MOSBY Flashcards
Dental wear caused by tooth-to-tooth contact is _____.
A. Abrasion
B. Attrition
C. Erosion
D. Abfraction
B. Attrition
NOTES:
Attrition: physiologic wearing of teeth as a result of mastication (tooth to tooth contact)
Abrasion: pathologic (mechanical) wearing of teeth as a result of an abnormal habit or use of abrasive substances orally
Erosion: loss of toith structure from a non-bacterial chemical process like acids
Afraction: due to flexural forces, usually seen in the cervical area
Occlusal loading resulting in tooth flexure, mechanical microfractures, and loss of tooth substance in the cervical area is _____.
A. Abrasion
B. Attrition
C. Erosion
D. Abfraction
D. Abfraction
NOTES:
Attrition: physiologic wearing of teeth as a result of mastication (tooth to tooth contact)
Abrasion: pathologic (mechanical) wearing of teeth as a result of an abnormal habit or use of abrasive substances orally
Erosion: loss of toith structure from a non-bacterial chemical process like acids
Afraction: due to flexural forces, usually seen in the cervical area
The distance from the CEJ to the base of the pocket is a measure of _____.
A. Clinical attachment level
B. Gingival recession
C. Probing pocket depth
D. Alveolar bone loss
A. Clinical attachment level
NOTES:
PPD- Distance from gingival margin to the base of the probable pocket
GR- Measurement from CEJ to the gingival margin
CAL- Distance from CEJ to the base of probable pocket
CAL= PPD+ GR
Your examination reveals a probing pocket depth of 6 mm on the facial of tooth 30. The free gingival margin is 2 mm apical to the CEJ (there is 2-mm recession on the facial). How much attachment loss has there been on the facial of this tooth?
A. 6 mm
B. 2 mm
C. 8 mm
D. 4 mm
C. 8 mm
NOTES:
CAL= PPD+GR
In general, what species are predominant in supragingival tooth-associated attached plaque?
A. Gram-negative rods and cocci
B. Gram-negative filaments
C. Gram-positive filaments
D. Gram-positive rods and cocci
D. Gram-positive rods and cocci
NOTES:
SUBGINGIVAL PLAQUE IN CERVICAL REGION
Tooth associated - Gram (+) rods and cocci
Tissue associated – Gram (-) rods and cocci filaments, flagellated rods and spirochetes
SUBGINGIVAL PLAQUE IN DEEPER SULCUS OR POCKET
Tooth associated – Gram (-) rod
Tissue associated – gram (-) rods and cocci filaments, flagellated rods and spirochetes
The inorganic component of subgingival plaque is derived from _____.
A. Bacteria
B. Saliva
C. Gingival crevicular fluid
D. Neutrophils
C. Gingival crevicular fluid
NOTES:
GCF
- “Access of microorganism”
- is defined as physiologic fluid secreted in the gingival crevice that is classified as inflammatory exudate during disease or serum transudate during health.
What are the characteristics of the primary (initial) bacterial colonizers of the tooth in dental plaque formation?
A. Gram-negative facultative
B. Gram-positive facultative
C. Gram-negative anaerobic
D. Gram-positive anaerobic
B. Gram-positive facultative
NOTES:
SUBGINGIVAL PLAQUE IN CERVICAL REGION
Tooth associated - Gram (+) rods and cocci
Tissue associated – Gram (-) rods and cocci filaments, flagellated rods and spirochetes
SUBGINGIVAL PLAQUE IN DEEPER SULCUS OR POCKET
Tooth associated – Gram (-) rod
Tissue associated – gram (-) rods and cocci filaments, flagellated rods and spirochetes
Which of the following is an important constituent of gram-negative microorganisms that contributes to initiation of the host inflammatory response?
A. Exotoxin
B. Lipoteichoic acid
C. Endotoxin
D. Peptidoglycan
C. Endotoxin
Calculus is detrimental to the gingival tissues because it is _____.
A. A mechanical irritant
B. Covered with bacterial plaque
C. Composed of calcium and phosphorous
D. Locked into surface irregularities
B. Covered with bacterial plaque
Restoration margins are plaque-retentive and produce the most inflammation when they are located _____.
