47. Rounding internal cavity preparation angles is part of what form in cavity
preparation?

A. Resistance form

B. Retention form 

C. Convenience form 

D. Outline form 


48. Which of the following terms refers to tooth structure 


loss in the cervical area secondary to biomechanical loading?

A. Abfraction

B. Abrasion 

C. Attrition 

D. Erosion 


49. For a mechanical pulp exposure that is noncarious and 


the exposure is less than 1.0 mm, what is usually the most appropriate
treatment?

A. No pulp treatment

B. Direct pulp cap 

C. Indirect pulp cap 

D. Endodontic therapy 


50. A beveled shoulder design around a capped cusp of a 


gold onlay preparation is termed a ____. 


51.

A. Skirt

B. Stubbed margin

C. Secondary flare

D. Groove extension bevel

E. Collar

After completing the tooth preparation for the applica- tion of an etch-and-rinse (total-
etch) three-step dental adhesive, what is the next step?

A. Apply adhesive

B. Rinse etchant and leave surface wet

C. Apply two to three layers of primer

D. Etch enamel and dentin with phosphoric acid for

10 to 15 seconds E. Light-cure

_.
 A cervical lesion should be restored if
A. Carious

B. Very sensitive

C. Causing gingival inflammation D. All of the above

43. With regard to the mercury controversy related to the use of amalgam restorations,
which of the following statements is not correct?