Question: 1. The dental lamina: a. Consists of dental mesenchyme b. Is also known as the basal lamina c.

Is composed of type I and type III collagen d. Initiates the formation of the enamel organ Explanation: Refer to pg(s): 454 Question: 2. The stellate reticulum: a. Lies between the inner and outer epithelium Explanation: Refer to pg(s): 454 b. Gives rise to the odontoblastic layer c. Gives rise to the periodontal ligament and attachment apparatus d. Is a neural network that controls innervations of the dental pulp Question: 3. During tooth development, neural innervation: a. Takes place in the bud stage b. Occurs after the crown shape is defined by the enamel Explanation: Refer to pg(s): 455 c. Follows sympathetic innervations d. Is necessary for histodifferentiation of ameloblasts and odontoblasts Question: 4. Mantle dentin: a. Underlies enamel and is highly mineralized to support adhesion b. Is composed of calcospherites that failed to fuse during mineralization c. Is located adjacent to cementum d. Is the first layer of primary dentin Explanation: Refer to pg(s): 458 Question: 5. Hertwigs epithelial root sheath: a. Is derived from the enamel organ and forms cementum b. Consists of the inner and outer enamel epithelium Explanation: Refer to pg(s): 457 c. Is derived from the epithelial rests of Malassez d. Is composed of cells that differentiate into cementoblasts e. Separates the root from the connective tissues prior to eruption

Question: 6. Which of the following statements regarding the structure of dentin is correct? a. The percentage of dentinal tubules per surface area is constant. b. No peritubular dentin is present when the tubules reach the predentin and pulp. Explanation: Refer to pg(s): 459 c. Dentin varies considerably from the human in cats, dogs, and monkeys. d. Sclerosis of the tubules occurs coronally but is uncommon in the apical portion of the tooth. Question: 7. Dentinal fluid: a. Resembles blood plasma, but the protein content is higher b. Has a high concentration of calcium in the predentin area Explanation: Refer to pg(s): 460 c. Prevents embrittlement of dentin d. Has collagenolytic properties that assist in the dentinal remodeling Question: 8. Von Korff fibers are thought to be: a. Remnants of the lateral lamina persisting near the basement membrane following the initiation of ameloblasts b. Terminal nerve fibers entering the predentin and regulating the calcification front c. The terminal odontoblastic processes prior to initial calcification d. The first formed collagen fibers located between the preodontoblasts and extending toward the basal lamina Explanation: Refer to pg(s): 456 Question: 9. Each of the following statements regarding the dentinal tubules is correct EXCEPT ONE. Which is this EXCEPTION? a. The tubule diameter near the pulp/dentin interface is approximately 1 to 2.5 m. b. In the coronal dentin, the tubules exhibit an S-shaped curvature. c. Intertubular dentin lines the inner walls of tubules Explanation: Refer to pg(s): 459 d. Lateral microtubules contain branches of the odontoblastic process. e. Peritubular dentin, when present, lines the tubule. Question: 10. The structure of peritubular dentin: a. Is similar to intertubular dentin in collagen and mineral content b. Exhibits a lower content of collagen when compared to intertubular dentin Explanation: Refer to pg(s): 459 c. Restricts removal by acids, owing to the low sulfated proteoglycans and mineral content

d. Adds strength and structural support to the intertubular dentin e. Is formed only in the presence of a vital odontoblastic process Question: 11. Which of the following statements best describes dentinal fluid? a. Plasma proteins are present in concentrations similar to blood plasma. b. The fluid in dentin is homogeneous and uniform. c. The fluid is an ultrafiltrate of blood in the pulpal capillaries. Explanation: Refer to pg(s): 460 d. Slow outward movement of dentinal fluid activates mechanoreceptors, producing pain. e. Dentinal fluid is responsible and necessary for maintaining the physical properties of dentin. Question: 12. The odontoblast differs from other mesenchymal cell lines because of: a. Secretion of phosphophoryn Explanation: Refer to pg(s): 466 b. Production of type I collagen c. Production of sialoprotein d. Production of alkaline phosphatase e. The presence of multiple nucleoli Question: 13. The lamina limitans is: a. An electron-dense membrane lining the dentinal tubule Explanation: Refer to pg(s): 467 b. Another term for the vital odontoblastic process c. The peripheral peritubular dentin d. Composed of microfilaments and microtubules e. A layer between the predentin and dentin which regulates calcification Question: 14. Odontoblastic production of: a. Proteoglycans takes place in the Golgi complex prior to secretion at the base of the odontoblastic process b. Collagen consists of synthesis of procollagen, secretion of tropocollagen, and aggregation of fibrils on the outer odontoblastic membrane Explanation: Refer to pg(s): 468 c. Proteoglycans increases calcification of predentin by increasing transport of calcium through the microtubules d. Lysosomal enzymes are an important first line defense against microbial invasion

