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TEST – FINAL EXAM TEST 1 - Ontogenetic development 1. List the periods of prenatal development in the correct sequence and indicate their duration : ………………………………………………………………………………………………… ……………………………………………………………………………………………… ……………………………………………………………………………. pro...

TEST – FINAL EXAM TEST 1 - Ontogenetic development 1. List the periods of prenatal development in the correct sequence and indicate their duration : ………………………………………………………………………………………………… ……………………………………………………………………………………………… ……………………………………………………………………………. proliferative - two weeks, embryonic - from the end of the second to 8 weeks, fetal - then until birth 2. How long does it last the proliferative period? a) One week b) Two weeks c) Three weeks d) Four weeks 3. Indicate the duration of embryonic period: a) First two weeks b) 2-8 weeks c) After 8th week 4. Which statement is true: a) The cells of the inner cell mass are the progenitors of the embryo; b) The future embryo is formed on the outside of the inner cell mass; c) The process of gastrulation begins at the end of the second embryonic week; d) The thickening of the surface of the primitive ectoderm is called primitive plaque; e) The mesoderm is responsible for the formation of bones, muscles, etc.; A (all answers are correct) B (а, c, d, e) C ( c, d, e) D (b, c, d) E (a, b, d, e) 5. Give a brief description of the gastrulation process: ………………………………………………………………………………………………… ………………………………………………………………………………………………… ………………………………………………………………………………………………….. Gastrulation lasts from the 14th to the 20th day. It is expressed in the stratification of the ecto- and endoderm and the insertion of a third layer between them - the forming mesoderm. This is how the three embryonic leaves are formed, from which the human body is formed. It begins in the cranial part, and from there gradually progresses caudally. 6.Which statement is false: a) On the 17th day the notochord is formed; b) The paraxial mesoderm realizes primary induction on the notochord; 1 c) The notochord induces the proper ectoderm to differentiate into a specialized mucosa; d) The notochord is a cluster of cells from which somites are formed; A (all answers are correct) B (а, c) C ( c, d) D (b, c) E (b, d) 7. Give a brief description of the neurulation process: ………………………………………………………………………………………………… ………………………………………………………………………………………………… ………………………………………………………………………………………………… At approximately 20th day shaped gastrula enters into next phase – neurulation. Also there is a differentiation of cells from the ectoderm, which forms the neuroectoderm - a neural plate forms. This plate thickens with proliferation, invaginates centrally and forms the neural groove. This groove deepens and is surrounded by the two neural folds. After that the development of the neural crest cells starts from these neural folds. The neural folds reach midlaine, first in the neural tube closes cervical region, and than the neural tube closes both anteriorly and posteriorly. 8. Nervous system, sensory system, epidermis, mammary and cutaneоus glands, epithelium of oral and nasal cavities, and tooth enamel develop from: a) Mesoderm b) Endoderm c) Ectoderm 9. Bone cartilage, blood, dentin, pulp, cementum and periodontal ligament develop from: a) Ectoderm b) Mesoderm c) Endoderm 10. Name the parts of the embryonic tube: a) ………………………………………… b) ………………………………………… c) ………………………………………… a) Pars cranialis, b) pars umbilicalis, c) pars caudalis 11. The following is true for the neural tube: a) Formed after disintegration of the neuroectodermal ligament; b) Its two lateral ends give rise to the neural ridges/folds; c) The neural tube in the cranial part of the embryo forms the primitive brain; d) The neural groove deepens and turns into a neural tube; e) In the umbilical part of the embryo, the neural tube forms the spinal chord; A (all answers are correct) B (а, c) C ( c, d) D (b, c) E (b, d, e) 2 12. Which statement is true: a) The initial appearance of the oral pit occurs at 14 weeks; b) A deep oral pocket is formed between the forebrain and the heart, from which the oral cavity will be formed; c) In the most superficial part of the oral pocket is the oropharyngeal membrane; d) After disintegration of the oropharyngeal membrane, the primary mouth is formed; e) The primary mouth and the upper part of the digestive tract form the oropharynx; A (all answers are correct) B (а, c, d, e) C ( c, d, e) D (b, d, e) E (b, c, d) 13. Аround the pharynx are formed bars of tissue called: a) Pharyngeal arches b) Notochord c) Stomadeum 14. The oral pit first appears in the midline between: a) The brain and the heart b) The brain and the notochord c) The foregut and the spinal cord 15. Which branchial arch is forming the maxillary and mandibular processes? a) The mandibular arch b) The hyoid arch c) The pharyngeal arch d) Fourth and sixth arch 16. Which statement about the pharyngeal arches is NOT true: a) The pharyngeal arches are responsible for the formation of the head, neck and torso/trunk; b) It consists of five pharyngeal arches and four grooves; c) Completes its development in 14 weeks; d) The first arch is called the mandibular; e) The second arch is called the maxillary; A (all answers are correct) B (а, c, е) C ( c, d) D (b, c) E (b, d, e) 17. The side and front of the neck, facial muscles, vessels, and hyoid bone develop from: a) First mandibular arch b) Second hyoid arch c) Third pharyngeal arch 18. From which arch do the Stapes, styloid, and lesser horn of the hyoid form? a) First b) Second c) Third 3 19.Which of the following statements are true: a) The development of the individual takes place from the fourth to the seventh week; b) The palatal growths close after the tenth week; c) The tongue grows from the floor of the oral cavity; d) The maxillofacial area is formed by one mandibular, one maxillary and one fronto-nasal process; e) The upper jaw develops before the lower jaw; A (all answers are correct) B (а, c) C ( c, d, e) D (а, d, e) E (а, d) 20. The following is true for the formation of the lower jaw: a) The contours of the lower jaw are formed around the fourth week; b) Both mandibular processes are involved in its construction; c) The two mandibular processes increase inwards and downwards through an intussusception process; d) The lower border of the mouth is formed by a process of medialization of the two mandibular growths; e) The joining of the mandibular processes is realized along the medial line; A (all answers are correct) B (а, c) C ( c, d, e) D (а, b, d, e) E (а, d) 21. The following is true for the formation of the upper jaw: a) Both maxillary processes participate in its formation; b) Formed earlier by the lower jaw; c) It is formed with the help of two maxillary and one frontal nasal process; d) The maxillary processes grow forward and upward and form the upper lateral edge of the mouth; e) The secondary palate is formed from the maxillary processes; A (all answers are correct) B (а, c) C ( c, d, e) D (а, d, e) E (а, d) 22.Describe the formation of the upper jaw: ………………………………………………………………………………………………… ………………………………………………………………………………………………… ……………………………………………………………………………………………… It is formed with the help of two maxillary and one frontal nasal process. The maxillary processes grow forward and upward and form the upper lateral edge of the mouth. The frontal nasal process grows downwards towards the maxillary processes. The fusion between the maxillary and frontal nasal processes takes place in the 7th week 23. During the the sixth week of the development of the embryo occurs: a) The side of the face widens significantly; b) The medial nasal growth forms the filter; 4 c) The possibility and risk of clefts has passed; d) The orbicular muscle is formed; e) The eyelids are formed; A (all answers are correct) B (а, b, d) C ( c, d, e) D (а, d, e) E (а, d) 24. The following is true for the development of the palate: a) It is formed by the maxillary processes; b) The primary palate is formed by the fronto-nasal process; c) The secondary palate is formed by the lateral palatal growths of the upper jaw; d) Ossification of the palate covers all areas of the primary and secondary palate; e) The medial nasal processes gives rise to the nasal septum; A (all answers are correct) B (b, с, е) C ( c, d, e) D (а, d, e) E (а, d) 25. Describe how and when is the palate formed: ………………………………………………………………………………………………… …………………………………………………………………………………………………. The palate is formed by the frontonasal and maxillary processes. The upper anterior part (primary palate) is formed from the frontonasal process which carries the incisors. Two symmetrical palatal growths/processes are formed from the maxillary processes, which grow downwards and then horizontally and fused into a raphe palatinae. The primary and secondary palate join at the level of the foramen incisivum. The palate is finally formed - 12th embryonic week. 26. Draw the lines of fusion of the processes involved in the formation of the upper jaw and palate 27. From the fusion of how many processes is developed the face? a) Four b) Three c) Two d) Five 28. The maxilla develops from: a) ……………….. process b) ………………...processes 5  Forehead/frontonasal process, maxillary processes 29. The mandible develops from ……………………………. processes Two mandibular processes 30. When do the two mandibular processes fuse? a) 20-25 day b) 15-20 day c) 30-35 day d) 40-50 day 31. When do the maxillary and frontonasal processes fuse? a) Sixth week b) Seventh week c) Fifth week 32. Which structures develop from the maxillary