mock exam Flashcards
1
Q
Secondary occlusal trauma
A
- normal/excessive occlusal forces
- Bone Loss
- occurs in presence of insertion loss
- tissue injury due to normal/excessive occlusal forces on reduced periodontal support
2
Q
Surgical techniques for pocket therapy
A
Zone 1: Soft tissue pocket wall
zone 2: tooth surface
zone 3: underlying bone
zone 4: attached gingiva
3
Q
Appointment calendar for patients with implants
A
- every 6-9 months
- patients with improved Oral hygiene, chronic periodontal disease, regular smoker.
- probing depth 4-6 mm with bleeding
- suppuration when pressing or probing
- masticatory mucosa 2-3 mm
- irregular controlled diabetes
4
Q
Mombelli (1999) general principles
A
- Bone regeneration/ tissue recovery
- Removal of biofilm from peri-implant pocket
- Reduction or elimination of locations that are difficult to clean
Decontamination/conditioning of the surface
NOT - reduction of bleeding sites
5
Q
Maintenance protocol for patient with dental implants
A
- submucosal irrigation of the peri-implant sulcus with disinfectants and oral antiseptics
- another appointment 2-4 weeks to ealuate results of mechanical therapy
- evaluation of the use of topical antibiotic in the peri-implant sulcus
- CHX / 10% providine-iodine can be used
6
Q
localised papillary gingivitis
A
it is attached to one or more interproximal spaces in a limited area
7
Q
generalised papillary gingivitis
A
Affects most interproximal spaces
8
Q
localised marginal gingivitis
A
it is limited to the free gum of a tooth or some
9
Q
generalised marginal gingivitis
A
affects the entire free gum of an arch or both
10
Q
localised diffuse gingivitis
A
inflammation extends from the gingival margin to the mucogingival line in a single tooth or in some teeth
11
Q
generalised diffuse gingivitis
A
it affects the entire gum. The alveolar mucosa and the inserted gum show inflammation, so the anatomical separation between them, the mucogingival line, is erased.
12
Q
Advanced flap procedures
A
- Coronally repositioned flap
- Semilunar coronally repositioned flap
13
Q
Rotational flap procedures
A
- Laterally sliding flap
- double papilla flap
- oblique rotated flap
14
Q
X-ray must be individualised depending on the initial severity of the case and findings at the recall visit. On a patient with periodontal disease without good periodontal control, we will take:
A
- vertical/periapical bitewing x-ray of problematic areas one every 12-14 months, whole mouth x-ray series every 3-5 years.
15
Q
Selecting root cover procedure, several factors must be taken into account:
A
- Aesthetics of the area and availability of donor tissue
- Presence of muscle inserts and recession form (width and depth)
- Recession form (width and depth) and Presence of muscle inserts
- Presence of muscle inserts and availability of donor tissue
16
Q
On papilla bleeding index, probing is done in all 4 quadrants. which ones?
A
Facially (in quadrants 2 and 4) and orally (in quadrants 1 and 3).
17
Q
From an epidemiological point of view, when can we determine that patient has gingival health?
A
When it has less than 10% of locations that bleed with drilling depths of 3mm or less.
18
Q
Measurements of CT attachement, Junctional epi attachment, gingival sulcus and the biological width?
A
CT attachement = 1.07mm
Junctional epi attachment = 0.97mm
Gingival sulcus = 0.69mm
Biological width = 2.04 mm
19
Q
Factors that determine the pattern in which this bone destruction develops?
A
- way of propagation
- food impaction
- normal variation in alveolar bone
- radius of action
20
Q
Depending on a periodontal patient characteristics in fixed prostheses.
A
Connective attachment: more constant structure.
21
Q
Many cells repopulate the curetted root surface, however only two of them would achieve complete periodontal regeneration, which 2 cells are they?
A
- Cells derived from the periodontal ligament and bone perivascular cells.
22
Q
What “requires the removal of very small amounts of supporting interproximal bone and it is indicated when interproximal bone levels vary horizontally”?
A
Flattening of the interdental bone
23
Q
“usually progress without producing clinical symptoms and may therefore go undetected unless observed radiographically” responds to
A
Root surface resoption
24
Q
How do we calculate the percentage of hygiene index (HI) (O’leary et al, lindhe)
A
(number of plaque free areas) / (number of examined areas) x 100
25
Ramfjord teeth. which ones?
Teeth 16, 21, 24, 36, 41 and 44
26
Grade of disease progression
Grade A : Slow rate of progression where there is evidence of no loss over 5 years.
