Canadian Acfd Eligibility Exam Thread 2

[tinman831]

The last thread has been closed due to the discussion of remembered questions on the exam. Remember that you are not permitted to discuss exam questions per the non disclosure clause you sign when taking it. Any future posts discussing remembered questions will be deleted and the user infracted. This will be your only warning.

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[chanty]

That would be awesome, thanks!!

 

[Sarna]

There are a few classifications of pulpitis such as clinical, histopathological, etc. Different authors respect different classifications, hence confusion and different terminology.
Terms reversible/irreversible pertain to the clinical classification, suppurative is a hist-pat. term.
In hist-pat, there are acute types of pulpitis such as serous pulpitis, and suppurative.
I have always thought that suppurative means that the tissue is transformed to pus.
Maybe I am wrong. But if it is as I think, then the pulp is not necrotic because that is a different condition..In suppurative pulpitis it is very common that the pus forms in the pulp horn, it does not spread immediately to the root pulp.
That is how I was taught at school, maybe here the classification is different.
If the pus did not spread to the canal then you can occasionally perform pulpotomy in multi-rooted teeth as emergency treatment and I don't think is out of date. However the preferred way is to proceed with RCT obviously.

 

[chanty]

Thank you for the info Sarna, do you know the difference between serous pulpitis and suppurative pulpitis?

 

[Sarna]

Thank you for the info Sarna, do you know the difference between serous pulpitis and suppurative pulpitis?

In serous the pus hasn't formed yet, there are signs of hyperemic pulp, and oedema, some white blood cells leave the capillaries. This is the transition to the suppurative stage.
I'll try to find some reference.
Dent rdh found some reference, that says otherwise, but I don't have that book unfortunately.

 

[chanty]

In serous the pus hasn't formed yet, there are signs of hyperemic pulp, and oedema, some white blood cells leave the capillaries. This is the transition to the suppurative stage.
I'll try to find some reference.
Dent rdh found some reference, that says otherwise, but I don't have that book unfortunately.

Thank you for your answer. Yes Dent rdh found that suppurative pulpitis was complete pulp necrosis. But I think there might be some necrosis, but not a complete one, thus the term "pulpitis"

 

[dent rdh]

ok i will try attaching this file or i will send it to u guys through mail

 

[dent rdh]

can anyone tell me how to attach a file or put an image in this forum

 

[Sarna]

I have only Pathways o the Pulp, and they use only terms reversible/irreversible.
The hist-pat classification is rather old. I think necrosis is a distinct condition, however one condition leads to another if not treated.
So coming back to the problematic question, I think acute suppurative pulpitis does not require incision because apical tissues are not involved YET. It requires drainage but in a sense, that we open the tooth and remove its content (typical RCT) but there is no need to leave the canal open to drain as the apical tissues are not involved.
So this is another Q which does not make sense.
However, if anyone finds the hist-pat classification reference please share, as those terms appear in other questions too.

 

[chanty]

Sorry, I don't know....

 

[Sarna]

In a quick response box there is an icon- insert an image

 

[Sarna]

In a quick response box there is an icon- insert an image

And also there is option go advanced- there is an icon of a paper clip- attachments

 

[chanty]

I just found that suppurative pulpitis is an "obsolet term for a purulent irreversible pulpitis" Stedman's Medical Dictionary.

I looked in several books: Endodontics (Ingle), Endodontics (Torabinejad), Pathways of the pulp, Endodontics(Pitt), Color Atlas of endo (Williams), and none of them have that term.

 

[dent rdh]

look up ur hotmail acc chanty i send something on it.the file was too big for this forum i guess.

 

[dent rdh]

did u get it??

 

[chanty]

I got it, thank you. I see it and I don't believe it hahaha. I mean, of course I believe it, but in my mind it doesn't make any sense (the term).
But now that we have the reference we can answer this type of questions. However, I am hoping that this term is not currently used, and that in the test we only see reversible and irreversible pulpitis or pulpar necrosis. But in the meantime I finally agree with you, and it seems that the best answer for that question is open the canal and drainage for one week. Maybe that is what the generation before us, used to do.....

 

[chanty]

In pathways of the pulp page 36 it says but referring to a periapical abscess:

"......If pus continues to drain through the canal and cannot be dried within a reasonable period of time, the tooth may be left open. Leaving a tooth open because of persistent drainage is necessary only in rare occasions.........

