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Lekarski Egzamin Końcowy (LEK)

Practice Questions100 questions

Lekarski Egzamin Weryfikacyjny (LEW)

Practice Questions100 questions

Exam Review

Key Facts: LDEK Exam

200

Official Exam Questions

Ustawa o zawodach lekarza i lekarza dentysty, art. 14d

56%

Passing Threshold

Ustawa o zawodach lekarza i lekarza dentysty, art. 14e

240 min

Exam Duration (4 hours)

MZ Regulation of 12 August 2025, §10

250 PLN

Fee for Later Polish-Language Applications

MZ Regulation of 12 August 2025, §17

70%

Questions Drawn from CEM's Public Question Base

Ustawa o zawodach lekarza i lekarza dentysty, art. 14c

2 sessions

February and September Each Year

MZ Regulation of 12 August 2025, §7

The Lekarsko-Dentystyczny Egzamin Końcowy (LDEK) is Poland's 200-question final dental examination, run by Centrum Egzaminów Medycznych (CEM) in February and September sessions. It lasts 4 hours, needs 56% to pass, and can be taken in Polish or, by those who studied dentistry in English in Poland, in English. OpenExamPrep offers an independent English-language MCQ study bank with four-option questions; it is not an official CEM translation or a simulation of the five-option test.

Sample LDEK Practice Questions

Try these sample questions to review concepts for the LDEK exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 28-year-old female presents with severe, lingering pain in her mandibular left first molar triggered by cold drinks and lasting for several minutes even after removal of the cold stimulus. The pain also occurs spontaneously, particularly at night. Physical examination reveals a deep disto-occlusal composite restoration with secondary caries extending close to the pulp chamber. The tooth is not tender to axial percussion. What is the pulpal diagnosis?

A.Symptomatic irreversible pulpitis

B.Reversible pulpitis

C.Asymptomatic irreversible pulpitis

D.Pulp necrosis

Explanation: Symptomatic irreversible pulpitis is characterized by acute or lingering pain following thermal stimulation (lasting >30 seconds to minutes after stimulus removal), spontaneous unprovoked pain, and pain exacerbated by recumbency. Reversible pulpitis produces transient pain that ceases immediately when the stimulus is removed. Pulp necrosis typically produces no response to thermal testing.

2Which irrigant solution is considered the gold standard in endodontic treatment due to its unique dual properties of potent antimicrobial activity and effective dissolution of vital and necrotic organic pulp tissue?

A.17% Ethylenediaminetetraacetic acid (EDTA)

B.0.5%–5.25% Sodium hypochlorite (NaOCl)

C.2% Chlorhexidine gluconate

D.3% Hydrogen peroxide

Explanation: Sodium hypochlorite (NaOCl) in concentrations ranging from 0.5% to 5.25% (most commonly 2.5%–5.25%) is the primary endodontic irrigant of choice. It is the only widely used irrigating solution capable of effectively dissolving both vital and necrotic organic tissue while exerting broad-spectrum antimicrobial action against endodontic biofilms. EDTA is a chelating agent that removes inorganic smear layer but does not dissolve organic tissue.

3What is the primary pharmacological action and rationale for utilizing ethylenediaminetetraacetic acid (EDTA 17%) as an adjunct rinse during root canal instrumentation?

A.Neutralization of acidic anaerobic bacterial byproducts within the pulp chamber

B.Coagulation of bacterial cell wall proteins to achieve sterilization of deep periapical granulomas

C.Chelating calcium to remove the smear layer's inorganic part and open dentinal tubules

D.Chemical acceleration of zinc oxide-eugenol endodontic sealer setting reaction

Explanation: 17% EDTA is a polyamino carboxylic acid that acts as a chelating agent, binding divalent calcium ions (Ca2+) in dentinal hydroxyapatite. It demineralizes and dissolves the inorganic component of the smear layer produced during mechanical instrumentation. When used sequentially with NaOCl, it removes the smear layer and unplugs dentinal tubules, allowing better sealer penetration and tubule disinfection.

4During endodontic therapy of a maxillary first molar, which root is most likely to contain two separate root canals (MB1 and MB2) in over 70–90% of cases?

A.Distobuccal root

B.All three roots possess two canals with equal frequency

C.Palatal root

D.Mesiobuccal root

Explanation: Anatomical studies and micro-CT evaluations show that the mesiobuccal (MB) root of the maxillary first permanent molar contains a second mesiobuccal canal (MB2) in 70% to >90% of cases. Failure to detect, negotiate, and disinfect the MB2 canal is one of the most common causes of persistent endodontic failure in maxillary molars. The distobuccal and palatal roots almost universally have a single canal.

5What is the recommended intracanal medicament of choice between appointments in multi-visit endodontic treatment of teeth with infected necrotic pulps and apical periodontitis?