processes? a) Middle part of the upper lip b) Lateral parts of the upper lip c) The primary palate d) The secondary palate e) The lateral parts of the maxilla and the gingiva in this area f) The middle part of the maxilla and the gingiva in this area Choose the correct combination: A. a, c, f B. b, d, e C. a, b, c D. c, d, e, f 33. Which structures develop from the frontonasal prominence? a) Middle part of the upper lip b) Lateral parts of the upper lip c) The primary palate d) The secondary palate e) The lateral parts of the maxilla and the gingiva in this area f) The middle part of the maxilla and the gingiva in this area A. a, c, f B. b, d, e C. a, b, c D. c, d, e, f 6  Test 2 - Tooth germ 1. List the elements of the tooth germ :.................................................................................................................................................................................................................. Answer: Enamel organ; Papilla dentis; Sacculus dentis 2. List the morphological stages in the development of the tooth: …………………………………………………………. …………………………………………………………. ………………………………………………………….. ………………………………………………………….. Answer: Tooth bud/Bud stage; Tooth cap/Cap stage; Tooth bell/Bell stage; Early crown; Late crown; Early root development; Late root development 3. What are the physiological stages in the development of the tooth? a. Early root develop b. Late root development c. Histodifferentiation d. Morphodifferentiation e. Mineralization f. Maturation g. Eruption h. Initiation i. Proliferation A) a, b, c, d, f, h, i B ) c, d, e, f, g, h, i C ) a, b, e, f, g, h, i D ) all listed 4. List the physiological stages in the development of the tooth: …………………………………………………………. …………………………………………………………. ………………………………………………………….. ………………………………………………………….. Answer: Initiation; Proliferation; Histodifferentiation; Morphodifferentiation; Apposition or mineralization; Maturation; Eruption 5. Which is the correct order of the physiological stages? a. 1..Initiation 2.Proliferation 3.Morphodifferentiation 4.Histodifferentiation 5.Maturation 6. Apposition 7. Eruption; b. 1.Initiation 2. Proliferation 3.Histodifferentiation 4. Morphodifferentiation 5. Apposition 6.Maturation 7. Eruption; c. 1.Initiation 2.Proliferation 3.Eruption 4. Morphodifferentiation 5.Apposition 6. Maturation 7. Histodifferentiation; d. 1.Initiation 2. Proliferation 3.Histodifferentiation 4. Morphodifferentiation 5. Maturation 6.Apposition 7. Eruption 7  6. The primary initiation of dental development is due to signals from: A. Ectoderm B. Mesenchyme C. Ectomesenchyme D. Endoderm 7. The morphological stages in the tooth development are: a. Early crown b. Late crown c. Eruption d. Bud stage e. Cup stage f. Bell stage g. Initiation h. Early root development i. Late root development A ) a, b, c, d, e, h, i B ) a, b, d, e, f, g C ) a, b, d, e, f, h, i D ) all listed 8. Specify the correct statements about proliferation: a. It is a process of development of different cells b. It is a process of cell multiplication c. During proliferation, lamina vestibularis and lamina dentis are formed d. During proliferation, individual layers of cells differentiate e. Proliferation occurs only in the ectodermal layer A ) a, c, d, e B ) a, b, d C ) b, c, e D ) b, c E ) a, d, e 9. The outer enamel epithelium is : a. with transport function b. with forming function c. one layer cubic epithelium d. the main cell layer, for the function of which all other layers work e. connected to the lamina dentis by the gubernaculum dentis A ) a, c, e B ) a, b, c, e C ) b, c, d D ) b, d, e E ) all listed 10. The functions of the inner enamel epithelium are: a. Transport b. Enamel formation c. Stimulation of preodontoblasts and odontoblasts d. Germinative e. Formative A ) a, b, c, d B ) b, c C ) b, d D ) b, d, e E ) b, c, e 11. The functions of the stellate reticulum are: a. Limits growth impulses b. Transport 8  c. Storage of nutrients d. Transformation of nutrients e. Formative f. Provides the volume for the development of the tooth crown A ) b, c, d, f B ) a, b, c, d C ) c, d, f D ) a, b, d, f E ) all listed 12. The functions of the intermediate layer are : a. Transport b. Formative c. Product storage d. Germinative e. Provides volume for tooth development A ) a, c, e B ) a, d C ) b, d, e D ) a, c, d E ) a, b, d, e 13. List the layers of the enamel organ during the bell stage, starting from the most superficial: …………………………………………………. ………………………………………………….. ………………………………………………….. ………………………………………………….. Answer: Outer enamel epithelium; Stellate reticularum; Intermediate layer; Inner enamel epithelium 14. Which is correct for the bud stage? a) There is cell differentiation; b) There isn’t any cell differentiation; c) Proliferation of epithelial cells; d) The dental follicle is formed; e) The cells are identical in shape and size a. a, c, e B) a, c, d, e C) b, c, e D) b, c, d, e 15. During the cap stage, the following processes take place: a. Four layers are formed in the enamel organ b. The cells of the inner enamel epithelium differentiate into ameloblasts c. Ectodermal cells divide into three layers d. The dental papilla is formed and the formation of the dental sacculus begins e. An enamel knot is formed A ) a, b, d, e B ) c, d, e C ) b, c, d, e D ) a, d E ) a, b, e 16. The enamel knot: a. is formed during the bell stage b. is formed during the cap stage c. Corresponds to the future tip of the tooth d. It consists of cells that do not divide e. Is the most important signal center for tooth development A ) a, c, d, e B ) b, c, d, e C ) c, d, e D ) a, c, d E ) b, c, e 9  17. The finished cervical loop is made of: A) outer and inner enamel epithelium B) outer and inner enamel epithelium, stellate reticulum and intermediate layer C) outer and inner enamel epithelium and stellate reticulum D ) outer and inner enamel epithelium and intermediate layer 18. Primary epithelial band is: a) certain areas of basal cells of oral endoderm proliferate rapidly, it invades along the dental archs making a horseshoe; b) certain areas of basal cells of oral ectoderm proliferate rapidly, it invades along the dental archs making a horseshoe; c) certain areas of basal cells of oral mesenchyme proliferate rapidly, it invades along the dental archs making a horseshoe; 19. Which is correct for the cap stage: a) There is cell differentiation; b) There isn’t any cell differentiation; c) The formative elements of the tooth are already visible d) The formative elements of the tooth aren’t visible e) Differentiated cells are arranging in layers; A) a, c B) b, c, e C) a, d, e D) a, c, e 20. The enamel knot and cord: a) Act as a reservoir of the dividing cells and growing dentin, signaling center, determining the shape of the tooth; b) A structure with ill-defined function; c) Act as a reservoir of the dividing cells and growing enamel, signaling center, determining the shape of the tooth; 21. Which are the four cells layers of the enamel organ in the bell stage? ………………………………………………………………………. ………………………………………………………………………. ………………………………………………………………………. ………………………………………………………………………. Answer: Outer dental epithelium; Inner dental epithelium; Stellate reticulum; Stratum intermedium; 22. What is the function of the outer enamel epithelium? a) Transporting products from the dental follicle to the enamel organ; b) Transporting products from the dental papilla to the enamel organ; c) Transporting products from the enamel organ to the dental follicle; d) The cells of the outer enamel epithelium produce and secrete the enamel; e) Determine the shape of the crown; 23. The enamel organ is derived from: a) Mesenchyme; b) Endoderm; c) Ectoderm; 10  24. The dental papilla develops into: a) Enamel; b) Dentin and pulp; c) Cementum; d) Alveolar bone; 25. The inner enamel epithelium differentiates into: a) Odontoblasts; b) Ameloblasts; c) Fibroblasts; d) Its cells disintegrate; 26. The dental follicle develops into: a) Pulp and dentin; b) Cement and alveolar bone; c) Dentin; d) Enamel; e) Periodontium, alveolar bone and cement; f) Alveolar bone and periodontium; g) Enamel, pulp, dentin; 27. The origin of the dental follicle is from: a) Mesenchyme and ectomesenchyme; b) Endoderm; c) Ectoderm; d) Ectoderm and endoderm; 28. Describe SR (Stellate reticulum): a) Multiple layers of highly unusual star-shaped epithelium cells with large amounts of intracellular fluid; b) Multiple layers of highly unusual flattaned epithelium cells with large amounts of intracellular fluid; c) Multiple layers of highly unusual star-shaped epithelium cells with small amounts of intracellular fluid; 29. The origin of the Hertwig’s shealth is from: a) Endoderm; b) Mesenchyme; c) Ectoderm; d) Ectomesenchyme; 30. What is the origin of Hertwig's sheeth? A ) Ectomesenchymen B ) Ectodermal 11 C ) Mesenchymen 31. Which statement is true? a. The enamel knot is formed above the enamel organ b. The enamel knot forms above the inner enamel epithelium c. The enamel niche is located in the most concave part of the bell d. From the enamel niche begins the initial formation of enamel e. The enamel cord is located at the site of Gubernaculum dentis f. The enamel cord is a transport highway for the cells of the inner enamel layer A ) a, e, f B ) b, f C ) b, c, d D ) a, c, e, f E ) a, c, f 32. From the dental papilla are formed ……………………………… The beginning of these processes begins in ……. ………… stage of development of the tooth germ Answer: Dentin and pulp; Cap stage 33. From sacculus dentis are formed ………………………………………………….. The beginning of these processes begins