Question: 15. Pulpal fibroblasts: a. Are equally distributed throughout the pulp b. Synthesize type I and type III collagen Explanation: Refer to pg(s): 468 c. Are end-line cells incapable of differentiation d. Exhibit a polygonal morphologic shape when mature Question: 16. Dendritic cells: a. Are similar to Langerhans cells found in the epidermis and mucous membranes Explanation: Refer to pg(s): 469 b. Are primarily phagocytic cells that are centrally located in the pulp c. Provide a population of replacement cells for disintegrating odontoblasts d. Are specialized cells that transmit pain impulses toward the central nervous system via the spinothalamic pathway e. Present antigens to polymorphonuclear leukocytes Question: 17. Which of the following statements regarding lymphocytes is correct? a. Lymphocytes are not found in normal pulp tissues. b. B lymphocytes are usually found in the pulp and are responsible for antigen presentation to macrophages. c. T4 (helper) lymphocytes predominant in the normal pulp. d. T8 (suppressor) lymphocytes are the predominant subset in the normal pulp. Explanation: Refer to pg(s): 469 Question: 18. The principle proteoglycans of the dental pulp: a. Are fibronectin, laminin, and tenascin b. Are hyaluronic acid, dermatan sulfate, heparin sulfate, and chondroitin sulfate Explanation: Refer to pg(s): 472 c. During active dentinogenesis are hyaluronic acid and dermatan sulfate d. When mineralization activity is low is chondroitin sulfate e. Are not affected during inflammation, because of their hydrophilic nature and colloidal state Question: 19. Type IV collagen is typically: a. Absent from the pulp b. A component of the ground substance and provides structure for the body of the pulp c. Found in basement membranes Explanation: Refer to pg(s): 453, 472

d. Synthesized by odontoblasts at the mineralization front and regulates calcification rates e. Synthesized by osteoclasts and is absent from the dental pulp Question: 20. Which of the following statements regarding innervation of the pulp is correct? a. Myelinated fibers are the last major structures to appear in the developing pulp. Explanation: Refer to pg(s): 474 b. Autonomic fibers are afferent neurons which regulate microcirculation. c. A-beta and A-delta exist in equal numbers and are stimulated by fluid movement in the dentinal tubules. d. The dental papilla contains both myelinated and unmyelinated fibers. e. A-delta and C fibers are exhibit separate and distinct functions. Question: 21. Electric pulp testing in young teeth: a. May be unreliable because of the late development of A-delta fibers Explanation: Refer to pg(s): 475 b. Results in a sharp, rapid response because of the predominance of the C fibers in the pulp c. Does not differ from more mature normal teeth that are without calcific metamorphosis d. Is best accomplished with cold, owing to the predominance of the A-delta fibers in the pulp Question: 22. Each of the following might explain why a necrotic pulp might respond to testing or mechanical manipulation EXCEPT ONE. Which is this EXCEPTION? a. The nerve fibers may be resistant to necrosis. b. Nerve bundles are more resistant to autolysis. c. C fibers remain active in the presence of hypoxia. d. The cell body of the neuron lies outside the pulp. e. A-delta fibers exhibit a lower threshold for stimulation in hypoxia. Question: 23. Each of the following statements regarding deafferentation is correct EXCEPT ONE. Which is this EXCEPTION? a. It is the process of degeneration of neurons centrally following nerve resection. b. Pain may be a result of this process. c. Transsynaptic degenerative changes may be reflected in the sensory cortex. d. With pulp extirpation, degeneration of nerves can extend beyond the trigeminal ganglion. e. It is the elimination of pain transmission to the central nervous system resulting from the application of a local anesthetic on the nerve. Explanation: Refer to pg(s): 478 Question: 24. Which of the following statements regarding pulp testing is correct?

a. C fibers are normally stimulated by electric pulp testing but do not respond to thermal pulp testing. b. C fibers are normally stimulated by thermal pulp testing but do not respond to electric pulp testing. c. C fibers normally have a high threshold and require a more intense stimulus when compared to A-delta fibers. Explanation: Refer to pg(s): 475 d. A-delta fibers normally respond to thermal stimulation better than C fibers, but both fiber groups respond the same to electric pulp testing. Question: 25. Which of the following statements regarding dentinal sensitivity is correct? a. The movement in the tubules is translated into electrical signals by sensory receptors within tubules or the pulp. Explanation: Refer to pg(s): 478 b. The rate of fluid flow is not a factor in producing an electrical stimulus. c. The inward flow of fluid produces a more pronounced sensory nerve response. d. There must be a change in temperature at the pulp/dentin interface for a sensory response to occur. e. The application of heat causes expansion of the dentin, widens the dentinal tubules, draws fluid from the pulp into the dentin, and results in sensory stimulation. Question: 26. Which of the following statements regarding neuropeptides is correct? a. Sympathetic agents used in local anesthesia can modify the release of calcitonin gene-related peptide. Explanation: Refer to pg(s): 480-481 b. The primary function of these peptides is the production of pain. c. The release of neuropeptides occurs only in the presence of tissue injury, and their actions contribute to tissue damage, creating a vicious cycle of inflammation. d. These agents are released by odontoblasts and fibroblasts following sensory stimulation, and efferent messages are received from the central nervous system. Question: 27. Each of the following statements regarding pulpal hyperalgesia is correct EXCEPT ONE. Which is this EXCEPTION? a. There is a decreased pain threshold and an increased response to stimulation. b. An enhanced response to a stimulus results, but spontaneous pain is not characteristic of this phenomenon. Explanation: Refer to pg(s): 482 c. Increased pressure may be a contributing factor. d. The upregulation of tetrodotoxin-resistant sodium channels in inflamed tissues makes local anesthesia more difficult. e. Silent nerve fibers in the pulp become sensitized and may be activated.