A.Calcium hydroxide (Ca(OH)2) paste

B.Formocresol pledget sealed in the pulp chamber

C.Paraformaldehyde paste

D.Phenol-camphor solution

Explanation: Calcium hydroxide (Ca(OH)2) is the standard inter-appointment intracanal medicament in teeth with infected necrotic pulp and apical periodontitis. Its high alkaline pH (~12.5) exerts potent bactericidal activity by damaging bacterial cytoplasmic membranes, denaturing proteins, and breaking DNA strands. It also hydrolyzes bacterial lipopolysaccharide (endotoxin) and stimulates hard tissue repair. Aldehyde-based agents (formocresol, paraformaldehyde) are toxic and mutagenic.

6In adhesive restorative dentistry, what is the 'hybrid layer' as originally described by Nakabayashi?

A.The zone of resin composite cured under an oxygen-inhibited layer

B.Resin monomers interdiffused into the demineralized collagen network of etched dentin

C.The layer of glass ionomer cement placed beneath a composite restoration ('sandwich technique')

D.The protective varnish applied over composite margins to prevent moisture contamination

Explanation: The hybrid layer (hybridized dentin zone) is created when acid etching (e.g., 37% phosphoric acid in etch-and-rinse systems) removes the smear layer and demineralizes the superficial 3–5 mcm of intertubular dentin, exposing a porous scaffolding of collagen fibrils. Hydrophilic resin monomers (HEMA, Bis-GMA) infiltrate this microporous collagen meshwork and polymerize in situ, creating micromechanical retention and sealing dentinal tubules.

7Which class of dental restorative material exhibits true chemical adhesion to both enamel and dentin via ionic carboxylate bonding to hydroxyapatite calcium ions, alongside sustained fluoride release?

A.Microhybrid resin composite

B.Dental amalgam alloy

C.Conventional glass ionomer cement (GIC)

D.Zinc phosphate cement

Explanation: Conventional glass ionomer cements (GICs), formed by an acid-base reaction between fluoroaluminosilicate glass powder and polyacrylic acid liquid, bond chemically to tooth structure. The ionized carboxyl groups (-COO-) of the polyalkenoic acid chelate with calcium ions (Ca2+) in the hydroxyapatite crystals of enamel and dentin. They also act as fluoride reservoirs, continuously releasing and recharging fluoride ions.

8During composite restoration placement, what clinical complication is directly caused by polymerization shrinkage stress when restorative increments exceed the depth of cure or have a high configuration factor (C-factor)?

A.Immediate chemical corrosion of the underlying dentin

B.Excessive expansion causing fracture of antagonist teeth

C.Spontaneous conversion of the composite into a resin-modified glass ionomer

D.Cuspal deflection, marginal gaps, microleakage and postoperative sensitivity

Explanation: Dental resin composites undergo 1.5% to 4% volumetric polymerization shrinkage during curing. In cavities with a high C-factor (ratio of bonded to unbonded surfaces, highest in Class I occlusal boxes = 5:1), the relief of shrinkage stress through flow at unbonded surfaces is restricted. This generates high interfacial stress, leading to adhesive bond failure, marginal gap formation, microleakage, secondary caries, cuspal deflection, and postoperative sensitivity. Incremental placement techniques mitigate this stress.

9A 35-year-old male has an accidental root perforation during mechanical instrumentation in the middle third of the mesiobuccal root of a mandibular molar. Which biocompatible material is considered the gold standard for immediate perforation repair due to its osteogenic potential, excellent sealing in moist environments, and hydraulic setting reaction?

A.Mineral Trioxide Aggregate (MTA) or calcium silicate-based bioceramic material

B.Zinc oxide-eugenol cement (IRM)

C.Resin-based composite with 4th-generation adhesive

D.Polycarboxylate cement

Explanation: Mineral Trioxide Aggregate (MTA) and hydraulic calcium silicate-based bioceramics are the materials of choice for repairing furcal, lateral, or stripping root perforations. They set in the presence of moisture/blood via a hydration reaction, form a tight seal of calcium silicate hydrate and calcium hydroxide, exhibit excellent biocompatibility, and promote cementogenesis and periodontal ligament regeneration without eliciting cytotoxicity.

10What is the primary histological and biochemical role of tertiary (reparative) dentin formed in response to deep, active dental caries?

A.Rapidly dissolving to enlarge the pulp chamber and relieve hydrostatic pressure

B.An irregular, atubular barrier from odontoblast-like cells that shields the pulp

C.Increasing the vascularity of the dental pulp by promoting angiogenesis in dentinal tubules

D.Producing proteolytic enzymes to digest advancing cariogenic bacteria

Explanation: Tertiary dentin is deposited in response to noxious external stimuli (caries, attrition, cavity preparation). When severe injury destroys primary odontoblasts, undifferentiated ectomesenchymal dental pulp stem cells differentiate into odontoblast-like cells that secrete reparative dentin. This reparative dentin has an irregular, atubular or sparsely tubular structure that acts as a physical barrier, sealing off the pulp and reducing permeability to bacterial toxins.

About the LDEK Exam

Independent LDEK practice by OpenExamPrep for Poland's Lekarsko-Dentystyczny Egzamin Końcowy, run by Centrum Egzaminów Medycznych (CEM). Features 100 English-language, four-option study questions with explanations across the official LDEK subjects: conservative dentistry and endodontics, pediatric dentistry, dental surgery, prosthodontics, periodontology, orthodontics, emergency medicine, medical law, public health and medical certification.

