牙体牙髓习题集与答案

选择题对牙髓最具有破坏性的是Nd激光CO2激光红激光光固化灯牙髓活力电测定仪感染根管常见的优势菌不包括普氏菌放线菌G＋细菌真杆菌梭形杆菌3.备洞时易损伤牙髓的因素不包括施力大用冷却剂持续常时间钻磨制备深的窝洞不用冷却剂4.与顽固性根尖周病变和窦道经久不愈可能有关的细菌为普氏菌放线菌G＋细菌真杆菌梭形杆菌5.判断牙髓活力最可靠的检查方法是热诊冷诊牙髓活力电测定试验性备洞X线检查6．诊断残髓炎最准确的依据是叩诊牙髓活力测试病史 症状探查治疗后根管有痛觉7．急性根尖周脓肿最佳的排脓途径从牙周间隙排脓从颊、舌侧粘膜或皮肤排出经根管从龋洞排脓从上颌窦或鼻腔排脓以上都不对8．感染侵入牙髓组织的途径深龋深牙隐裂深牙周袋重度磨耗 以上都有可能9．根尖周炎疼痛最剧烈的阶段是粘膜下脓肿期骨膜下脓肿期浆液期根尖脓肿期瘘管形成期10．上颌第一磨牙的根管形态特点是：c多数是2根管，即1个颊根管和1个腭根管多数是3根管，即1个近颊、1个远颊和1个腭根管多数是4根管，即2个近颊、1个远颊和1个腭根管多数是4根管，即1个近颊、2个远颊和1个腭根管多数是4根管，即1个近颊、1个远颊和2个腭根管11．15号标准根管锉的锉尖直径和刃部末端直径分别是：d0.10mm和0.47mm0.10mm和0.45mm0.15mm和0.45mm0.15mm和0.47mm以上都不对12．弯曲根管预备的常见并发症是：a根管台阶药物性根尖周炎牙周组织坏死皮下气肿误戏和误咽13．根管预备的工作长度是指：d牙的实际长度从牙冠参照点到牙本质牙釉质界从牙冠参照点到解剖根尖孔从牙冠参照点到生理根尖孔从牙冠参照点到距生理根尖孔0.5~1mm14．根管成形的标准是：a根管比原来直径至少扩大3个器械号根尖预备到20号标准器械根管内无大量渗出根管冲洗无混浊液体根管内无严重气味15．下列哪一项不是牙髓切断术的潜在并发症：e根髓感染根管钙化内吸收牙髓坏死髓室穿孔16．下列哪一项描述不是玻璃离子粘固剂修复术窝洞预备的特点（）C玻璃离子粘固剂与牙体组织有化学粘接，对固位形的要求可放宽不必作倒凹、鸠尾等固位形去除龋坏牙本质，必须作预防性扩展窝洞的点、线角圆钝洞缘釉质不作斜面17．深龋患者激发痛较重，洞底软龋能够彻底去净，治疗方法应选择（）C双层垫底，一次完成充填治疗局麻下开髓失活，行牙髓治疗先做安抚治疗，待1~2周复诊时症状消除后，再以双层垫底充填治疗实行活髓切断术间接盖髓、双层垫底，一次完成充填治疗18．临床上不易查出的继发龋可用下列哪些方法帮助诊断（）C探诊温度测验X线染色法麻醉法19．深龋备洞时，下列哪项措施是错误的（）A洞底平、侧壁直，两相垂直去尽腐质保护牙髓洞缘线圆钝尽量保留健康牙体组织20．复合树脂充填后脱落的原因如下，除了（）A制备了固位形牙齿表面未注意清洁酸蚀后的牙面接触唾液未制备洞斜面充填体过薄21．下列哪项不是窝洞的基本固位形(B)侧壁固位钉道固位倒凹固位鸠尾固位梯形固位22．制备倒凹是为了：(B)获得良好的抗力形获得良好的固位形便于垫底便于充填便于放置盖髓剂23．=5\*ROMANV类洞充填备洞时，要求：(A)适当的固位形严格的抗力形必须做鸠尾口小底大底平壁直24．右下颌第一恒磨牙颊面龋洞破坏越过边缘嵴至咬合面窝沟是：(A)=1\*ROMANI类洞=2\*ROMANII类洞=3\*ROMANIII类洞=4\*ROMANIV类洞=5\*ROMANV类洞25．垫底的部位为：(D)仅在髓壁仅在轴壁仅在侧壁仅在髓壁和轴壁任何壁均可垫26．下列说法正确的是B男性患龋率略高于女性龋病流行率主要随社会经济模式而变化龋病流行模式依靠地理环境而改变遗传因素对龋病的发生和发展产生重要的影响环境因素对龋病的发生和发展无影响27．釉质龋损害的4个区不包括A坏死区透明带暗带损害体部釉质表面层28．牙本质龋损在光镜下可看到微生物渗透至牙本质小管的区域是B坏死区感染层牙本质脱矿区硬化区修复性牙本质层29．静止龋属于B急性龋慢性龋继发龋牙釉质龋牙骨质龋30．病程进展快，多数牙在短期内同时患龋的急性龋称为E湿性龋慢性龋干性龋继发龋猛性龋31WhichisthebestwayofpaincontrolforendodontictreatmentLocalanestheticsDevitalizationAnalgesicsOcclusalreductionIncisinganddrainage32WhichoneisnotthereasonforuseofrubberdamProtectaspirationorswallowingofinstrumentsorirrigantsEliminatethedentalfearofpatientsImprovevisibilityReducedriskofcross-contaminationLegalconsiderations33ThefollowingstatementsarecorrectexceptNearlyallcanalsexhibitacertaindegreeofcurvature.Theremaybemorethanonecanalswithinoneroot.Theapicalforamenusuallyopensattheanatomicalapex.Apicalconstrictionoccursat0.5~1mmfromtheapicalforamen.Lateralandaccessorycanalsmightbethecauseoftreatmentfailure.34WhichoneiswrongregardingtheprincipleofaccesscavityA Straight-lineaccessB ConservationoftoothstructureC UnroofingofthechamberandexposureofpulphornsD FacialsurfaceofanteriorteethE