Dent Sci 126: Periodontology

Question 1

In detecting active periodontal disease, detecting the BACTERIA as an indicator for active disease has:

Answer 1

Low sensitivity, high specificity

Question 2

Highest quality of evidence

Answer 2

Meta-analysis of randomized controlled clinical trials

Question 3

Systemic antibiotics would be of LEAST additional value in tx of:

Answer 3

Chronic periodontitis that responds to conventional tx; MORE ADDITIONAL VALUE in – chronic periodontitis that DOES NOT respond to conventional tx; aggressive periodontitis that DOES NOT respond to convential tx; patients with uncontrolled diabetes + chronic periodontitis

Question 4

Gingivitis VS. Periodontitis

Answer 4

In periodontitis, there is loss of connective tissue attachment

Question 5

Clinical attachment level (CAL) is measured from:

Answer 5

CEJ to the bottom of the probeable sulcus or pocket

Question 6

Major problem with use of antimicrobials is periodontal pockets have been:

Answer 6

maintaining high concentration of antimicrobial in the pocket

Question 7

All of the following medicaments have been marketed in the US in controlled release local delivery anti-microbial systems for tx of chronic periodontitis EXCEPT:

Answer 7

Chloropromazine – others marketed: doxycycline, minocycline, tetracycline, chlorohexidine

Question 8

“Zero order kinetics” of a drug delivery system implies:

Answer 8

the drug is released in constant amounts, even as the amount of drug remaining at the site is decreasing.

Question 9

Gingival crevicular fluid (GCF) is a clear serous fluid from inflamed gingiva that is:

Answer 9

a transudate of serum and tissue fluids

Question 10

Dominant features of the progression of periodontitis are inflammation-induced bone and connective tissue lysis, the search for risk predictors of disease has centered on all the following except:

Answer 10

Cell wall components of Porphyromonas gingivalis and other pathogens — NOT EXCEPTIONS: tissue breakdown products, host-derived enzymes + their inhibitors, inflammatory mediators + host-response modifiers

Question 11

For maximum clinical utility a GCF marker or risk predictor of the progression of periodontitis should be tested in:

Answer 11

who are in a maintenance care program

Question 12

The primary cellular sources of matrix metalloproteinase-8 (MMP-8) in GCF are:

Answer 12

neutrophils

Question 13

Low-dose doxycycline (PerioStat) inhibits matrix metalloproteinases because the antibiotic is a:

Answer 13

chelating agent

Question 14

In a patient with untreated chronic periodontitis, most of the IgG and IgM in whole saliva comes from:

Answer 14

Gingival crevicular fluid (GCF)

Question 15

In the whole saliva of an untreated patient with chronic periodontitis, this one is not a component of innate immunity:

Answer 15

Secretory IgA2 – all the following are components on innate immunity: B-definsins, neutrophils, interluekin-1 (IL-1), complement

Question 16

The majority of IgG found in whole saliva comes from:

Answer 16

gingival crevicular fluid (GCF)

Question 17

Experimental gingivitis studies in humans have histologically shown that extensive loss of gingival connective tissue adjacent to pocket epithelium occurs:

Answer 17

within 7 days of starting with “no oral hygiene” period

Question 18

A major difficulty in the effective use of antimicrobials in periodontal pockets has been the

Answer 18

rapid clearance of the active agent from the pocket.

Question 19

Controlled-release drug delivery systems placed in periodontal pockets

Answer 19

release high concentrations of antimicrobials for up to 14 days.

Question 20

According to a meta-analysis reported by Bonito et..al. in 2005, adjunctive use of a locally delivered antimicrobial (LDA) along with SRP will most likely add no more than an additional

Answer 20

0.05 mm to the reduction in probing depth obtained by SRP alone.

Question 21

The active ingredient of the PerioChip is

Answer 21

Chlorhexidine.

Question 22

Arestin is an LDA system that

Answer 22

releases minocycline from microspheres.

Question 23

Gingival crevicular fluid (GCF) is a clear serous fluid from inflamed gingiva that is

Answer 23

a transudate of serum and tissue fluids.

Question 24

Since the dominant features of the progression of periodontitis are inflammation- induced bone and connective tissue lysis, the search for risk predictors of the disease has centered on all of the following EXCEPT ONE. Which one is the EXCEPTION?

Answer 24

Cell wall components of Porphyromonas gingivalis and other pathogens. – Others search for risk predictors of disease: Tissue breakdown products; Host-derived enzymes and their inhibitors; Inflammatory mediators and host-response modifiers.

Question 25

For maximum clinical utility a GCF marker or risk predictor of the progression of periodontitis should be tested in

Answer 25

who are in a maintenance care program

Question 26

β-defensins are produced in high quantities by

Answer 26

epithelial cells at inflamed sites.

Question 27

Matrix metalloproteinases (MMPs) are a family of at least 15 endopeptidases that

Answer 27

are zinc-dependent.

Question 28

An antibacterial component of whole saliva that might offer some protection against the progression of Gingivitis to Periodontitis is

Answer 28

secretory IgA.

Question 29

Low-dose doxycycline (PerioStatTM) inhibits matrix metalloproteinases because the antibiotic is a

Answer 29

chelating agent

Question 30

In the whole saliva of an untreated patient with chronic periodontitis, all of the following are components of innate immunity EXCEPT ONE. Which one is the EXCEPTION?