in ………………………………..stage of development of the tooth germ Answer: Cement, periodontium, alveolar bone; Cap stage 34. The functions of sacculus dentis are : a. Nourishes the enamel organ b. Marks the location of tooth germs c. Limits growth impulses d. After stimulation it forms cementum, periodonium and alveolar bone e. After stimulation it forms the root pulp A ) a, c, d B ) b, c, e C ) a, d D ) b, e E ) a, b, c, d 35. Connect the elements of the dental germ with the structures that they form: Enamel organ Alveolar bone Pulp Dental papilla Cement Email Sacculus dentis Periodontium Dentin Answer: Enamel organ – enamel Papilla - dentis dentin and pulp Sacculus dentis - Cement, periodontium, alveolar bone 12  36. Which of the following is true for the germ formation? a. Temporary teeth are formed by the primary dental lamina b. The first 5 permanent teeth are formed by the secondary dental lamina c. Permanent molars are formed by the secondary dental lamina d. Temporary and permanent teeth are formed by the primary dental lamina e. Permanent molars are formed by the distal growth of the primary dental lamina, called the tertiary dental lamina. A ) a, b, e B ) a, b, c C ) d, e D ) a, d, e E ) b, c 37. Which statements are true about Hertvig's sheeth? a. It participates in the formation of enamel b. The first 4-5 cells of it are called guide cells and do not divide c. It is a temporary structure d. It participates in root formation e. It has a mesenchymal origin A ) a, b, d B ) b, c, e C ) b, c, d D ) a, b, c, e E ) b, d, e 38. At what stage does histodifferentiation begin? a. bud stage b. cap stage c. bell stage d. Early root development e. Early crown 39. Connect the morphological stages of development with the processes that are characteristic of them: Bud stage Histodifferentiation Initiation Cap stage Maturation Eruption Bell stage Morphodifferentiation Early / late crown Apposition and mineralization Early root development Proliferation Answer: Bud stage – initiation, proliferation Cap stage – histodifferentiation Bell stage – morphodifferentiation Early / late crown – apposition and mineralization, maturation Early root development - eruption 40. Specify the correct statements about the bud stage: a. This is the first physiological stage b. The tooth germ is a ball of cells of the lamina dentis c. Cell specialization and cells of different shapes are observed 13  d. It is characterized by rapid cell division e. Initiation and proliferation take place A ) a, b, d B ) a, c, e C ) b, c, d D ) b, d, e E ) a, b, d, e 41. List the specific structures that can be detected during the bell stage as part of the enamel organ: …………………………………… …………………………………… ………………………………….. Answer: Enamel knot; Enamel cord; Enamel niche 14  TEST 3 Enamel – amelogenesis, morphology, composition and physiology 1. At what stage of the development of the tooth germ does the histogenesis of the enamel begin? a. Bud stage; b. Cap stage; c. Early bell stage; d. Late bell stage. 2. Which of the following statements regarding the changes in the dental papilla are correct? a. Preameloblasts are the inner layer of the enamel organ; b. Preameloblasts are the outer layer of the enamel organ; c. The odobtoblasts are situated in the periphery of the dental papilla; d. The odontoblasts are situated in the central area of the dental papilla; e. Between the preameloblast and odontoblasts is the basal lamina. A – a, b, c, d B – a, c, d C – c, d, e D – a, b, e E – a, c, e 3. Describe the formation of the enamel-dentin junction ………………………………………………………………………………………… ………………………………………………………………………………………… ………………………………………………………………………………………… Answer – It is building on membrana limitans. The disintegration of the basement membrane allows the preameloblasts to come into contact with the newly formed predentin. This indicates the preameloblasts to differentiate into ameloblasts. Ameloblasts begin deposition of enamel matrix. Preodontoblasts and ameloblasts deposit an organic matrix that begins to mineralize. Then the odontoblasts begin production of very thin dentine, which is sufficient to stop nutrients from the dental papilla to the preameloblasts. 4. The origin of the dentin-enamel junction is: a) Ectodermal; b) Mesodermal; c) Endodermal and mesodermal; d) Ectodermal and mesodermal; 15  5. Which of the following statements regarding the changes in the enamel organ are correct? a. Folding the outer cuboidal epithelium; b. Intracellular organelles of the ameloblasts are changing its positions; c. Ameloblasts are in their protective phase; d. Maturation stage begins; e. Formation of Tomes’ process. A – a, b, c B – b, c, e C – c, d, e D – a, b, e E – a, b, c, e 6. Which are the phases of the amelogenesis? a. …………………………………… b. …………………………………… c. …………………………………… Answer – a. Enamel matrix formation; b. Mineralization; c. Maturation. 7. The life cycle of ameloblast described in as many as six phases but generally is subdivided into three main functional stages which are: a) Presecretory stage; b) Secretory stage; c) Maturation stage; d) Postmaturative stage; e) Transitional stage A - a, b, c B - a, b, d C - b, c, e D - a, b, d 8. Which of the following six stages about the life cycle of ameloblasts are in the correct order? a. Morphogenic stage, Oragnizing stage, Maturative stage, Protective stage, Formative stage, Desmolytic stage; b. Morphogenic stage, Maturative stage, Oragnizing stage, Protective stage, Desmolytic stage, Formative stage; c. Morphogenic stage, Oragnizing stage, Formative stage, Maturative stage, Desmolytic stage, Protective stage; d. Morphogenic stage, Formative stage, Oragnizing stage, Maturative stage, Desmolytic stage, Protective stage; e. Morphogenic stage, Oragnizing stage, Formative stage, Maturative stage, Protective stage, Desmolytic stage. 16  9. What are the phases of ameloblast’s life? a. …………………………………… b. …………………………………… c. …………………………………… Answer – a. Presecretory stage; b. Secretory stage; c. Maturation stage. 10. What happens in the presecretory stage? a) The cells of the inner epithelium differentiate into odontoblasts; b) The cells of the inner epithelium differentiate into ameloblasts; c) The superficial cells of the dental papilla differentiate into odontoblasts; d) The superficial cells of the dental papilla differentiate into ameloblasts; e) Odontoblasts secrete an organic matrix and they mineralize it to form the first layer of dentin; f) Odontoblasts secrete an organic matrix and they mineralize it to form the first layer of enamel; g) The new source for nutrients for the ameloblasts is the dental papilla; h) The new source for nutrients for the ameloblasts is the dental follicle; A - a, c, e, h B - b, c, e, g C - b, c, e, h D - a, d, f, g 11. Which of the following statements regarding the secretory stage are correct? a. As the ameloblast differentiates, the matrix is synthesizing within the RER, which then migrates to Golgy’s apparatus, where is condensed the packaged in membrane-bound granules; b. The initial layer if enamel does not contain enamel rods; c. The secretion of the enamel matrix becomes at two sites; d. The enamel is forming in the space provided by the enamel organ; e. Ameloblasts secrete the enamel proteins enamelin and amelogenin, which later will help of the mineralization. A – a, b, d, e B – d, c, d, e C – All of them D – a, b, d, e E – a, b, c 12. Describe the secretory phase of amelogenesis: a) Tome's process (TP) develops at the distal end of ameloblast b) The secretion of enamel matrix stops c) One enamel rod involves 4 TPs (1 head and 3 tails) d) Secretions made at TP e) This stage ends when full thickness enamel is laid down and TP retracts and a thin layer of aprismatic enamel is laid f) Ameloblast shortens and the no is reduced to 50% g) Protein synthesising organelle are destroyed A - a, c, d, e B - a, c, d, f C - b, e, f, g D - a, b, d, f 13. What is typical for the maturation stage: 17  a) The ameloblasts lose Tomes’ process; b) The ameloblasts become involved in the removal of water and inorganic material; c) The ameloblasts become involved in the removal of water and organic material; d) additional inorganic material is introducing; e) additional organic material is introducing; f) ameloblasts increase their volume and height; g) ameloblasts decrease their volume and height; h) the apical end of the ameloblast becomes ruffled along the enamel surface; A - b, c, e, f, h B - a, c, d, g, h C - c, d, g, h D - a, b, d, g, h 14. Which are the proteins of the enamel? …………………………………………………………………………………………. Answer – amelogenins, ameloblastins, enamelin, tuftelin 15. Describe the major extracellular events involved in enamel formation: a. ……………………………………………………………….. b. ……………………………………………………………….. c. ……………………………………………………………….. d. ……………………………………………………………….. e. ……………………………………………………………….. Answer – a. Delineation of space by the secretory ameloblasts and dentin-enamel junction; b. Self-assembly of amelogenin proteins to form the supramolecular structural framework; c. Trasportation of calcium and phosphate ions by the ameloblasts resulting in supersaturated solution; d. Nucleation of apatite crystallites; e. Elongated growth of the crystallites. 16. Which of the following statements regarding the mineralization of the enamel matrix are correct? a. The initial deposition of mineral amounts is approximately 25% of the total enamel; b. 70% of enamel mineral is result if the crystal’s growth; c. Matrix formation and mineralization continue peripherally to the tips of the cusps, laterally on the sides of the crowns; d. Mineralization begins laterally to the cervix and continues to the top of the tooth; e. As the enamel matrix is completing and tuftelin is depositing, the matrix begins to mineralize. 