Grade B: moderate progression in which there has been less than 2mm of loss in a period of 5 years.
Grade C: Rapid rate of progression in which there has been more or equal to 2mm of loss in over 5 years.
27
In a publication a surgical procedure was described to be used in the treatment of "periodontal pus pockets". Who described the technique for the first time?
Kirkland
28
Modified windman flap
- The initial incision should be parallel to the long axis of the tooth and plaed approximately 1mm from the buccal gingival margin.
- if the pockets on the buccal aspects of the teeth are <2mm deep, an intracrevicular incision may be made.
- a third incision made in a horizontal direction and in a position close to the surface of the alveolar bone crest separates the soft tissue collar of the root surfaces from the bone.
- The pocket epithelium and the granulation tissues are removed by means of curettes.
Not -The dressing, as well as the sutures, is removed after 4 weeks.
29
Objectives of bone graft procedures
- Regeneration of a functional insertion apparatus
- Elimination or reduction of the pocket
- Restoration of the alveolar process
Not - Elimination of dental plaque
30
Which parameter is a sign of non-reversible bone loss?
Mobility
31
Which flap design pointed out the importance of removing the soft tissue pockets, that is replacing the flap at the crest of the alveolar bone?
Windman flap.
32
Pulp vitality
- Teeth with periodontal infection are generally vital on thermal tests
- Provocation of sharp pain sensation indicates a vital pulp
-Teeth with a peri-radicular infection and a periodontal abscess are generally non-vital in the test
NOT - the vitality of the pulp is tested rather than its sensitivity
33
During pregnancy the subgingival microbiota undergo changes including an increase in...
prevotella intermedia
34
A failing case can be recognised by
gradual increases in tooth mobility
35
Radiographic implantitis
a standardised parallel technique is required using position devices
36
Changes in the forces exerted on the teeth. The pattern of changes that may follow failure to replace missing first molars is characteristic. In extreme cases it consist of the following
- The maxillary incisors are pushed labially and laterally
- the second and third molars tilt, resulting in a decrease in vertical dimension
- anterior overbite is increased. the mandibular incisors strike the maxillary incisors near the gingiva or traumatise the gingiva.
Not - the premolars move mesially, and the mandibular incisors tilt or drift labially.
37
Necrotising ulcerative gingivitis (NUG)
There is a "metallic" foul taste, and the patient is conscious of an excessive amount of "pasty" saliva.
38
Vitamin C deficiency does not cause
-Edema
-Bleeding
-Edema of the gingival connective tissue
- Collagen degeneration
Not - Gingival inflammation
39
Radiographic signs of trauma from occlusion may include
- Radiolucency and condensation of the alveolar bone
-Increased width of the periodontal space
-Root resoption, these areas are usually insufficient in magnitude to be detected on radiographs.
Not - A horizontal rather than vertical destruction of the interdental septum.
40
Which is the most common clincial sign of trauma to the periodontium?
- increased tooth mobility
41
What is the distinguished feature of necrotising ulcerative periodontitis (NUP)?
Bone destruction
42
Primary trauma from occlusion
- Supracrestal gingival fibers are not affected and therefore prevent apical migration of the junctional epithelium
- An example of primary from occlusion would be the insertion of a prosthetic replacement that creates excessive forces on abutment and antagonistic teeth.
-an example would be the insertion of a "high filling"
-Occlusion is considered the primary etiologic factor in periodontal destruction and if the only local alteration to which a tooth is subjected is form occlusion.
Not - Changes produced by primary trauma alter the level of connective tissue attachment and do not initiate pocket formation.
43
Papilla Bleeding Index (PBI)
All incorrect
44
When there is acute outbreak in the periodontal pocket
There is an increase in gram-negative anaerobes, especially mobile bacteria.
45
In a non-periodontal patient, periodontal abscesses may occur
by trauma or impaction
46
According to the stages, the severity of the disease is assessed using
The loss of teeth (stages I and II when there is no loss of teeth due to periodontitis; Stage III when there are 4 or less teeth lost due to periodontitis and Stage IV when there are 5 or more missing teeth).
47
Miller Class I
Marginal tissue recession does not extend to the mucogingival junction. There is no loss of bone or soft tissue in the interdental area. This type of recession can be narrow or wide. 100% coating possible.