Answer 30

Secretory IgA2; All others are components of innate immunity – β-defensins; Neutrophils; Interleukin-1 (IL-1); Complement

Question 31

The majority of the neutrophils in whole saliva come from

Answer 31

inflamed periodontal tissues.

Question 32

All of the following are risk factors for periodontitis EXCEPT one. Which one is the EXCEPTION?

Answer 32

Bleeding on probing (doesn’t say on maintenance perio pt, so this would be the answer otherwise); – all others are risk factors for periodontitis: emotional stress,d diabetes mellitus, cigarette smoking, subgingival plaque

Question 33

Widely used markers of bone resorption in such diseases as osteoporosis, bone metastases, and multiple myeloma are

Answer 33

pyridinoline and deoxypyridinoline cross-links.

Question 34

The best way to clinically determine the progression of periodontitis is by detecting increased

Answer 34

loss of clinical attachment from one visit to the next

Question 35

Patients with Down syndrome often have an increased risk for all of the following health problems EXCEPT ONE. Which one is the EXCEPTION?

Answer 35

Dentin dysplasia – all others with down syndrome have increased risk for: leukemia, periodontitis, Alzheimer’s disease, congenital heart disease

Question 36

The familial aggregation (i.e., genetic tendency to be inherited) of cases of Localized Aggressive Periodontitis is due to

Answer 36

Mendelian genetic traits.

Question 37

The genetic predisposition to type 1 diabetes mellitus is associated with

Answer 37

HLA-linked genes and other genetic loci.

Question 38

The genetic predisposition to type 2 diabetes mellitus is associated with

Answer 38

multiple genetic defects.

Question 39

Variant forms of a gene that occur with a frequency of 1-2% in a population and fall within the normal biological range are referred to as

Answer 39

gene polymorphisms.

Question 40

Acetylation of DNA-bound histones is usually associated with

Answer 40

activation of nearby genes

Question 41

For a genetic variable to be considered as a risk factor for Chronic Periodontitis it must be

Answer 41

part of, or related to, the causal chain.

Question 42

Let’s say in 2010 a new bacteria is detected called californicus absurdicans by 16s RNA analysis in subgingival plaques. When present above 2% of the total plaque it not a good indicator of the presence of active periodontal disease at the probed site. However the absence this bacteria, is a good indicator of the absence of active disease at that probed site. Therefore in detecting active periodontal disease, one can say that detecting californicus absurdicans as an indicator for active disease has:

Answer 42

Low sensitivity, high specificity

Question 43

In an evidence based approach to analyzing studies, the highest quality of evidence would be

Answer 43

A meta analysis of randomized controlled clinical trials

Question 44

While the use of antimicrobial testing for specific plaque bacteria is currently limited in periodontal practice, its use may be of LEAST value in the treatment of:

Answer 44

Severe plaque associated gingival disease – more effective for: Chronic periodontitis that does not respond to conventional treatment; Aggressive periodontitis that does not respond to conventional treatment; Patients a high risk for periodontal breakdown (e.g. uncontrolled diabetes)

Question 45

Which of the following periodontal conditions would you probably most likely prescribe an antibiotic,

Answer 45

An acute periodontal abscess

Question 46

Clinical attachment level (CAL) is measured from

Answer 46

the CEJ to the bottom of the probeable sulcus or pocket.

Question 47

The key to maintaining a high concentration of an antibmicrobial agent in a periodontal pocket is:

Answer 47

use of the proper vehicle to deliver the antimicrobial

Question 48

“Zero order kinetics” of a drug delivery system means that

Answer 48

at any given time, the amount of drug released doesn’t not depend on the amount of drug remaining

Question 49

Locally delivered antimicrobials (LDA) have been proposed as “adjunctive” (as opposed to “stand alone”) therapy. This means that the LDA

Answer 49

will be used in conjunction with scaling and root planing.

Question 50

Gingival crevicular fluid (GCF) is a clear serous fluid from inflamed gingiva that is

Answer 50

a transudate of serum and tissue fluids.

Question 51

Since the dominant features of the progression of periodontitis are inflammation- induced bone and connective tissue lysis, the search for risk predictors of the disease has centered on all of the following EXCEPT ONE. Which one is the EXCEPTION?

Answer 51

Cell wall components of Porphyromonas gingivalis and other pathogens – others, search for risk predictors has centered on: Tissue breakdown products; Host-derived enzymes and their inhibitors; Inflammatory mediators and host-response modifiers.

Question 52

For maximum clinical utility a GCF marker or risk predictor of the progression of periodontitis should be tested in

Answer 52

who are in a maintenance care program

Question 53

Matrix metalloproteinases (MMPs) are a family of at least 15 endopeptidases that

Answer 53

are zinc-dependent.

Question 54

An antibacterial component of whole saliva that might offer some protection against the progression of Gingivitis to Periodontitis is

Answer 54

secretory IgA.

Question 55

Low-dose doxycycline (PerioStatTM) inhibits matrix metalloproteinases because the antibiotic is a

Answer 55

chelating agent

Question 56

In the whole saliva of an untreated patient with chronic periodontitis, all of the following are components of innate immunity EXCEPT ONE. Which one is the EXCEPTION?

Answer 56

Secretory IgA2 – all others are components of innate immunity: β-defensins; Neutrophils; Interleukin-1 (IL-1); Complement

Question 57

The majority of the neutrophils in whole saliva come from

Answer 57

inflamed periodontal tissues.

Question 58

The production of gingival crevicular fluid (GCF) is enhanced by increased vascular permeability in inflamed gingiva and

Answer 58

ulceration of the pocket wall.