Occlusalsurfaceofposteriorteeth35Theadvantagesofgutta-perchaasafillingmaterialareItiscompactibleandadaptsexcellentlytotheirregularitiesandcontourofthecanalItisradiopaqueItcanbeeasilyremovedfromthecanalwhennecessaryItcanbesoftenedandmadeplasticbyheatorbyorganicsolventsAlloftheabove36Whichoneisincorrectaboutthecriteriaoftherootcanalisreadytobefilledafterthecompletionofrootcanalcleaningandshaping?Thetoothisasymptomatic.Thecanaliswet.Thereisnosinustract.Thereisnofoulodor.Thetemporaryfillingisintact37Whichoneisnotthepathwaysofpulpalandperiapicalinfections?DentinaltubulesPulpexposureGingivalPeriodontalligamentAnachoresis38Tug-backisachievedandthecanalisreadyforfillingWhenthegutta-perchahasextendedbeyondtheapexWhenthegutta-perchaiseasilyremovedfromtherootcanalWhenthegutta-perchaplacedtoapicalconstrictionexhibitsresistanceonremovalAftercementationNoneofabove39Mostrootcanalinfectionsinvolveasingleobligateanaerobicspeciesmultipleanaerobicspeciesonlymixedaerobicandanaerobicmicroorganismsmultipleaerobicspeciesonlynoneofabove40Anabnormallyshapedtooththatmayappearasanextrawidecrown,anormalcrownwithanextraroot,orothercombinationsresultingfromtheunionoftwoadjacenttoothgermsbydentinduringdevelopmentiscalledfusedteethconcresenceofteethgeminatedteethdilacerationsoftoothtaurodontism41Whichisn’tthenon-operativetreatmentofdentalcariesinthefollowing?applicationoffluorideapplicationofAPFgelremineralizativetherapyenameloplastypitandfissuresealing42Whichisnottheaimofoperativetherapyonthedentalcariesmanagement?ToremoveinfecteddentineandprohibitcariesToprotectthepulpandavoidpainToenhancethestrengthofthetoothTofacilitateplaquecontrolTorestoretheappearance(ofteeth)anditsfunction43WhichisthebeststatementaboutresistanceformResistanceformisthedesignofacavityinsuchawaythattheremainingtoothsubstanceandtherestorativematerialcanwithstandmasticatorystressThebulkrequiredwilldependontheflexuralstrengthofrestorativematerial.Inthecaseofamalgamitisestimatedthataminimumof1.5-2mmthicknessoftherestorativematerialisrequiredtowithstandmasticatorystressIfamarginalridgeisfoundtobetooweakinthecauseofanocclusalcavitypreparation,aClassIIcavitymayhavetobepreparedinstead,soastoeliminatetheweakmarginalridge.ThisisparticularlyindicatedwheretheridgeisonlyofenamelthicknessandunsupportedbysounddentineThecavityshouldbedesignedthattheocclusalmarginsofthecavityareinareasnotsubjectedtoexcessiveocclusaltrauma,otherwisetheenamelwallofthecavityand/orthemarginsoftherestorativematerialmayfracture.Inpractice,thismaybeachievedbyplacinganocclusalmarginsofacavityaboutone-quarter(1/4)oftheintercuspaldistance.Note,thateffortsshouldalwaysbemadetoconservesoundtoothtissueAlloftheabove44Whichisthemostdangerareaoftoothindentalcariesoccurredafteryouhavelearneddentalcaries?PitsandfissuresonocclusalsurfacesofmolarsandpremolarsApproximalsurfacesofallteeth.Gingivalthirdsofallteeth,bothonfacialandlingualsurfacesPitsandfissuresnearthelingualofmaxillaryincisorsandcanines(lingualpits)Pitsandfissuresonthebuccalofmolars45Whichisnottrueinthefollowingstatementaboutdentalcariesandmicro-organisms?Cariescouldbeinducedbyspecificbacteria,especiallymutansstreptococci-group(eg.StreptococcusmutansandStrep.sobrinus).Therearecariesoccurredwhenonlyfedacariogenic(highsucrose)diet.Inthe’60sKeyesinfectedgerm-freeanimalswithknownstrainsofstreptococciandfoundthattheseorganismsweretransferredtouninfectedlittermateswhothenbecamesusceptibletocaries.Hethusdemonstratedthatdentalcarieswaspotentiallyinfectiousandtransmissible.Whentalkingaboutcariogenicmicroorganisms,weoftenrefertoStreptococcusmutans,LactobacillusandActinomyces.Occlusalcariescouldbepreventedusingpenicillininanimalstudy.46Theadvantagesglass-ionomercementincludehighadhesionpropertieslowabrasionpropertiesuseasapermanentrestorationreductionincariesduetofluoridereleasingpropertiesalloftheabove47Whichoneofthestatementsiserrorinretentivepinplacementbeavoidedbifurcationandtrifurcationareasparalleltotheexternalsurfaceofthetoothmanypinholesbebetterplacedindifferentplanesthelengthofpinindentineshouldbelongerthanthatofinrestorationbeinthehardestdentine48Thereasonsofspontaneouspainaftertoothfillingincludemistakenlyjudgetheconditionofpulpneglectsmallpulpexposureirritationofmaterialstopulpresidualcariousdentinealloftheabove49Whichofthefollowingisacontra-indicationtoendodontictreatmentDiabetesPregnancyHIV-infectedpatientsPatientsufferingfromheartattackwithinpast6monthsCancer50Centralcuspismostcommoninmaxillarythesecondpremolarsmaxillarythefirstpremolarsmandibularthefirstpremolarsmandibularthesecondpremolarsmaxillarythesecondmolars51Submergeddeciduousteethoccursmostcommoninprimarymaxillarythesecondmolarsprimarymaxillarythefirstmolarsprimarycentralincisorsprimarymandibularthesecondmolarsprimarymandibularthefirstmolars52Inclinicalassessment,whichisnotcorrect?SpontaneousdiscomfortatnightprovideaclueasthetoothisinflamedVitalometertestsareveryunreliableIfthetoothisexcessivelymobile,itmayhaveabnormalrootresorptionSwellingorwithafistuloustractisindicativeofanecroticpulpNopainhistoryaffirmednoinflammation53Ifyoumechanicallyexposethemesiobuccalpulphornontheprimarymaxillaryfirstmolar.Thecariouslesiononthemesialanddistalsurfacesismoderate,thetreatmentnowshouldbePulpcappingwithCa(OH)2;restorwithsilveramalgamPulpotomy;restoredwithastainlesssteelcrownPulpectomy;restoredwithastainlesssteelcrownPulpcappingwithCa(OH)2;restoredwithastainlesssteelcrownExtractionandaspacemaintainer54Thetoothofrootfractureshouldbetreatedwithsplintfor2-3weeks1-2weeks3-8weeks2-3months1-2months55Inwhichsituationbelowthepulpwouldbeexposed?EnamelinfractionEnamelfraciureEnamel-dentinfractureComplicatedcrownfractureUncomplicatedcrown-rootfracture56WeshouldadvocatearoutinedentalappointmentonorbeforetheZERObirthdaythefirstbirthdaythesecondbirthdaythethirdbirthdaythesixbirthday57TheorderofsusceptibilityoftheprimaryteethtocariousattackisasfollowsMandibularprimarymolar>Maxillaryprimaryincisor>Maxillaryprimarymolar>mandibularprimaryanteriorteethMaxillaryprimaryincisor>Maxillaryprimarymolar>mandibularprimarymolar>mandibularprimaryanteriorteethMaxillaryprimaryincisor>mandibularprimarymolar>mandibularprimaryanteriorteeth>MaxillaryprimarymolarMaxillaryprimaryincisor>mandibularprimarymolar>Maxillaryprimarymolar>mandibularprimaryanteriorteethMaxillaryprimaryincisor>mandibularprimaryanteriorteeth>mandibularprimarymolar>Maxillaryprimarymolar58A7year’soldboywithbilaterallossofthemandibularprimaryfirstandsecondmolars,whichofthefollowingmaybebestBandandlooprespectivelyLingualarchRemovableappliancesDistalshoeNoneofthem59ClinicalfeaturesofdentalfluorosisdonotincludeThelesionsymmetricallydistributedinthemouth,butnotallteethareequallyaffectedTheleastaffectedteetharetheincisorsandfirstpermanentmolarsChangesfromfinewhiteopaquelinesrunningacrossthetoothonallpartsoftheenameltofeatureswherepartsofthechalkywhiteandporousouterenamelbecomedetachedanddiscoloredThelossofsurfaceenamelintheseverestcasesresultsinalossofanatomicalformoftheteethWell-demarcatedborderslesionalongincrementalline60Forintrusiveluxationofteeth,themostcommoncomplicationisPulpnecrosisOsteitisRootresorptionAlveolarprocessresorptionAllofabove名词解释acquiredpellicleresistanceformindirectpulpcappingretrogradepilpitis自发痛和激发痛DentinehypersensitivitySmearlayerPulpotomyInitialapicalfileDentalplaque简答题简述影响根管冲洗效果的因素简述深龋的治疗特点简述深龋的治疗特点简述窝洞的基本固位形简述牙隐裂的病因Whatisthesequelaeofrootfractures?Pleasebrieflydescribethebenefitsofrootcanalirrigation.Whatisthegoalsofpulptherapyinchildren?WhatarethepropertiesoftheCariogenicBacteria?问答题详述窝洞的结构及窝洞预备的基本原则结构引起牙髓活力测定误诊的原因是什么？根尖周脓肿与急性牙周脓肿的鉴别要点PleasediscussthepurposeofrootcanalpreparationandtheproceduresofStep-downtechnique.Explaintheindicationsandtypesofpulptreatmentforprimaryandyoungpermanentteeth.StateThePrinciplesOfCavityPreparationonAmalgamRestoration.答案一、选择题