 

[dent rdh]

i don't think they will use such terms in the new exam ,EE was full of old terms most of the time.thats why i got this book becoz it has old as well as new terminology.very confusing.

 

[chanty]

Let's be optimistic..... now we know both..... so better chances for us, don't you think???

 

[dent rdh]

sarna did u get it ??

 

[Sarna]

Thanks dent rdh. That book must be really old. And I'm under the same impression as Chanty - it doesn't make sense.
I understand acute suppurative pulpitis as purulent pulpitis and of course it's irreversible.
Liquefactive necrosis of entire pulp I know as a distinct condition.

By the way- they recommend for both acute suppur.pulpitis and chronic pulpitis extraction as an option

 

[chanty]

Jajaja, yes and in "the acute pulpitis (usually irreversible) the treatment is endodontic therapy, extraction...." what if it was one of the few that was reversible???

 

[Sarna]

I got it, thank you. I see it and I don't believe it hahaha. I mean, of course I believe it, but in my mind it doesn't make any sense (the term).
But now that we have the reference we can answer this type of questions. However, I am hoping that this term is not currently used, and that in the test we only see reversible and irreversible pulpitis or pulpar necrosis. But in the meantime I finally agree with you, and it seems that the best answer for that question is open the canal and drainage for one week. Maybe that is what the generation before us, used to do.....

Even if we agree with Wells and Reeds they don't mention leaving the tooth open for one week. Even if the pulp is necrotic and liquefied what is there to drain for a week? Another thing is when we have apical tissues involved which is not the case in this question.

 

[chanty]

Even if we agree with Wells and Reeds they don't mention leaving the tooth open for one week. Even if the pulp is necrotic and liquefied what is there to drain for a week? Another thing is when we have apical tissues involved which is not the case in this question.

I totally agree with you....but having only those options....it is difficult

 

[dent rdh]

it is just an option like for cases with periodontally involved teeth I am sure u will also agree it is better to extract them then to go for anything,this book is from 2001.I am surprised none of u guys know abt it becoz it is quite popular EE preparation.
anyways lets not waste our time on this .
I wanted to know abt formocresol is it still ok to use i will post the Qs for it.

 

[chanty]

You are right, let's move on. What question of formocresol? let me find it....

 

[chanty]

"Formocresol is the most common pulpotomy medicament used in pediatric dentistry today" Ingle's Endodontics 2008

 

[Sarna]

it is just an option like for cases with periodontally involved teeth I am sure u will also agree it is better to extract them then to go for anything,this book is from 2001.I am surprised none of u guys know abt it becoz it is quite popular EE preparation.
anyways lets not waste our time on this .
I wanted to know abt formocresol is it still ok to use i will post the Qs for it.

I used formocresol for primary teeth only. I don't know if this chemical hasn't been withdrawn.

As to the EE Qs Bank, I don't think we should rely on the answers 100% as there is info, that some of the Qs may be old or inaccurate.
But even if so, discussion is always beneficial, we can use the knowledge for other Qs too..

 

[chanty]

I used formocresol for primary teeth only. I don't know if this chemical hasn't been withdrawn.

As to the EE Qs Bank, I don't think we should rely on the answers 100% as there is info, that some of the Qs may be old or inaccurate.
But even if so, discussion is always beneficial, we can use the knowledge for other Qs too..

Yes, that is helpful. I really appreciate this sharing. Thank you guys!!!

 

[dent rdh]

which of the following are true regarding formaldehyde containing pastes
a.formaldehyde containing pastes remain non approved
b.the drug manufacturer maybe held reliable along with the dentist
c.formaldehyde containg pastes have a high antigenic potential
d.there are cases on record of parasthesia following overextrusion of such paste in the vicinity of the mandibular nerve
e.all of the above

 

[chanty]

E. all of the above.

Pathwas of the pulp page 380.

"..........Dental literature reports that permanent paresthesias are associated with gross overfilling with paraformaldehyde sealant (N2)........A dentist may be liable for fraudulent........On february 12, 1993 the FDA dental advisory panel confirmed that N-2's safety and effectiveness remain unproven....."

 

[dent rdh]

is this in 9th edition.

 

[chanty]

7th

 

[dent rdh]

ok thanx

 

[chanty]

did you find it? Do you agree with the answer?

 

[leda]

hi guys,

Did I miss something ?? Dent rdh would you please send to me the materila as well ?? Thanks..

 

[dent rdh]

leda sure i wud the file is too big to post here ...can u send me ur email add.