18 A – a, b, c B – b, c, e C – a, b D – d, e E – b, c, d 17. Which are the two stages of the maturation? a. …………………………………….. b. …………………………………….. Answer – a. Ruffle-ended maturation stage; b.Smooth-ended maturation stage. 18. Which of the theories for the mineralization of the enamel does the following statement correspond for? Amelogenins have the remarkable spontaneous self-assembly and hierarchical organization of amelogenin “ microribbons” and have ability to facilitate oriented growth of apatite crystals. a. Booster mechanism; b. Seeding mechanism; c. Matrix vesicle concept; d. Nanosphere theory. 19. Which of the following statements regarding enamel rod structures are correct? a. Each rod is formed by four ameloblasts; b. Enamel is composed of rods that extend from DEJ, to the enamel outer surface; c. The rods run almost perpendicular to the enamel surface at the cervical region; d. Near to the cusps the rods are perpendicular; e. The rod has a keyhole-shaped form. A – All of them B – a, b, c, d C – b, c, d D – a, b, c, e E – c, d, e 20. How many ameloblasts does it take to make a complete rod and sheath? a) It takes two amelolasts; b) It takes three ameloblasts; c) It takes four ameloblasts; d) It takes five ameloblasts; 21. How many ameloblasts does it take to make the head and the tail? a) One for the head and three for the tail; b) Two for the head and two for the tail; c) Three for the head and one for the tail; d) Two for the head and three for the tail; 22. Complete the sentence The areas between adjacent prisms are called ……………………………. Answer – interprismatic 19 23. Which of the following statement regarding the Striae of Retzius is correct? a. They are optical phenomen; b. They are a weekly rhythm in enamel production resulting in a structural alteration of the rod; c. They are made of crystals, but arranged at a different angle from those in the prism; d. This is the border between the enamel and dentin; e. They are defect in the innermost layer of the enamel. 24. What are the striae of Retzius? a) An accentuated incremental line that occurs at the time of birth due to stress of birth; b) Indicate a daily variation in the secretory activity of the ameloblasts; c) They are a weekly rhythm in enamel production resukting in structural alteration of the rod; d) An optical phenomen produced by changes in direction between adjacent groups of rods; e) A defect in the innermost layer of the enamel; 25. What are the bands of Hunter and Schreger? a) An accentuated incremental line that occurs at the time of birth due to stress of birth; b) Indicate a daily variation in the secretory activity of the ameloblasts; c) They are a weekly rhythm in enamel production resulting in structural alteration of the rod; d) An optical phenomen produced by changes in direction between adjacent groups of rods; e) A defect in the innermost layer of the enamel; 26. What are the enamel tufts? a) An accentuated incremental line that occurs at the time of birth due to stress of birth; b) Indicate a daily variation in the secretory activity of the ameloblasts; c) They are a weekly rhythm in enamel production resukting in structural alteration of the rod; d) An optical phenomen produced by changes in direction between adjacent groups of rods; e) A defect in the innermost layer of the enamel; 27. Describe the Enamel Tufts ………………………………………………………………………………………… ………………………………………………………………………………………… ………………………………………………………………………………………… 20 Answer – They are defect in the innermost layer of the enamel. They extend at right angles to the enamel-dentin border and are slightly mineralized. They are many residues of enamel protein, mainly enamelin. 28. Describe the Enamel spindles ………………………………………………………………………………………… …………………………………………………………………………………………. Answer – Enamel spindles represent the terminal end of the odontoblasts process. They extend from the DEJ and point to the surface of the enamel. 29. Write the chemical composition of enamel ………………………………………………………………………………………… ………………………………………………………………………………………… Answer – The mineral composition is from xydroxyapatite, fluorapatite, carbonateapatite. In the intercrystalline spaces, they are amorphous calcium carbonate, manganese, zinc, copper, magnesium, aluminum, etc. 30. Which is a larger crystal, fluorapatite or hydroxyapatite? …………………………………………………………….. Answer - Fluorapatite 31. The major extracellular events involved in enamel formation are: a) delineation of space by the secretory ameloblasts and the dentino-enamel junction; b) self-assembly of amelogenin proteins to form the supramolecular structural framework; c) transportation of calcium and phosphate ions by the ameloblasts resulting in a supersaturated solution; d) elongated growth of the crystallites; A - a, d B - a, b, c, d C - c, d D - b, c, d 32. Write the stages of ionic exchange in the enamel a. ……………………………………………. b. ……………………………………………. c. ……………………………………………. d. ……………………………………………. Answer – a. The first stage of the ionic exchange is reversible – the ions diffuse into the superficial hydration layer; 21  b. The second stage is easily reversible – the ions enter into the subsurface layer of absorbed ions neutralize their charges; c. The third stage is difficult to reverse – the ions are included in the surface of the crystal; d. The fourth stage is irreversible – the ions replace defects inside of the crystal lattice. 33. True or false? Primary mineralization: deposited enamel matrix, needle shaped crystals appear after deposition of thickness, 50 nm of matrix initially thin widespread dispersed, rapidly increase in size and become hexagonal. a) True b) False 34. True or false? Secondary mineralization: occurs the dental-enamel junction, rapid process, cannot be easily distinguish from initial phase, enamel is transformed from soft material into hard substance, large quantities inorganic material deposited in matrix. a) True b) False 22  TEST 4 Dentin 1. What is the origin of the dentin? a) From the dental papilla b) From the dental follicle c) From the enamel organ 2. Which cells are involved in the dentin formation? a) Ameloblasts b) Odontoblasts c) Odontoblasts and subodontoblasts d) Fibroblasts 3. Which is the basic structural unit of the dentin? a) Dentinal tubule b) Odontoblastic process c) Apatite crystal 4. Which is the main morphological and physiological structure of the dentin? a) Dentinal tubule b) Odontoblastic process c) Apatite crystal 5. Which statement is true about dentin? a) It is formed by the second element of the dental germ - papilla dentis; b) The beginning of its formation is in the early bell stages; c) Starts its formation from the area of the neck of the tooth; d) Dentin has ectodermal origin; e) It is divided into primary, secondary and tertiary according to the time of tooth development; А (a, b, d, e) B (a, b, c, d, e) C (a, b, e) D (a, c, e) E ( b, c, e) 6. The beginning of dentinogenesis is associated with: a) The formation of an EDG; b) First preodontoblasts secrete active products stimulating preameloblasts; c) Preodontoblasts form the first thin, fibrous structures; d) Preodontoblasts form spindle-shaped growths in the enamel; e) Preodontoblasts and preameloblasts secrete fibrous structures; A (a, b, c, d, e) B (a, c, d) C (b, c, d) D (b, d, e) E (c, d, e) 7. List and describe the stages of dentinogenesis: 23 ………………………………………………………………………………………………… ………………………………………………………………………………………………… ………………………………………………………………………………………………… Answer - Dentin formation involves the initial formation of an organic matrix (collagenous and non-collagenous). It is conditionally divided into two sub-stages. Initially, fiber formation occurs (fibrillogenesis). There are two types of fibers. ß -fibers are formed from odontoblasts and α-fibers or Korff’s fibers from subodontoblasts. Amorphous matrix (organic and inorganic) secreted by the odontoblasts is then deposited on the fiber network. It masks the fibrillar structure, and the changes that occur lead to the maturation of the dentinal organic matrix (second substage). After the maturation of the organic matter, the mineralization of the dentin begins (the second stage of dentinogenesis). Mineralization is globular and linear 8. Which cells are involved in dentinogenesis? What is their origin? ………………………………………………………………………………………………… ………………………………………………………………………………………………… ……………………………………………………………………………………………….. Answer - Two types of cells, odontoblasts and subodontobasts, which are of ectomesenchymal origin, are involved in the formation of dentin. They arrive with the migratory flows from the neural combs and are located near the ridge of the tooth bud, in the area of its future indentation. Under the influence of ectoderm stimulation, the undifferentiated ectomesenchymal cells of the papilla dentis begin to divide. The ectomesenchymal cell closest to this effect differentiates into an odontoblast. The other daughter cell, which is further from this influence, differentiates into a subodontoblast. 9. Which statement is true about the process of fibriliogenesis: a) Process of synthesis and secretion of inorganic matrix; b) Odontoblasts synthesize and secrete type 1 and 3 collagen; c) Subodontoblasts secrete β-fibers or Corfu fibers; d) The corrugated fibers are arranged perpendicular to the EDG; e) Odontoblasts secrete β-fibers; A (a, b, c, d, e) B (b, c, e) C (b, c, d) D (b, d, e) E (a, c, d, e) 10. Which are the specific non-collagenous proteins in dentin: Answer - Dentin phosphoprotein, Dentin sialoprotein, Dentin phosphophorin 11. Describe the mineralization in the dentin: ………………………………………………………………………………………………… ………………………………………………………………………………………………… ………………………………………………………………………………………………… 24 Answer - The mineralization of the dentin is two types - laminar and globular. The initial mineralization is manifested by calcium phosphate crystals located in small vesicles on the surface and inside the collagen fibers. The crystals are formed in mineralization centers inside the deposited matrix layer. Globules of radially arranged crystals form around these centers. The crystals grow, expand and coalesce. As the crystals grow, so do the globules. Mineralization progresses to complete fusion of the globules and homogenization of the site. The role of mineralization centers is performed by acidic mucopolysaccharides. Laminar mineralization proceeds cyclically and is realized by withdrawal of the odontoblast, freeing of space, deposition and maturation of the matrix and its subsequent mineralization. 12. Which statement about dentin mineralization is true: a) Begins in parallel with fibriliogenesis; b) The crystals are deposited along the course of the fibers; c) Mineralization centers are formed inside the deposited matrix; d) The role of mineralization center is performed by chondroitin sulfate; e) The mineralization takes place in layers, inside the deposited dentin layer; A. all answers are correct B (b, c, d, e) C (c, d, e) D (b, c, d) E (a, b, d, e) 13. Maturation of the dentin: a) Represents the maturation of precollagen fibers into collagen; b) Precollagen fibers from argyrophilic become argyrophobic; c) Leads to the transition of non-apatite impurities to apatite; d) Leads to a change in the function of odontoblasts and their transformation into short adsorption cells; A (all answers are correct) B (а, b, c) C ( a, b, d) D (a, c, d) 14. The basic/main morphological and physiological structure of dentin is: Answer – dentinal tubule; apatite crystal 15. The basic structural unit of dentin is: ………………………………………………………………………………………………… …………………………………………………………………………………………………. Answer – apatite crystal 16. At cross section in dentin the following layers are found: ………………………………………………………………………………………………… ………………………………………………………………………………………………… ………………………………………………………………………………………………… ………………………………………………………………………………………………… ……………………………………………………………………………………………….. 25 Answer - a) Odontoblastic outgrowth/process; b) Dentine dialysate; c) Inner hypomineralized area/zone; d) Peritubular dentin; e) Outer hypomineralized area/zone; f). Intertubular dentin 17. Characteristic of peritubular dentin is: a) It is located between the tubules; b) Shapes the wall of the dentinal canal from inside; c) The least mineralized area of dentin; d) Missing in predentine; e) Also called intratubular;; A (all answers are correct) B (b, c, d, e) C ( c, d, e) D (b, d, е) E (a, b, d, e) 18. Intertubular dentin: a) It is located between the individual tubules; b) Also called intercanalicular; c) Represents the smallest part of the whole dentin; d) It is identical in structure to the peritubular dentin; e) Slightly changes during the life cycle of the tooth; A (всички отговори са верни) B (а, b, c, d) C ( a, b, d, e) D (c, d, е) E (b, c, d, e) 19. In the case of a longitudinal section, the following layers are found in the dentin (point them in the direction from the enamel-dentin junction to the pulp): a) ----------------------------------------------- b) ----------------------------------------------- c) ----------------------------------------------- d) ----------------------------------------------- Answer: a). Mantle dentine; b). Circumpulpal/Orthodentin; c). Globular dentin; d). Predentin 20. Which statement about circumpulpal/orthodentin is true: a) The thickest layer of dentin; b) Stronger mineralized than mantle dentine; c) Korff’s fibers are in less quantities; d) β-fibers in it are harmoniously and precise arranged; e) Crystals deposited on β-fibers provide larger intercrystal spaces; A (all answers are correct) B (а, b, c, d) C ( a, b, d, e) D (b, d, е) E (а, c, e) 21. For predentin it is true: a) It is located between the mantle dentin and the interglobular dentin; b) Newly formed, non-mineralized dentin matrix; c) Newly formed, single globules can be seen in it; d) Predentin formation does not continue after primary dentin formation; A (all answers are correct) B ( a, b, d) C (b, c) D (c, d) 26  22. What is the predentin? a) The most superficial layer of dentin b) The largest mass of dentin c) A newly formed less mineralized dentin 23. Which layer of the dentin is the most mineralized? a) Interglobular dentin b) Mantle dentin c) Circumpulpal dentin d) Predentin 24. The odontoblast processes are in the dentin and the bodies of the odontoblasts are located in the: a) Dentin b) Enamel c) Pulp d) Cementum 25. The secondary dentin: a) It is the dentin that is formed during the dentinogenesis; b) Is formed after root formation is finished and occurs at a much slower rate; c) Is the local secretion of dentin in response to external influences 26. Korff’s fibers are produced by: a) Ameloblast b) Odontoblasts c) Subodontoblasts 27. What are the Korff’s fibers? a) Thick collagen fibers which are perpendicular to the dentin-enamel border b) Thick collagen fibers which are parallel to the dentin-enamel junction c) They are called Beta fibers and are thin collagen-1 fibers d) Thick fibers produced by odontoblasts 28. List the incremental lines in the dentin and indicate the reason/mechanism for their formation:: ………………………………………………………………………………………………… ………………………………………………………………………………………………… ………………………………………………………………………………………………….. Answer: a). Owen - a result of the layered deposition of dentin, accentuated deficiencies in mineralization; they are uneven; b). Ebner - the result of the circadian/daily cycle of dentin formation and are located at equal intervals; c). Neonatal line - in all primary teeth and the first permanent molar; distinguishes intrauterine dentin from postpartum dentin. 27  29. Which statement about dentin is false: a) Dentin is composed of 70% organic matter; b) Inorganic matter is represented by hydroxylapatite and non-apatite impurities; c) The exchange in the dentin takes place through the exchange in the pulp ; d) The apatite crystals in the dentin are larger than those in the enamel; e) Dentin is one of the most sensitive structures in the human body; A (all answers are correct) B (а, b, c) C ( a, d, e) D (b, d) E (а, c) 30. The odontoblast processes: a) reaches only the inner third of the dentin b) passes through the entire thickness of the dentin and reaches the dentin-enamel junction c) reaches only predentine, as it is responsible for the secretion of organic matter. 31. Describe the main characteristics of the odontoblast - origin, location and functions: ………………………………………………………………………………………………… ………………………………………………………………………………………………… ………………………………………………………………………………………………… ………………………………………………………………………………………………… ………………………………………………………………………………………………… Answer - The odontoblast is a highly differentiated and unique cell. It has an ectomesenchymal origin - it comes through the migratory flows from the neural ridges/folds during the initiation of tooth development. It is part of the papilla dentis. It reaches its final differentiation faster then the ameloblasts. The cell has a pronounced synthesizing activity in the cell body and secretory activity of its growth/processes. It lives and acts in the pulp, in its periphery. It is responsible for the formation of dentin, while the pulp is vital. After the death of these cells, new true odontoblasts cannot differentiate, odontoblast-like cells are formed. 32. Which statement about dentin mineralization is true: a) Begins in parallel with fibriliogenesis; b) The crystals are deposited along the direction of the fibers; c) Mineralization centers are formed inside the deposited matrix; d) The role of mineralization center is performed by chondroitin sulfate; e) The mineralization takes place in layers, inside the deposited dentin layer; A (all answers are correct) B (b, c, d, e) C ( c, d, e) D (b, c, d) E (a, b, d, e) 28  33. List the types of tertiary dentin and the cells from which it is formed: ………………………………………………………………………………………………… ………………………………………………………………………………………………… ………………………………………………………………………………………………… Answer: This type of dentin is called tertiary. It is the result of pulp stimulation and is an expression of a protective reaction. Reasons for its formation may be the development and progression of a carious lesion, increased masticatory pressure, abrasion, treatment procedure. Tertiary dentin is deposited only at the site of stimulation. It is reactive dentin, which is formed by true odontoblasts, and reparative dentin, which is formed by odontoblast-like cells after the death of true odontoblasts. 29  Test 5 – Dental pulp 1. Which are the true statements about the dental pulp? a. It originates from the dental papilla b. It begins its development during the bud stage c. It originates from the dental follicle d. It has an epithelial origin e. It has a mesenchymal origin A) a, c, e B) a, d C) b, c, e D) a, e E) c, e 2. When does the development of dental pulp end? A) After the formation of the dental crown B) After the formation of the enamel C) After EDJ formation D) Continues throughout the life of the tooth E) After the eruption of the tooth and the complete root formation 3. List the layers of pulp starting from the nearest to the dentine enamel junction (DEJ): ……………………………………. ……………………………………. ……………………………………. …………………………………… Answer - Odontoblast zone; Cell-free zone/ Weil’s zone; Cell-rich zone; Parietal nerve layer/ Rashkoff’s plexus 4. The zone of Weil/ Cell-free zone in the pulp is: a. A cell-rich zone b. A cell-free zone c. A reservoir for a body fluid and food d. Under the odontoblast cells e. In the central part of the pulp A) a, c, d B) b, c, d C) b, c, e D) a, c, e E) b, d 5. The cell-rich area is: a. With densely spaced cells b. It contains mainly fibroblasts c. Contains undifferentiated mesenchymal cells d. It is located below Weil's cell-free zone e. It is located in the peripheral zone A) a, b, d B) b, c, d C) c, d, e D) b, c, d, e E) all are correct 6. The central area of the pulp is: a. Composed only of cells, fibers and nerves b. Composed of odontogenic cells 30  c. Consists of cells, fibers, nerves, blood vessels, lymph, intercellular substance d. Below the peripheral zone e. Most organized in the area of the pulp horns A) a, d, e B) b, d, e C) c, d D) b, e E) c, d, e 7. State the correct statements about fibroblasts in the pulp: a. The most numerous cells in the pulp b. They have the function of producing fibers c. They originate from the first element of the tooth germ d. They synthesize collagen type I and type III, as well as proteoglycans and glycoaminglycans e. They are found only in the central area A) b, c, d B) a, b C) b, d, e D) a, d, e E) d, e 8. Indicate the correct statements concerning the odontogenic zone of the pulp: a. It consists of odontoblasts and fibroblasts b. It participates in the formation of dentin c. It is preserved though the whole life of the pulp d. The cells connect with each other with tight connections, Gap-links and intermediate connections e. The pulpo-dentinal complex is formed by the cells of this zone A) a, b, c B) b, c, d, e C) b, d, e D) a, b, e E) all are correct 9. List at least 7 types of cells, besides odontoblasts and fibroblasts that can be found in the pulp: 1………………………………………. 2………………………………………. 3………………………………………. 4………………………………………. 5………………………………………. 6………………………………………. 7………………………………………. Answer - Schwan’s cells/ nerve cells; Endothelial cells; Pericytes; Undifferentiated cells; Stem cells; Monocytes; Lymphocytes; Macrophages; Reticulocytes; Plasmocytes; Neutrophil leukocytes; Mast cells; Erythrocytes 10. Briefly describe what shunts in the pulp are and their function: …………………………………………………………………………………….. …………………………………………………………………………………….. …………………………………………………………………………………….. Answer - Shunts are connective vessels between an arterial and a venous vessel. They lead off arterial blood, before it reaches its final destination. 11. Point the correct statements about collaterals in the pulp: a. They are additional side vascular pathways b. They are connecting vessels between an arterial and a venous vessel c. The are needed for ensuring the odontoblast metabolism 31  d. They regulate the pH and temperature of the tissue e. They provide additional blood suply to the tissue A) a, b, d B) b, c C) a, c, e D) a, e E) all are correct 12. Shunts in the dental pulp are: a. Connecting vessels between arterial and venous vessel b. Regulators of blood flow through sphincters c. When the pulp is at rest, 1/3 of the blood reaching it is removed through them d. When there is inflammation, most of them are closed e. They can be composed of one or more vessels with a collective shell A) a, b, e B) a, b, c, e C) b, c, d D) a, b, d E) all are correct 13. Indicate which statements are true for the microcirculation system in the pulp: a. It is located in the subodontoblast space b. It provides the metabolism of the odontoblast zone c. Actively participates in blood regulation d. In it the blood slows down e. Regulates the pH and temperature of the tissue A) a, b, e B) b, c, e C) a, c, e D) a, b, c, e E) all are correct 14. What is the function of hyaluronic acid in the pulp? a. Regulation of water exchange b. Regulation of Na and K transport c. Protective function d. Trophic function e. Dentin mineralization A) a, b, d B) a, c, d, e C) a, b, e D) a, b, c E) all are correct 15. List the functions of the dental pulp: …………………………………………................. ……………………………………………………. ……………………………………………………. ……………………………………………………. Answer – Inductive; Formative; Protective; Nutritional; Reparative; Maintaining the vitality 16. List the stages of dental pulp development: ……………………………………………………. ……………………………………………………. ……………………………………………………. Answer - Embryonic period; Functional period; Regression period / senile 17. List 3 differences between coronal and root dental pulp: 1…………………………………….. 2……………………………………... 3……………………………………… Answer - The crown pulp is: - more voluminous / wider - follows the shape of the crown 32  - with a richer peripheral area 18. List at least 3 differences between young and old dental pulp: 1………………………………………… 2………………………………………….. 3………………………………………….. Answer - The young pulp is: - with a small number of fibers; - the fibers are thinner; - intercellular substance and cells predominate; - loose and liquid in appearance; - with a larger volume; - with strongly emphasized pulp horns; 19. Describe the changes that occur during the preparation of the odontoblasts for synthesis and secretion: ……………………………………………. ……………………………………………. ……………………………………………. Answer - They grow in length and turn into large pear-shaped cells. They develop a large nucleus, a Golgi apparatus, an endoplasmic reticulum, and numerous mitochondria. 20. Which nerves can innervate the dental pulp? ……………………………………………. ……………………………………………. ……………………………………………. Answer - N. Trigeminus, n. Facialis, n.glossopharyngeus, n.hypoglossus. 21. Which of the following statements are true about dental pulp: a. The volume of the dental pulp is about 0.2 ml b. It is innervated only by n.trigeminus c. Its final differentiation ends with the closure of the apex d. The pulp originates from the dental papilla e. The pulp originates from the dental papilla and the dental sacculus f. The volume of the dental pulp is about 0.5 ml A) a, b, c, d B) a, c, d C) b, c, d, f D) a, c, e E) c, e, f 22. Which of the following statements is true for accessory channels: a. They are branches of blood vessels inside the pulp b. In temporary molars, they are commonly located in the bifurcation c. They don't have any importance in the clinic d. They can be the result of a rupture of the epithelial sheet during root formation e. They occur in 33% of permanent teeth A) b, d, e B) b, c, e C) a, b, e D) a, c, d E) a, c, d, e 33 23. Rashkoff's plexus is: a. The microcirculatory system of the dental pulp b. Parietal nerve layer in the dental pulp c. Composed of peripheral nerve branches d. Composed of peripheral nerve branches that do not make a direct connection with the odontoblasts e. System of anastomoses, providing regulation of the pressure of tissue fluids in the pulp A) a, e B) b, c C) b, d D) d, e E) none is correct 24. Stem cells in the pulp: a. Are found only in the pulp of permanent teeth b. Can develop into connective tissue cells c. They can develop into odontoblasts d. After differentiation, they can build an organic matrix and mineralize it e. They cannot participate in the construction of organic matrix A) a, b, d B) a, c, d C) b, d D) b, c, e E) a, b 25. Dendritic cells in the pulp: a. Originate from the bone marrow b. Are antigen-presenting cells c. Are part of the specific immune response d. In carious teeth, they infiltrate the odontoblast layer and increase their number e. They can phagocytose f. Remove dead cells from the pulp A) a, c, e B) a, b, d, f C) a, b, d D) b, c, e D) all are correct 26. The embryonic period of the dental pulp is characterized by: a. Beginning - forming of the tooth germ and ending with the formation of the crown b. Plenty of fibroblasts and young undifferentiated cells c. Fully structured circulatory and nervous system d. Fully formed apical opening, which would impede the drainage of inflammatory exudate e. Mostly liquid tissue medium with fast transport A) b, e B) a, b, c C) b, c, d D) a, c, d E) all are correct 27. The senile period of the dental pulp is characterized by: a. Reducing the volume of the pulp b. Reducing the protective properties of the pulp c. Increased sensitivity d. Beginning after the formation of the apical opening e. It occurs only in teeth with pulp inflammation A) a, c, d B) b, d, e C) a, b, e D) a, b E) b, e 34  28. Specify the correct statements about the pulp stones: a. They are found in teeth with pulp inflammation b. They are formed only after the completion of the eruption and the start of function of the tooth c. Result of excessive stimulation of the dental papilla d. They can be real or fake e. They can be attached, freely existing or included in the dentin A) a, c, d B) b, d, e C) c, d D) a, d, e E) d, e 29. What is the origin of the dental pulp? d) From the dental papilla e) From the dental follicle f) From the enamel organ 30. When does it start the vascularization of the developing dental pulp? a) Bud stage b) Bell stage c) Cap stage 31. Anatomically, the dental pulp is divided into:…….. pulp and ………. pulp. Answer - Coronal and radicular pulp 32. Which is the correct order of the zones in the peripheral pulp (when we start counting from the most superficial zone)? a) Cell-free zone b) Cell-rich zone c) Odontoblastic layer d) Rashcoff’s parietal nerve plexus A) a-b-c-d B) b-a-c-d C) c-a-b-d D) d-b-a-c 33. Which are the correct statements for the odontoblasts? a) They are living throughout