1CCBBD6ECEBC11DADAE16CCCAA21BBAAD26BABBE31BCDEB36CCCAD41DCEAB46EDEDA51DEBDD56BDCEA二、名词解释acquiredpellicle唾液蛋白或糖蛋白吸附至牙面所形成的生物膜称获得性膜。resistanceform修复体和余留牙结构获得足够抗力，在承受合力时不折裂的形状称抗力形。indirectpulpcapping(P91)用具有消炎和促进牙髓－牙本质修复反应的制剂覆盖于洞底，促进软化牙本质再矿化和修复性牙本质形成，从而全部生活牙髓的方法叫间接盖髓术。retrogradepulpitis逆行性牙髓炎：感染来源于深牙周袋，通过根尖孔或测副根管逆行入牙髓，引起跟部牙髓的慢性炎症。自发痛和激发痛自发痛是指患牙在未受到外界刺激而发生的疼痛。激发痛是指患牙受到外界刺激而发生的疼痛。6.DentineHypersensitivityDentinehypersensitivityisaformofhypersensitivitycausedbytheeffectofthermal,tactile,osmoticorchemicalstimulionexposeddentine.7.smearlayerCuttingorabradingthehardtissueswithrotaryandhandinstrumentsproducesalittlechipsorparticleswhichattachedtothetoothsurfaceproducethesmearlayer8.PulpotomyItisindicatedforcariousormechanicalexposuresinprimaryteethandtoinducerootclosuresintheyoungpermanentdentition9.initialapicalfileThefirstfilethatbindsinthecanalatWL.10.dentalplaqueAnadherentdepositsofbacteriaandtheirproducts,whichisnotmineralizedandformsonalltooth,denturerestorationssurfaces.Itisnotanaccidentaccumulationofbacteriabutdevelopsinasequenceofsteps.三、简答题简述影响根管冲洗效果的因素药物种类根管的直径冲洗的液体量病变情况根管内玷污层简述深龋的治疗特点停止龋病发展，促进牙髓的防御性反应保护牙髓正确判断牙髓状况治疗方法：垫底充填，安抚治疗，间接盖髓术简述窝洞的基本固位形侧壁固位到凹固位鸠尾固位梯形固位举例4．简述牙隐裂的病因1）牙结构的薄弱环节是隐裂牙发生的易感因素2）牙尖斜度愈大，所产生的水平分力愈大3）创伤性合力5.Whatisthesequelaeofrootfractures?HealingwithcalcifiedtissueHealingwithinterproximalconnectivetissueHealingwithinterproximalboneandconnectivetissueInterproximalinflammatorytissuewithouthealing6.Pleasebrieflydescribethebenefitsofrootcanalirrigation.GrossdebridementFrequencyandvolumeofirrigantIntracanalplacementofdeliveryneedleEliminationofmicrobesDissolutionofpulpremnantsRemovalofthesmearlayerLubricatinginstrument7.Whatisthegoalsofpulptherapyinchildren?•Allowingthetoothtoremaininthemouthinanonpathologicstate•Maintenanceofarchlengthandtoothspace•Restorationofcomfortwiththeabilitytochew•Preventionofspeechabnormalitiesandabnormalhabits8.WhatarethepropertiesoftheCariogenicBacteria?•Acidogenic:theyareabletoproduceacidrapidlyfromfermentablecarbohydrates.•Aciduric:Theythriveunderacidconditions.•Adherent:Abletoadheretothetoothsurfacebecauseoftheirabilitytosynthesizestickyextracelluarpolysaccharidesfromdietarysugars.