Exam sponsor: Centrum Egzaminów Medycznych (CEM). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Questions

200 questions

Time Limit

4 hours

Passing Score

56%

Exam / Certification Fees

Free first attempt; 250 PLN later attempts (400 PLN in a foreign language)

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

46 of 200 questions (23%)

Conservative Dentistry (Stomatologia zachowawcza)

Cariology, operative and adhesive dentistry, dental materials and endodontics

29 of 200 questions (14.5%)

Pediatric Dentistry (Stomatologia dziecięca)

Primary dentition, eruption, fluoride prevention, pulp therapy in children and dental trauma

25 of 200 questions (12.5%)

Dental Surgery (Chirurgia stomatologiczna)

Exodontia, local anesthesia, odontogenic infections, cysts and oroantral communication

25 of 200 questions (12.5%)

Prosthodontics (Protetyka stomatologiczna)

Fixed and removable prosthetics, complete dentures, occlusion and ceramics

20 of 200 questions (10%)

Periodontology (Periodontologia)

Periodontal classification, diagnosis and therapy, and oral mucosal conditions

20 of 200 questions (10%)

Orthodontics (Ortodoncja)

Angle classification, cephalometrics, oral habits, tooth movement and retention

10 of 200 questions (5%)

Emergency Medicine (Medycyna ratunkowa)

Syncope, anaphylaxis, local anesthetic systemic toxicity, choking and acute coronary syndrome

10 of 200 questions (5%)

Bioethics and Medical Law (Bioetyka i prawo medyczne)

Consent, medical records, adverse events, refusal of treatment and advertising rules

8 of 200 questions (4%)

Public Health (Zdrowie publiczne)

DMFT and caries epidemiology, prevention levels and NFZ dental care

7 of 200 questions (3.5%)

Medical Certification (Orzecznictwo lekarskie)

e-ZLA certificates issued by dentists, sickness benefits and disability adjudication

Preparing for the LDEK Exam

What You Need to Know

Passing score: 56%
Exam length: 200 questions
Time limit: 4 hours
Exam / certification fees: Free first attempt; 250 PLN later attempts (400 PLN in a foreign language) Official sources

Using Our Practice Resources

Work through all 100 available questions
Review every answer and explanation
Track weak areas and revisit them
Use our AI tutor for tough concepts

LDEK: Suggested Study Strategy

1Conservative dentistry (46 questions) and pediatric dentistry (29 questions) make up 37.5% of the exam, so give them the most study time.

2Expect at least 25 oncology questions spread across the clinical dental subjects, as required by the 2025 LDEK regulation.

3Know the core classifications: Black, Kennedy, Angle, Hamp furcation grades and the 2017 AAP/EFP periodontal staging and grading.

4Review dental-chair emergencies, including adrenaline dosing for anaphylaxis and lipid emulsion for local anesthetic systemic toxicity.

Frequently Asked Questions

What is the Lekarsko-Dentystyczny Egzamin Końcowy (LDEK)?

The LDEK is Poland's national final dental examination, organized twice a year (in February and September) by Centrum Egzaminów Medycznych (CEM) in Łódź under articles 14a–14f of the Act on the Professions of Physician and Dentist. A positive result, together with the postgraduate internship and the other statutory conditions, is required for a full right to practise as a dentist (prawo wykonywania zawodu lekarza dentysty) in Poland.

What is the structure and passing score of the LDEK?

The LDEK is a written test of 200 questions, each with five answer options and one correct answer. Each correct answer scores one point and there is no negative marking. The exam lasts 4 hours, and a pass requires at least 56% of the maximum score (112 of 200 points if no question is annulled).

Can I take the LDEK in English?

Under article 5(4) of the Act, the LDEK counts towards the right to practise when it is taken in Polish, or in the language in which the candidate studied dentistry at a Polish university (in practice, English); the foreign-language test is a translation of the Polish paper. OpenExamPrep's bank is an independent English-language MCQ study adaptation with four-option questions, not an official CEM translation or a simulation of the exam format.

How are LDEK questions distributed across subjects?

The Minister of Health regulation of 12 August 2025 (Dz.U. 2025 poz. 1132) sets the split: conservative dentistry 46 questions, pediatric dentistry 29, dental surgery 25, prosthodontics 25, periodontology 20, orthodontics 20, emergency medicine 10, bioethics and medical law 10, public health 8 and medical certification 7. At least 25 of the questions in conservative dentistry, pediatric dentistry, dental surgery, periodontology and orthodontics must concern oncology.

What does the LDEK cost?

The first application is free, and a second free application is possible only after failing or missing the first attempt. Other Polish-language applications cost 250 PLN, and every foreign-language application costs 400 PLN, paid to the individual account generated in SMK no later than 5 days after the application deadline.

How do I register for the LDEK?

Applications are submitted only through the SMK system: by 15 July for a September session and by 30 November of the previous year for a February session. Under current law, 70% of each test comes from CEM's public question base and 30% are new questions; a June 2026 Ministry of Health draft (UD384) proposes all-new, non-public questions, so check CEM for the rules that apply to your session.