48
Miller Class II
Marginal tissue recession extends to or beyond the mucogingival junction . There is no loss of bone or soft tissue in the interdental area. This type of recession can be subclassified into wide and narrow. 100% coating possible
49
Miller Class III
Marginal tissue recession extends to or beyond the mucogingival junction. There is bone and soft tissue loss interdentally or malpositioning of the tooth. Practical coating possible.
50
Miller Class IV
Marginal tissue recession extends to or beyond the mucogingival junction. There is severe bone and soft tissue loss interdentally or severe tooth malposition. No coating possible.
51
Chronic trauma from occlusion...
It most often develops from gradual changes in occlusion produced by tooth wear, drifting movement, and extrusion of teeth, combined with parafunctional habits such as bruxism and clenching.
52
What materials are used as an allograft (allogenic bone) material?
- Lyophilised bone
- Cryopreserved medullary bone
- lyophilised bone - demineralised
-frozen iliac trabecular bone
Not - Frozen mineralised cyporpreserved cortical bone.
53
One of the clinical findings on a patient gingiva is changes in consistency. Which is a chronic gingivitis characteristic?
Soft swelling that sinks under pressure.
54
Which model refers to the following definition: "suggests that periodontal destruction occurs around affected teeth during defined periods of life".
The asynchronous, multiple burst model.
55
The conservative treatment strategy would be reflected in the following surgical principles:
- Minimal excision of gingival tissue
- Lifting a flap of total thickness as small as possible that allows good access to the root surface and bone place.
- comprehensive and systematic debridement of soft tissues housed in bone lesion
- the intimate adaption of the tissue and its replacement to a situation as close as possible to the pre-surgical conditions of the gingival margin.
56
According to wound healing of gingival augmentation by graft procedures
The definitive healing of the graft occurs in one week with the coating of a new thin layer of epithelium.
57
Horizontal resorption pattern
- The periodontal pocket will be infraosseous/infrabony
- The thickness of the interproximal septum is less than 1.5-2.5mm
- the result is an alveolar bone profile that draws a line parallel to the occlusal plane.
- The periodontal pocket will be supraosseous/suprabony.
Not - the thickness of the external bone table is less than 1.5-2.5mm.
58
Merin Classification First-year patient
Revisions every 3 months during the first year if there aren't any complication. Difficult case with complicated prosthesis, furcation involvement, poor crown to root ratios, or questionable patient cooperation, revisions every 1-2 months during the first year.
59
Merin Class A
Revisions every 6 months or 1 year in patients with excellent results well maintained. Patient displays good oral hygiene, minimal claculus, no occlusal problems, no complicated prostheses, no remaining pockets, and no teeth with less than 50% of alveolar bone remaining.
60
Merin Class B
Revisions every 3-4 months. Decided recall interval based on number and severity of negative factors.
61
Merin Class C
1-3 months (decide recall interval based on number and severity of negative factors; consider re-treating some areas or extracting severely involved teeth).
62
To handle periodontal pockets on the palatal aspect of the maxillary teeth, Friedman described a modification of the "apically repositioned flap", which he termed
Repositioning of attached gingiva.
63
How long should we wait after the completion of periodontal therapy before we can start ortho...
6 Month
64
Which flap design indicated the importance of placing soft tissue margin at the level of the alveolar bone crest?
Original Widman Flap
65
Which of the following characteristics are true regarding NUP?
-Necrosis
-ulceration
-pain
-periodontal attachment and bone loss
NOT - Bright red marginal gingiva, not bleeding
66
The "bern spider" model evaluates number of pockets
>4mm
67
Plaque index Grade 0
No plaque
68
Plaue index Grade 1
Thin plaque layer at the gingival margin, only detectable by scraping with a probe
69
Plaque index Grade 2
Moderate layer of plaque along the gingival margin; interdental spaces free, but plaque is visible to the naked eye.
70
Plaque index Grade 3
Abundant plaque along the gingival margin; interdental spaces filled with plaque.
71
Gingival index Grade 0
Normal gingiva; no inflammation; no discolouration (erythema); no bleeding
72
Gingival index Grade 1
Mild inflammation; slight erythema; minimal superficial alterations. No bleeding
73
Gingival Index Grade 2
Moderate inflammation; erythema; bleeding on probing
74
Gingival index Grade 3
Severe inflammation; severe erythema and swelling; tendency to spontaneous bleeding; possible ulceration.
75
Papilla Bleeding Index (PBI) Saxer and Muhlemann
- It is a sensitive indicator of the severity of gingival inflammation
- Probing is done in all 4 quadrants
- It was created for private practice use
- Consists of 28 measurements
Not- Requires a long time to carry out.