四、问答题详述窝洞的结构及窝洞预备的基本原则结构洞壁：测壁，髓壁（轴壁）洞角：线角，点角，轴髓线角洞缘：洞缘角抗力形：洞深，盒状洞形，阶梯结构，窝洞的外形，去除无基釉和避免形成无基釉，薄壁弱尖的处理固位形：侧壁固位，倒凹固位，鸠尾固位，梯形固位原则去净龋坏组织保护牙髓组织尽量保留健康牙体组织引起牙髓活力测定误诊的原因是什么？=1\*GB2⑴引起假阳性反应的原因=1\*GB3①探头或电极接触了大面积的金属修复体或牙龈，使电流流向了牙周组织；=2\*GB3②未充分隔湿或干燥受试牙，以至电流泄漏至牙周；=3\*GB3③液化性坏死的牙髓有可能传导电流至根尖周，当电流调节到最大刻度时，患者可能会缓慢抬手示意；=4\*GB3④患者过度紧张和焦虑，以致在探头刚接触牙面或被问知感受时即抬手。=2\*GB2⑵引起假阴性反应的原因=1\*GB3①患者事先用过镇痛剂、麻醉剂或酒精饮料等，使之不能正常地感知电刺激；=2\*GB3②探头或电极未能有效地接触釉质，以致妨碍了电流到达牙髓；=3\*GB3③根尖尚未发育完全的新萌出牙，其牙髓通常对电刺激无反应；=4\*GB3④根管内过度钙化的牙，其牙髓对电刺激通常无反应，常见于一些老年患牙；=5\*GB3⑤刚受到外伤的患牙可能对电刺激无反应。3．根尖周脓肿与急性牙周脓肿的鉴别要点急性根尖周脓肿急性牙周脓肿感染来源感染根管牙周袋病史较长期牙体缺损史牙痛史牙髓治疗史长期牙周炎史牙体情况深龋洞近髓的非龋疾病修复体一般无牙体疾病牙髓活力多无多有牙周袋无深，迂回曲折脓肿部位靠近根尖部中心位于龈颊沟附近较近牙龈炎脓肿范围较弥漫局限于牙周袋壁疼痛程度重相对较轻牙松动度相对轻，病愈后牙恢复稳固明显，消肿后仍很松动叩痛很重相对较轻X片无明显异常表现，若患牙为慢性根尖周炎急性发作者，根尖周牙槽骨显现透射影像牙槽骨脊破坏，可有骨下袋病程相对较长，脓液自根尖周向外排除的时间约需5－6天相对较短，一般3－4天可自溃4.StateThePrinciplesOfCavityPreparation.RemovalOfDentalCariesHardstandardStainedstandardProtectpulpUsesharpinstrumentColdtheoperatingtoothbywaterDiscontinuitycuttingorshapingNeverpresstothepulpAnatomyacknowledgesCavitypreparationisasconservativeaspossibleCavitypreparationisasconservativeaspossibleCavitysizeandshapearedictatedmainlybytheextentofthecariouslesion.Thecavosurfaceonlyextendtothesounddentaltissues,notforpreventionEstablishingresistanceandretentionformResistanceformisthedesignofacavityinsuchawaythattheremainingtoothsubstanceandtherestorativematerialcanwithstandmasticatorystress.Toachievethis,thepreparedcavityshouldpossessthefollowingattributes:FlatfloorAdequatebulkoftherestorativematerial,inthecaseofamalgamitisestimatedthataminimumof1.5-2mmAbsenceofweakcuspsormarginalridgesOcclusalcavitymarginsinareasnotsubjectedtoexcessiveocclusaltrauma.Inpracticeone-quarter(1/4)oftheintercuspalwidthFlatflooratrightanglestothelineofstress.Thefloorofpreparedcavityshouldbeflatandrightanglestothelineofocclusalstress,whichisusuallyinthedirectionoflongaxisofthetooth.Soundtoothtissueshould,however,notberemovedsimplytoobtainaflatpulpalfloorofpreparedcavityWallsofthecavityparalleltothedirectionofthestress.Toachievethis,thewallsofthecavityarepreparedparalleltothecorrespondingtoothsurfacesObtainretentionformRetentionform:Retentionformreferstothoseaspectsofcavitypreparationwhichensurethattherestorationisnotdislodgedfromthepreparedcavity.WallsshouldbeparallelorslightlyocclusallyconvergentFlatwallsparallelwithorperpendiculartothetoothsurfacecomposetheformofthesebox-likepreparationsUseofdovetaillockincompoundcavitiesUseofundercuts,pinsandgroovesFlatfloorandroundedbutdefiniteinternallineanglesRetentionforms:UndercutsDovetaillockGroovesandbox