Question: 28. Which of the following statements regarding the vascular supply of the pulp is correct? a. Arteries enter the pulp and give rise to arterioles that branch and form a capillary network in the subodontoblastic zone. b. Capillary blood flow in the coronal portion of the pulp is twice that in the radicular portion of the pulp. Explanation: Refer to pg(s): 483 c. Arteriovenous anastomoses are present throughout the pulp but are more common in the coronal tissue. d. The volume of pulp occupied by vessels is higher than most tissues and approaches 25%. e. The pulp has the highest volume of blood flow of oral tissues and most visceral organs. Question: 29. Reactionary dentin is best described as: a. Atubular and amorphous as seen in calcific metamorphosis b. Tertiary dentin formed by the original odontoblasts Explanation: Refer to pg(s): 458 c. An area of tubule sclerosis below an advancing carious lesion d. Reparative dentin formed by cells replacing the original odontoblasts e. Dentin exhibiting decalcification due to the selective removal of peritubular dentin Question: 30. Which of the following best describes pulpal calcification? a. The radiographic appearance of pulp stones in the chamber indicates pathosis. b. Idiopathic pulpal pain has been demonstrated to be caused by laminated pulp stones which produce an alteration of blood flow. c. Calcific metamorphosis results in a high incidence of necrosis when canal obliteration is complete. d. Calcifications typically consist of carbonated hydroxyapatite. Explanation: Refer to pg(s): 494 Question: 31. The structure indicated by the arrow labeled A is: a. The periodontal ligament b. The cell-free zone c. Mantle dentin d. Predentin Explanation: Refer to pg(s): 459,464 e. Artifact separation of the odontoblastic layer

Question: 32. The structure indicated by the arrow labeled B is a(n): a. Vascular channel Explanation: Refer to pg(s): 483 b. Lymphatic c. Myelinated nerve fiber d. Unmyelinated nerve fiber e. Autonomic nerve fiber Question: 33. The structure indicated by the arrow labeled C is: a. The odontoblastic layer b. The cell-rich zone Explanation: Refer to pg(s): 464-466 c. von Korffs fibers d. Chronic inflammatory infiltration e. Mast cells Question: 34. The basal dental lamina: a. Is composed of an elastic network of type IV collagen Explanation: Refer to pg(s): 453 b. Is formed by dental mesenchymal cells c. Contains von Korffs fibers d. Differentiates to form odontoblasts e. Is an extracellular matrix Question: 35. Epithelial enamel knots: a. Induce the dental papilla to produce odontoblasts b. Control morphogenesis Explanation: Refer to pg(s): 455 c. Result in the formation of enamel pearls during root formation

d. Are developmental defects in the incisal and cusp areas and occur during morphodifferentiation Question: 36. Which of the following is correct regarding the physiology of the dental pulp? a. The rate of oxygen consumption is low compared to most tissues. Explanation: Refer to pg(s): 470 b. The phosphogluconate (pentose phosphate) shunt is absent in the dental pulp. c. Ischemia is not well tolerated by the tissue. d. The glycolytic pathway is an alternate energy pathway for respiration. Question: 37. Which of the following is primarily involved in active dentinogenesis? a. Hyaluronic acid b. Chondroitan sulfate Explanation: Refer to pg(s): 472 c. Dermatan sulfate d. Heparan sulfate Question: 38. Pulpectomy: a. Results in deafferentation and total cessation of symptoms b. Produces neurochemical changes in the cell bodies of neurons located in the Gasserian ganglia Explanation: Refer to pg(s): 478 c. Has no effect on central projection neurons of the spinal nucleus d. Produces complete axonal degeneration of the cell body Question: 39. Antidromic stimulation is best described by which of the following? a. An afferent barrage of signals centrally to the spinal tract of V b. Sympathetic stimulation resulting in vasoconstriction of arterioles c. An action potential that travels toward the periphery, resulting in neuropeptide release Explanation: Refer to pg(s): 481 d. Parasympathetic stimulation of C fibers, resulting in vasodilatation