A. Supragingival
B. Subgingival
C. At the level of the gingival margin
D. On buccal surfaces of teeth
B. Subgingival
Which of the following are cells of the innate immune system?
a. Neutrophils and monocytes/macrophages
b. T cells and B cells
c. Mast cells and dendritic cells
d. Plasma cells
A. a and b
B. a and c
C. b and d
D. b and c
B. a and c
NOTES:
CELLS OF THE INNATE IMMUNE SYSTEM:
- Neutrophils and monocytes/macrophages
- Mast cells and dendritic cells
CELLS OF THE ADAPTIVE IMMUNE SYSTEM:
- T cells and B cells
- Plasma cells
Which of the following are antigen-presenting cells?
A. Neutrophils
B. T-lymphocytes
C. Macrophages
D. Plasma cells
C. Macrophages
NOTES:
Neutrophils- primary defense cells if the innate immune system
T-lymphocytes- important activators of the specific (adaptive) immune system
Macrophages- antigen- presenting cells
Plasma cells- produce antibodies
Which of the following are the most important proteinases involved in destruction of the periodontal tissues?
A. Hylauronidase
B. Matrix metalloproteinases
C. Glucuronidase
D. Serine proteinases
B. Matrix metalloproteinases
NOTES
MMP
- It is considered as the most important proteinase involved in the destruction of periodontal tissues.
- They are produced by most cells of the periodontal tissue.
The predominant inflammatory cells in the periodontal pocket are _____.
A. Lymphocytes
B. Plasma cells
C. Neutrophils
D. Macrophages
C. Neutrophils
Which of the following are part of Preliminary Phase therapy?
a. Treatment of emergencies
b. Extraction of hopeless teeth
c. Plaque control
d. Removal of calculus
A. a, b, and c
B. b, c, and d
C. a and b only
D. b and d only
C. a and b only
Polymorphisms in which of the following genes have been associated with severe chronic periodontitis?
A. IL-6
B. IL-1
C. TNF
D. PGE2
B. IL-1
Given the same amount of attachment loss and same pocket depth, a single-rooted tooth and a multirooted tooth have the same prognosis. The closer the base of the pocket is to the apex of the tooth, the worse the prognosis.
A. Both statements are true.
B. Both statements are false.
C. First statement is true. Second statement is false.
D. First statement is false. Second statement is true.
D. First statement is false. Second statement is true.
NOTES:
Single rooted teeth have POORER prognosis than multirooted teeth with comparable loss of attachment.
Which of the following is most important in determining the prognosis for a tooth?
A. Probing pocket depth
B. Bleeding on probing
C. Clinical attachment level
D. Level of alveolar bone
C. Clinical attachment level
Offset angulation is a characteristic feature of _____.
A. Sickle scalers
B. Universal curettes
C. Area-specific curettes
D. Chisels
C. Area-specific curettes
Patients with which of the following should not be treated with ultrasonic instruments?
A. Deep periodontal pockets
B. Edematous tissue
C. Infectious diseases
D. Controlled diabetes
C. Infectious diseases
What is the most important procedure to perform during the initial postoperative visits following periodontal surgery?
A. Plaque removal
B. Visual assessment of the soft tissue
C. Periodontal probing
D. Bleeding index
A. Plaque removal
When performing a laterally repositioned flap, which of the following must be considered relative to the donor site?
A. Presence of bone on the facial
B. Width of attached gingiva
C. Thickness of attached gingiva
D. All of the above
D. All of the above
Which class of bony defect responds best to regenerative therapy?
A. One-walled
B. Two-walled
C. Three-walled
D. Shallow crater
C. Three-walled
NOTES:
Higher number of walls, Higher success rate after procedure.
One Wall – “hemiseptal”
Two Wall – “Osseous Crater”
Three Wall – Through
Four Wall – Circumferential (Exception because example is: EXTRACTION SITE)
The most common clinical sign of occlusal trauma is _____.
A. Tooth migration
B. Tooth abrasion
C. Tooth mobility
D. Tooth attrition
C. Tooth mobility
For most periodontitis-affected patients, what is the recommended interval for maintenance appointments?
A. 1 month
B. 3 months
C. 6 months
D. 1 year
B. 3 months
Loss of tooth substance by mechanical wear is _____.
A. Abrasion
B. Attrition
C. Erosion
D. Abfraction
A. Abrasion
NOTES:
Attrition: physiologic wearing of teeth as a result of mastication (tooth to tooth contact)
Abrasion: pathologic (mechanical) wearing of teeth as a result of an abnormal habit or use of abrasive substances orally
Erosion: loss of tooth structure from a non-bacterial chemical process like acids
Afraction: due to flexural forces, usually seen in the cervical area
The width of keratinized gingiva is measured as the distance from the _____.