76
Which of these is not the same for classification Class B and Class C after periodontal treatment?
Many remaining pockets
77
Regarding tissue response stages to increased occlusal forces, in which stage can be seen the phenomenon of buttressing?
Stage III
78
What is the main etiological factor of peri-implant diseases?
Bacterial (plaque) accumulation
79
Peri-radicular lesions from primary pulp infection leads to...
Retrograde periodontitis - migrating from the root apex in cervical direction.
80
Def. Acute gingivitis
Sudden onset, short duration and usually painful
81
Def. Recurrent gingivitis
Reappears in a relatively short period of time after having resolved either by treatment or spontaneously
82
Def. Chronic gingivitis
It is the most frequent form of gingivitis. It has a slow appearance and extends over time. It is painless unless is complicated by acute or semi-acute exacerbations. It is a fluctuating pathology in which inflammation persists or resolves in some areas and appears in others.
83
Wound healing usually occurs without problems if the graft is of adequate thickness of...
1-1.5 mm
84
Regarding characteristics of an index, which of the following is the correct definition of reliability?
That the results must be consistent under different conditions of use and therefore be reproducible by different examiners.
85
What is the cause of recurrent periodontal disease.
Incomplete subgingival plaque removal
86
During physiological bone remodelling, the resulting bone morphology places the bone profile between...
1.5-2mm from the should of the implant.
87
What is the recommended frequence to take readiographs to detect and monitor peri-implantitis?
once/year
88
The health sector does not involve:
- Health condition
- People
- The system
- Medical services
89
Which are factors of the "bern spider" model?
- Bleeding on probing
- Smoking
- Missing teeth
NOT - Alcohol
90
Regarding the radius of action of the bacterial plaque...
- Interproximal angular defects can only appear in spaces wider than 2.5mm
- Bacterial plaque's range of effectiveness is 1.5-2.5mm
- Large defects exceeding a distance of 2.5mm from the tooth surface may be caused by bacteria
91
Regarding Peri-implantitis...
- May result in loss of supporting bone
- May include bleeding on probing
- May include radiographic bone loss
- It is an inflammatory proccess
NOT - It affects the tissues around a new implant, not yet osseointegrated
92
Regarding orthodontic therapy
-If periodontal inflammation is not fully controlled durng the orthodontic treatment, this can lead to periodontal destruction
- Patients need to demonstrate good oral hygiene and periodontal health
- Orthodontic therapy should not start before 6 months after the completion of periodontal therapy.
Not - Fixed orthodontic appliances may promote gingival hyperplasia, especially in the upper incisor area.
93
Patient with untreated chronic periodontitis...
- Gingigival inflammation
- Pocket formation
- Loss of alveolar bone
- Loss of periodontal attachment
Not - Only supragingival plaque accumulation.
94
Regarding Frenectomy...
- A frenum is a fold of mucous membrean
- Frenectomy is complete removal of the frenum
- Frenotomy is the incision of the frenum
- A frenum becomes a problem if the attachment is too close to the marginal gingiva.
- Frenotomy generally suffices for periodontal purposes.
95
What finding may indicate the need for surgical phase of therapy?
Persistent inflammation in areas with moderate to deep pockets may require surgical approach.
96
Regarding characteristics of an index, which of the following is the correct definition of validity?
That serves to measure what is intended and that adapts to the characteristics of the problem under the study.
97
Regarding characteristics of an index, which of the following is the correct definition of clarity?
The examiner must easily understand their rules and criteria in order to apply them easily and quickly in their fieldwork.
98
Regarding characteristics of an index, which of the following is the correct definition of reliability?
The results must be consistent under different conditions of use and therefore be reproducible by different examiners.
99
Regarding characteristics of an index, which of the following is the correct definition of sensitivity?
Must be able to reasonably detect small variations in any direction of the health status of the population group studied.
100
Regarding characteristics of an index, which of the following is the correct definition of acceptability?
The use of the index should not cause discomfort or discomfort in the individuals examined.
101
In regenerative periodontal surgery what is an anorganic, bovine derived bone marked under the brand name Bio-Oss?
Xenografts
102
Which structures can excessive occlusal force injure?
- The masticatory muscles
- Periodontal tissues
- Pulp tissue
- The TMJ
103
Clincal findings in gingivitis
- Changes in gingival consistency
- contour
-color
-texture
Not - gingival insertion.