the pulp life. b) They produce enamel and dentin c) They are the main nutritional pathway for dentin metabolism d) They reach the DEJ e) They are the informational connection with the enamel f) They protect the pulp through the formation of tertiary dentin. A) All of the above B) a, c, d, e C) a, b, d, e, f D) a, c, d, e, f 34. Which is the wrong statement for the Central pulp? a) It’s called an odontogenic area b) In the central pulp can be found undifferentiated cells 35  c) The central region of the coronal pulp exhibits large blood vessels and nerves d) Blood vessels and nerves are surrounded by fibroblasts and collagen fibers embedded in an intercellular matrix 35. Which of the following cells can be found in the dental pulp? a) Fibroblasts b) Undifferentiated mesenchymal cells; c) Lypmphocytes; d) Macrophages; e) Dendritic cells; f) Neutrophils; g) Plasma cells; h) Mast cells; A) All of the above B) a, c, d, e C) b, c, f D) a, b, c. d, e, f, g 36. Which is the correct order of the pulpal blood vessels if you start from the vessels which enter the tooth from the apical foramen and finish with the vessels which exit the tooth? a) Venules b) Arterioles c) Pre-capillarys d) Capillary loops e) Collecting venules f) Terminal arterioles A. a-b-c-f-e-d B. b-f-c-d-e-a C. a-e-d-c-f-b D. b-a-c-d-e-f 37. Which are the most numerous connective tissue cells in the pulp? a) Undifferentiated mesenchymal cells; b) Fibroblasts; c) Immunocompetent cells; 38. The following sentence describes the functional period of the pulp: Starts at the moment of dental papilla formation and stops when the root apex is completely formed. A. True B. False 39. Which is the correct statement about the pulp physiology? a) Gradually, with age, the fibers and the cells are decreasing; b) Gradually, with age, the fibers are decreasing and the cells are increasing; 36  c) With age, the fibers and the cells are increasing; d) Gradually, with age, the fibers are increasing and the cells are decreasing; 40. Which is the most important function of the pulp? a) Inductive; b) To provide vitality to the teeth; c) Reparative; d) Sensory; 37  Test 6 Cementum 1. Which are the correct statements about the cementum: a) The beginning of its histogenesis is the first moment that gives impulse for beginning of root development; b) It doesn‘t stop forming throughout the life of the tooth; c) Cementoblasts are cells originating from Hertwig’s epithelial sheath; d) The cementum doesn‘t have its own blood vessels and nerves; e) The true origin of the cementum is ectodermal , as the cells of Hertwig’s epithelial sheath originate from the enamel epithelium; f) Its true origin is ectomesenchyme A). a, b, c, d, e B) a, b, c, d, f C). b , c, d, e D) b, d, f E) b, d, e 2. Which statements for Herwig’s root sheath are correct ? a) It is formed after proliferation of the cervical loop b) Has a mesenchymal origin; c) The guide cells (the first 4-5 cells) divide and direct its proliferation ; d) Its inner layer is in contact with cells of papilla dentis, and the outer layer - with cells of saculus dentis e) The cells of the epithelial sheath (cementoblasts) produce intermediate cementum. f) After the formation of a layer of root dentin and its covering with intermediate cement, cellular disintegration of the Hertvig-Brun vagina is performed A) a , d, f B) a , b, c, e C) All statements are true D) a , c, d, e, f E) a, e, f 3. Which statements are true about Hertwig's epithelial root sheath? a) Has powerful embryonic potential for intercellular stimulation; b) The first 4-5 cells of the root sheath do not divide and are called guide cells, which contain genetic information about the number, shape and size of the tooth roots; c) The Hertwig root sheath is a temporary structure associated with root formation and has three layers. d) The cells of its inner layer stimulate cells from the dental papilla to differentiate into odontoblasts ; e) The epithelial cell rests of Malassez originate from Hertwig‘s epithelial root sheath; A) All are true B). a , b, d, e C). a , b, c, d D) b, c, d, e E). c, d 4. Which statements about cementogenesis are true? 38  a) The cementogenesis begins after the formation of the enamel and after the development of Hertwig‘s epithelial root sheath from the cervical loop. b) Cementoblasts produce Sharpey‘s fibers c) Initially, the cervical loop is composed of cells of the inner and outer enamel epithelium and cells of the stellate reticulum inserted between them , which are pushed away later. d) The first layer of cementum, deposited on the root dentin does not contain cells; e) The epithelial diaphragm surrounds the opening of the developing root; A). a, c, d, e B ) a , b, c, d, e C) b , c, d D) b, c, e E) a , c, e 5. Which statements about cementogenesis are wrong? a) Cementoblasts originate from the inner layer of the dental follicle ; b) Cementoblasts secrete extracellular matrix (collagen and non-collagen) c) Fibers,produced from cementoblasts, are thick collagen fibers located perpendicular to the root surface; d) Sharpey‘s fibers and fibers produced by fibroblasts, are perpendicular to each other and form a collagen network; e) Sharpey‘s fibers are the connection between the Korff‘s fibers in the dentin and the periodontal ligaments ; f) The fibers produced by cementoblasts participate in the formation of periodontal ligament A) a , b, d, e B) c , d, f C). a , b, e D) b, c, d, e E) b, c, f 6. Which statements are true? a) A special differential growth of the epithelial root sheath is performed for the division of the roots of the multi-rooted teeth. b) In root formation, the epithelial diaphragm is visible until the last portion of deposited cement, after which it disappears; c) When the roots of the multi-rooted teeth are built, the cells of the epithelial diaphragm receive a stimulus for extensive growth and several lingual extensions are formed. d) Cementocytes produce extracellular matrix e) The cement matrix contains the collagen proteins sialoprotein and osteocalcin ; A) All are true B) a, b, c C) a, c D) a, c, d E) a, c, d, e 7. Which statements are true? a) Cementoblasts originate from Hertwig's epithelial root sheath b) Korff’s fibers are thick collagen fibers in the cementum c) In the construction of the roots of single- rooted teeth, the Hertwig’s epithelial root sheath is a tube of epithelial cells, an extension of the enamel organ, around which root dentin and cementum are formed. d) Cementoblasts originate from the outer layer of the dental follicle e) The first layer of cementum deposited on the root dentin is acellular and is called intermediate cementum. 39  f) Sharpey’s fibers and fibers produced from cementoblasts form a collagen network; A) a, b, c, e, f B) b, c, d, e, f C) c, e, f D) b, c, d, f E) a, c, e 8. Fill in the missing words in the sentences: a) With the formation of the cementum and shaping the root the epithelial root sheath undergoes disintegration and its cells are pushed further and further out and finally remain among the periodontium , and are known as (1) ……………………………………… b) Cementoblasts secrete an extracellular matrix , which consists of (2) ………………….. and (3) …………………………… c) Collagen fibers produced by cementoblasts are (4) ………………to the longitudinal axis of the root. The fibrillar network is covered with a non- collagen matrix which contains mainly the proteins (5) ……………………………….. and (6) ……………………… d) Almost in parallel with the deposition of the cement matrix, its (7) ………………… takes place. (e) (8) …………produce thick collagen fibers called …………… (9) fibers, which are located (10) …………………… to the root surface. They are the connection between the fibers of (11) …………… in the dentin and the periodontal ligaments. Thy have a role in (12)…………. function of cement. Answer - (a) (1) Epithelial cell rests of Mallasez b) (2) - fibrillar material, (3) non-collagen material c) (4) in parallel, (5) sialoprotein and (6) osteocalcin d) (7) mineralization e) (8) Fibroblasts , (9) Sharpey's , (10) perpendicular f) (11) Kofrr’s, (12) attaching 9. Write the possible types of CEJ (cementoenamel junction): ………………………………………………………………………………………… ………………………………………………………………………………………… ………………………………………………………………………………………… Answer - Cementum covers the enamel - 60-65% of cases Cementum and enamel meet, and there is no space between them - 30% of cases Cementum and enamel do not touch, forming an opening with uncovered dentin between them - 5-10% 10. Which type of cementum has the function of repairing defects in the cementum due to its ability to grow too fast? a) Acellular extrinsic fiber cmentum b) Acellular afibril cementum c) Cellular intrinsic fiber cementum d) Mixed layered cementum e) Intermediate cementum 40  11. Write the names of the five forms of root cement: ………………………………………………………………………………………… ………………………………………………………………………………………… ………………………………………………………………………………………… ………………………………………………………………………………………… Answer - 1) AAC - acellular afibrillar cementum 2) AEFC - acellular extrinsic fiber cementum 3) CIFC - cellular intrinsic fiber cementum 4) MC - mixed cementum 5) Intermediate cementum 12. For each form of cementum, write the numbers of the statements that are correct for it: a) Acellular afibrillar cementum - b) AEFC - c) CIFC - d) Mixed layered cementum - e) Intermediate cementum - 1. Does not contain cells. 2. Contains cementocytes. 3. It is located from the neck of the tooth to the middle of the root length. 4. It is located in the cervical area and covers a small area of enamel in the CEJ area. 5. Contains fibers perpendicular to the root surface, which are produced by fibroblasts. 