A. Free gingival margin to the mucogingival junction
B. Cementoenamel junction to the mucogingival junction
C. Free gingival groove to the mucogingival junction
D. Free gingival margin to the base of the pocket
A. Free gingival margin to the mucogingival junction
NOTES:
Alveolar Mucosa
➖➖➖➖➖➖ MGJ
Attatched Gingiva
➖➖➖➖➖➖FGG
Unattached Gingiva
➖➖➖➖➖➖GM
Which of the following best distinguishes periodontitis from gingivitis?
A. Probing pocket depth
B. Bleeding on probing
C. Clinical attachment loss
D. Presence of suppuration
C. Clinical attachment loss
A 22-year-old college student presents with oral pain, erythematous gingival tissues with blunt papillae covered with a pseudomembrane, spontaneous gingival bleeding, and halitosis. There is no evidence of clinical attachment loss. What form of periodontal disease does this patient most likely have?
A. Gingivitis associated with dental plaque
B. Localized aggressive periodontitis
C. Generalized chronic periodontitis
D. Necrotizing ulcerative gingivitis
D. Necrotizing ulcerative gingivitis
NOTES:
Necrotizing Ulcerative Gingivitis (NUG)
- “ punched out grayish pseudomembranous of interdental papilla”
- Characterized by interproximal necrosis and pseudomembrane formation on marginal tissues.
Which of the following methods of radiographic assessment are best for identifying small volumetric changes in alveolar bone density?
A. Bitewing
B. Periapical
C. Subtraction
D. Panoramic
C. Subtraction
What tooth surfaces should be evaluated for furcation involvement on maxillary molars?
A. Palatal, facial, and distal
B. Mesial, distal, and palatal
C. Facial, palatal, and mesial
D. Facial, mesial, and distal
D. Facial, mesial, and distal
What bacterial species are found in increased numbers in the apical portion of tooth-associated attached plaque?
A. Gram-negative rods
B. Gram-positive rods
C. Gram-positive cocci
D. Gram-negative cocci
A. Gram-negative rods
SUBGINGIVAL PLAQUE IN CERVICAL REGION
Tooth associated - Gram (+) rods and cocci
Tissue associated – Gram (-) rods and cocci filaments, flagellated rods and spirochetes
SUBGINGIVAL PLAQUE IN DEEPER SULCUS OR POCKET
Tooth associated – Gram (-) rod
Tissue associated – gram (-) rods and cocci filaments, flagellated rods and spirochetes
What are the major organic constituents of bacterial plaque?
- Calcium and phosphorous
- Sodium and potassium
- Polysaccharides and proteins
- Glycoproteins and lipids
A. 1 and 2
B. 2 and 3
C. 3 and 4
D. 2 and 4
C. 3 and 4
NOTES:
BACTERIAL PLAQUE
- Polysaccharides and proteins
- Glycoproteins and lipids
Although many plaque bacteria coaggregate, which of the following bacteria is believed to be an important bridge between “early colonizers” and “late colonizers” as plaque matures and becomes more microbiologically complex?
A. Porphyromonas gingivalis
B. Streptococcus gordonii
C. Hemophilus parainfluenzae
D. Fusobacterium nucleatum
D. Fusobacterium nucleatum
What features best characterize the predominant microflora associated with periodontal health?
A. Gram-positive, anaerobic cocci and rods
B. Gram-negative, anaerobic cocci and rods
C. Gram-positive, facultative cocci and rods
D. Gram-negative, facultative cocci and rods
C. Gram-positive, facultative cocci and rods
Which of the following microorganisms is frequently associated with localized aggressive periodontitis?
A. Porphyromonas gingivalis
B. Actinobacillus actinomycetemcomitans
C. Actinomyces viscosus
D. Streptococcus mutans
B. Actinobacillus actinomycetemcomitans
NOTES:
Aggressive Periodontitis- AA
- A. Actinomycetemcomitans
- Antibiotics
Which of the following is the primary etiologic factor associated with periodontal disease?
A. Age
B. Gender
C. Nutrition
D. Bacterial plaque
D. Bacterial plaque
Inadequate margins of restorations should be corrected primarily because they _____.