 

[dent rdh]

yes chanty i read it too just wanted to make sure we all are ont he same page.

 

[dent rdh]

this is something i found just today maybe u guys have already seen it regarding the whole equivalency process
http://www.ndeb.ca/en/publications/...icationProcessforGeneralDentistryinCanada.pdf

 

[leda]

dent rdh thanks for mailing me the material..

still I am notg convinced that we should choose leaving open the canal for a week..to me this question and its options do not have any coherence..

 

[chanty]

Here is another
Which of the following would you use to determine the status of the pulp of a tooth with a porcelain jacket crown?

1. Radiographic appearance
2. The electric pulp tester
3. Percussion and palpation
4. History and subjective symptoms
5. Thermal stimulus

A. 1,2
B. 1,2,3
C. 2,3,4,5
D. 1,3,4
E. All of the above

 

[leda]

Here is another
Which of the following would you use to determine the status of the pulp of a tooth with a porcelain jacket crown?

1. Radiographic appearance
2. The electric pulp tester
3. Percussion and palpation
4. History and subjective symptoms
5. Thermal stimulus

A. 1,2
B. 1,2,3
C. 2,3,4,5
D. 1,3,4
E. All of the above

d. 1,3,4

 

[leda]

histologically a pulp polyp consist of:

1. a mass of collagenous fibres
2. Russell bodies
3. proliferating capillars
4. fibroblasts
5. polymorphonuclear leucocytes

a. 1,2,3,4
b. 1,3,4
c. 1,3,4,5
d. 2,5
e. all of above

does anyone know what the Russell bodies are ?

 

[leda]

which of the following are true regarding formaldehyde containing pastes
a.formaldehyde containing pastes remain non approved
b.the drug manufacturer maybe held reliable along with the dentist
c.formaldehyde containg pastes have a high antigenic potential
d.there are cases on record of parasthesia following overextrusion of such paste in the vicinity of the mandibular nerve
e.all of the above

I think e. all of above...

 

[leda]

cleidocranial dysostosis can cause :

1. premature loss of teeth
2. concomitant micrognathia
3. high incidence of clefts
4. associated high caries index
5. multiple supernumerary and unerupted teeth

if it is the same with cleidocranial dysplasia I think it is 5, multiple supernumerary and unerupted teeth..what do you guys think ?

 

[leda]

calculus contributes to the peridontal disease through

1. mechanical
2. chemical
3. retention of plaque
4. all of above

I have contoversial refference about this, but after all I think I would choose retention of plaque.. need your oppinion too please..

 

[leda]

condensing osteitis in the periapical region is indicative to

1. acute inflamation of pulp
2. pulpal abscess
3. chronic inflamation of pulp I think this is the right answer
4. early apical abscess formation
5. none of above

 

[leda]

which of the following has the worst prognosis:
1. occlusal traumatism
2. gingivitis
3. juvenile periodontitis
4. periodontal atrophy
5. moderate periodontitis

between 3 and 4 it is difficult to decide about the course of the disease with such little information..howeve I think juvenile periodontits is the most unpredictable and difficult to treat..

 

[chanty]

d. 1,3,4

I found this en Pathways of the pulp: "In general, endodontists recommend that each tooth be isolated properly with a rubber dam and bathed in hot water or iced water to reproduce the environment in which the pain is evoked most closely. This method is also very effective in evaluating teeth with full coverage restorations, whether porcelain or metal"
So I say we should include the thermal stimulus option in the answer, but that is were I get confused about which one to choose.

 

[chanty]

condensing osteitis in the periapical region is indicative to

1. acute inflamation of pulp
2. pulpal abscess
3. chronic inflamation of pulp I think this is the right answer
4. early apical abscess formation
5. none of above

Agree with you. You can find a reference of this in Ingle's endodontics.

 

[chanty]

histologically a pulp polyp consist of:

1. a mass of collagenous fibres
2. Russell bodies
3. proliferating capillars
4. fibroblasts
5. polymorphonuclear leucocytes

a. 1,2,3,4
b. 1,3,4
c. 1,3,4,5
d. 2,5
e. all of above

does anyone know what the Russell bodies are ?

Russell bodies are eosinophilic, large, homogenous immunoglobulin-containing inclusions usually found in a plasma cell undergoing excessive synthesis of immunoglobulin; the russell body is characteristic of the distended Endoplasmic Reticulum.