6. Has a slow formation. 7. It forms quickly. 8. Contains fibers located parallel to the root surface, which are produced by cementoblasts. 9. It contains internal and external fibers for the cementum. 10. It is found in resorption lacunae and in areas of root fractures. 11. It is located just above the dentin, along the root. 12. Contains enamel rather than collagen proteins. Answer - a) 1, 4 b) 1, 3, 5, 6 c) 2, 7, 8, 10 d) 2, 9 e) 1, 11, 12 13. Which statements about the cementum are true? a) The mixed layered cementum contains cells. b) The cementum differs from the bone in the absence of blood vessels and nerves. c) Cellular cementum with internal fibrers forms quickly. d) Acellular cementum with external fibers contains Sharpey’s fibers. e) The intermediate cementum is located cervically. f) Cementoblasts are located in lacunae and have protoplasmic growths located in canals. g) The cementum is part of the periodontium of the tooth. 41 A) a, b, c, d, g B) All are true C) a, b, d, e, f D) a, c, d, e, f, g E) b, d, f, g 14. Which are the correct statements? a) CIFC is found in the furcation zones and in the apical half of the root. b) Incremental lines are found in the cementum. c) The cementum’s nutrition is by the dental pulp due to the lack of its own blood vessels. d) With age, the amount of apically deposited cementum increases. e) The cementum has a strong sensitivity. A) All are true B) a, b, d C) b, d, e D) a, b, c, e E) b, c, d, e 15. Which statements about the cementum are wrong? a) The main part of the collagen of the cementum is collagen type- III. b) The metabolic processes in the cementum are slow and difficult. c) CIFC is more mineralized than AEFC due to its thinner fibers and higher mineral content. d) Cementocytes are inactive cementoblasts e) The non-mineralized cementum matrix is called a cementoid A) a, c B) a, c, e C) b, d, e D) a, d, e 16. Which statements are true? a) The cementum is the thinnest in the middle of the root, but in the apical and cervical part is thicker b) The inorganic composition of the cementum is dominated by apatite crystals with small amounts of non-apatite impurities. c) Many lacunae inside the cementum are empty due to the death of cementocytes. d) Cementoblasts produce an organic matrix and cementocytes mineralize it. e) The intermediate cementum is deposited before the disintegration of the Hertwig‘s epithelial root sheath. A) All are true B) b, c, e C) a, b, c, d D) c, d, e 17. Specify the correct statements: a) The function of intermediate cement is to seal the dentinal tubules. b) The largest percentage of the root is covered by SSC. c) AAC is located apically and in the area of root furcations of multi- rooted teeth. d) CCVF has the ability to repair defects in cement. e) The CCVF is deposited slowly but for a long time and this allows the removal of cementoblasts from this layer. A) a, d, e B) a, b, c, d, e C) a, b, d, e D) b, c, d E) a, c, d 18. Which statements about the cementum are true? a) The intermediate cement is located in the area of the CEJ and covers part of the enamel in this area. b) AEFC contains collagen fibers that are perpendicular to the root surface. c) CIFC contains collagen fibers that are parallel to the root surface. d) Mixed cementum contains extrinsic and intrinsic fibers, it is acellular. 42  e) In most cases in the area of CEJ, enamel and cement occur, with no space between them. A) a, d, e B) a, b , c C) b, c, d D) b, c E) a, b, c, e 19. Which statements are true? a) Intermediate cement is the least mineralized form of cement, as it is deposited first. b) Cementoblasts have multiple growths located in the canaliculi. c) Cementogenesis ends after the end of root development. d) Cementum’s nutrition is by the periodontium. e) Cementum is more mineralized than dentin, but not than enamel. f) Resorption is a characteristic feature of cementus’s aging. A) d, f B) a, d, f C) b, d, e, f D) all are true E) a, b, e 20. List the functions of cement: ………………………………………………………………………………………… ………………………………………………………………………………………… ………………………………………………………………………………………… ………………………………………………………………………………………… Answer - Roofing, attaching, protective, adaptive 21. Which statements are true? a) The most important function of the cementum is its attacing function. b) With age, the cementum’s lacunae become more and more empty, leaving living cementocytes only in its surface areas. c) Cementicles are located in the periodontium d) Intermediate cement protects the dentinal tubules A) a, b B) a, b, c C) b, c, d D) a, b, d E) All of them 22. Which statements are true? a) With age, the cement surface becomes irregular and rough. b) Cementoblasts produce cementum matrix and mineralize it. c) Isomorphic growth factor and osteopontin are cement-specific proteins. d) Cementicles are a form of cement resorption that progresses with age. e) The mineralized cementum matrix is called a cementoid A) a, b B) a, c, d, e C) b, c, d, e D) All of them 23. Which statements are true about AEFC? a) It has cells b) Doesn’t have cells c) Contains fibers perpendicular to the root surface. d) Contains fibers parallel to the root surface e) Contains fibers extrinsic to the cementum f) Contains fibers intrinsic to the cementum g) Contains fibers extrinsic and intrinsic to the cementum. A) a, c, e B) b, c, e C) b, d, f D) a, c, f E) b, c, g F) a, d, f 43  24. Which statements are true about CIFC? a) It has cells b) Doesn’t have cells c) Contains fibers perpendicular to the root surface. d) Contains fibers parallel to the root surface e) Contains fibers extrinscis to the cementum f) Contains fibers intrinsic to the cementum g) Contains fibers extrinsic and intrinsic to the cementum. A) a, c, e B) b, c, e C) b, d, f D) a, c, f E) b, c, g F) a, d, f 25. Which statements are true about the MC? a) It has cells b) Doesn’t have cells c) Contains fibers perpendicular to the root surface. d) Contains fibers parallel to the root surface e) Contains fibers extrinscis to the cementum f) Contains fibers intrinsic to the cementum g) Contains fibers extrinsic and intrinsic to the cementum. A) a, c, d, e, f B) b, c, d, e, f C) a, c, d D) a, c, e E) a, e, f F) b, e, f 26. The cementum develops from: a) The dental papilla b) The dental follicle c) The dental papilla and dental follicle d) From the enamel organ 27. Which are the correct statement for the cementogenesis: a) Hertwig’s epithelial root sheath is formed from all of the layers of the enamel organ. b) Cementum formation involves mesenchyme of sacculus dentis and ectoderm of the Hertwig’s root sheath. c) Hertwig’s epithelial root sheath is a result of proliferation of the cervical loop. d) The outermost cells of the dental follicle differentiate to cementoblasts. e) All of the cells of Hertwig’s root sheath are dividing and that is how they determine the shape of the root. f) The first layer of cement is called intermediate cement which is a cellular layer, protecting the dentin. A) a, c, e B) a, b, c, e, f C) b, c, f D) b, c 28. Sacculus dentis/dental folicle has: a) Two layers of cells b) Three layers of cells c) Four layers of cells 29. Which are the stages of cementogenesis? 44 ………………………………………….............................................................................................................................................................................................................................................. Answer - formation of organic matrix ; mineralization of the organic matrix 30. Which are the correct statements about the cells, included in cementogenesis: a) Cementoblasts are involved in the production of organic matrix and in its' mineralization; b) Cementoblasts are involved in the mineralization of the organic matrix produced only by cells, called fibroblasts. c) Fibroblasts are producing Sharpe’s collagen fibers which are parallel to the longitudinal axis of the root. d) Cementoblasts are producing collagen fibers which are perpendicular to Sharpe’s fibers. e) Cementoblasts are involved in all cement layers and after the root formation they become cementocytes which are found in lacunes. f) Cementoblasts produce collagen fibers and amorphous organic matrix. A) a, c, e, f B) b, c, e C) a, d, f D) b, c, d, e 31. How many types of cement-enamel junction exist? a) Only one type b) Two types c) Three types d) Four types 32. What is the fate of Hertwig’s epithelial root shealth? ………………………………………………………………………………………………… …………………………………………………………………………………………………. Answer - With the progressive formation of cementum and shaping the root, the Hertwig`s sheat undergoes complete disintegration. Cementogenesis is completed with the construction of the root apex closure. During toot root maturation, cells within fragmented root sheath form discrete masses surrounded by a basement membrane, known as epithelial cell rests of Malassez. 33. Which is correct for the cementum? a) It is vascularized from the periodontal tissues but non-inervated tissue covering the root dentin. b) Sharpe’s collagen fibers are going out of the cementum like a part of periodontal ligaments. c) There are two types of cement - cellular cementum (containing cementoblasts) and acellular cementum (without cells) d) It is non-vascularized and non-inervated tissue and its’ cells are called cementoblasts, found in lacunes. e) The mineral component of the cement is hydroxyapatite with small amounts of amorphous calcium phosphates present. A) a, c, e B) b, d, e C) b, e D) b, c, d, e 45  34. Which are the correct st