A. Cause occlusal disharmony
B. Interfere with plaque removal
C. Create mechanical irritation
D. Release toxic substances
B. Interfere with plaque removal
Light smokers are likely to have less severe periodontitis than heavy smokers.
Former smokers are likely to have more severe periodontitis than current smokers.
A. Both statements are true.
B. Both statements are false.
C. The first statement is true, the second statement is false.
D. The first statement is false, the second statement is true.
C. The first statement is true, the second statement is false.
Well-controlled diabetics have more periodontal disease than nondiabetics.
Well-controlled diabetics can generally be treated successfully with conventional periodontal therapy.
A. Both statements are true.
B. Both statements are false.
C. The first statement is true, the second statement is false.
D. The first statement is false, the second statement is true.
D. The first statement is false, the second statement is true.
Oral contraceptives can cause gingivitis.
Oral contraceptives can accentuate the gingival response to bacterial plaque.
A. Both statements are true.
B. Both statements are false.
C. The first statement is true, the second statement is false.
D. The first statement is false, the second statement is true.
D. The first statement is false, the second statement is true.
Which of the following cells produce antibodies?
A. Neutrophils
B. T-lymphocytes
C. Macrophages
D. Plasma cells
D. Plasma cells
NOTES:
Neutrophils- primary defense cells if the innate immune system
T-lymphocytes- important activators of the specific (adaptive) immune system
Macrophages- antigen- presenting cells
Plasma cells- produce antibodies
Defects in which inflammatory cell have most frequently been associated with periodontal disease?
A. The T-lymphocyte
B. The mast cell
C. The plasma cell
D. The neutrophil
D. The neutrophil
What is the major clinical difference between the established lesion of gingivitis and the advanced lesion of periodontitis?
A. Gingival color, contour, and consistency
B. Bleeding on probing
C. Loss of crestal lamina dura
D. Attachment and bone loss
E. Suppuration
D. Attachment and bone loss
Which interleukin (IL) is important in the activation of osteoclasts and the stimulation of bone loss seen in periodontal disease?
A. IL-1
B. IL-2
C. IL-8
D. IL-10
A. IL-1
NOTES:
Interleukin 1- Bone resorption
Interleukin 8- Bleeding on probing
Tumor necrosis factor- Bone loss and tissue destruction
Prostaglandin- Triggers osteoclast and promotes overproduction of MMPs
Scaling and root planing are used in which phases of periodontal therapy?
- Initial (hygienic)
- Surgical (corrective)
- Supportive (maintenance)
A. 1 only
B. 1 and 2 only
C. 2 and 3 only
D. 1 and 3 only
E. 1, 2, and 3
E. 1, 2, and 3
What is the most objective clinical indicator of inflammation?
A. Gingival color
B. Gingival consistency
C. Gingival bleeding
D. Gingival stippling
C. Gingival bleeding
A 25-year-old patient presenting with generalized marginal gingivitis without any systemic problems or medications should be classified with which periodontal prognosis?
A. Good
B. Fair
C. Poor
D. Questionable
A. Good
Instrumentation of the teeth to remove plaque, calculus and stains is defined as _____.
A. Coronal polishing
B. Scaling
C. Gingival curettage
D. Root planing
B. Scaling
Scalers are used to remove supragingival deposits.
Curettes are used to remove either supragingival or subgingival deposits.
A. Both statements are true.
B. Both statements are false.
C. First statement is true. Second statement is false.
D. First statement is false. Second statement is true.
A. Both statements are true.
Which of the following is NOT a characteristic of sickle scalers?
A. Two cutting edges.
B. Rounded back.
C. Cutting edges meet in a point.
D. Triangular in cross section.
E. Used for removal of supragingival deposits.
B. Rounded back❌
NOTES:
Sickle scaler
- Two cutting edges
- Cutting edges meet in a point
- Triangular in cross section
- Used for removal of supragingival deposits
The modified Widman flap uses three separate incisions.
It is reflected beyond the mucogingival junction.
A. Both statements are true.
B. Both statements are false.
C. First statement is true. Second statement is false.
D. First statement is false. Second statement is true.
C. First statement is true. Second statement is false.
NOTES:
Three incisions are made in the modified Widman flap—internal bevel, crevicular, and interdental. It is designed to provide exposure of the tooth roots and alveolar bone. However, the flap is NOT reflected BEYOND the mucogingival junction
The free gingival graft technique can be used to increase the width of attached gingival tissue.
Apically displaced full-thickness or partial thickness flaps can also be used to increase the width of attached gingiva.
A. Both statements are true.
B. Both statements are false.
C. First statement is true. Second statement is false.
D. First statement is false. Second statement is true.
A. Both statements are true.
NOTES:
Surgical techniques designed to increase the width of attached gingiva:
- free gingival grafts
- apically repositioned flaps (partial thickness)
Miller Class I recession defects can be distinguished from Class II defects by assessing the _____.
A. Location of interproximal alveolar bone
B. Width of keratinized gingiva
C. Involvement of the mucogingival junction
D. Involvement of the free gingival margin
C. Involvement of the mucogingival junction
NOTES:
The Miller classification system for mucogingival defects takes into consideration the degree of recession (whether or not it extends to the mucogingival junction) and presence or absence of bone loss in the interdental area.
Class I- the marginal tissue recession does NOT extend to the mucogingival junction, no loss of bone in the interproximal areas
Class II - recession does extend to or beyond the mucogingival junction, no loss of bone in the interproximal areas
The reshaping or recontouring of nonsupportive alveolar bone is called _____.
A. Ostectomy
B. Osteoplasty
C. Osteography
D. All of the above
B. Osteoplasty
NOTES:
-ectomy: removal
-plasty: repair, restore, reshape
-grpahy: record
An interdental crater has how many walls?
A. One wall
B. Two walls
C. Three walls
D. Four walls
B. Two walls
NOTES:
One Wall – “hemiseptal”
Two Wall – “Osseous Crater”
Three Wall – Trough
Four Wall – Circumferential
During the healing of a surgically treated intrabony (infrabony) pocket, regeneration of a new periodontal ligament, cementum, and alveolar bone will only occur when cells repopulate the wound from which of the following sources?
A. Gingival epithelium
B. Connective tissue
C. Alveolar bone
D. Periodontal ligament
D. Periodontal ligament
Which of the following is least likely to be successfully treated with a bone graft procedure?
A. One-walled defect
B. Two-walled defect
C. Three-walled defect
D. Class III furcation defect
D. Class III furcation defect
When osseointegration occurs, which of the following best describes the implant–bone interface at the level of light microscopy following osseointegration?
A. Epithelial attachment
B. Direct contact
C. Connective tissue insertion
D. Cellular attachment
B. Direct contact
The most effective topical antimicrobial agent currently available is _____.
A. Chlorhexidine
B. Stannous fluoride
C. Phenolic compounds
D. Sanguinarine
A. Chlorhexidine
What is the active ingredient in PerioChip™?
A. Doxycycline
B. Tetracycline
C. Metronidazole
D. Chlorhexidine
D. Chlorhexidine
How many days does it usually take for surface epithelialization to be complete following a gingivectomy?
A. 3–7
B. 5–14
C. 14–18
D. 20–27
B. 5–14
The most obvious clinical sign of trauma from occlusion is increased tooth mobility.
The most obvious radiographic sign of trauma from occlusion is an increase in the width of the periodontal ligament space.
A. Both statements are true.
B. Both statements are false.
C. The first statement is true, the second statement is false.
D. The first statement is false, the second statement is true.
A. Both statements are true.
Trauma from occlusion refers to _____.
A. The occlusal force
B. The damage to the tooth
C. The injury to the tissues of the periodontium
D. The widened periodontal ligament
C. The injury to the tissues of the periodontium
Which of the following is the primary reason for splinting teeth?
A. For esthetics
B. To improve hygiene
C. For patient comfort
D. As a preventive measure
C. For patient comfort
In the treatment of an acute periodontal abscess, the most important first step is to _____.
A. Prescribe systemic antibiotics
B. Reflect a periodontal flap surgery
C. Obtain drainage
D. Prescribe hot salt mouth washes
C. Obtain drainage
Which of the following medications often result in overgrowth of gingival tissues?
A. Penicillin, calcium channel blockers, phenytoin
B. Calcium channel blockers, phenytoin, and cyclosporin
C. Cyclosporin, penicillin, and cephalosporins
D. Ampicillin, tetracycline, and erythromycin
B. Calcium channel blockers, phenytoin, and cyclosporin
Which of the following is the most important preventive and therapeutic procedure in periodontal therapy?
A. Professional instrumentation
B. Subgingival irrigation with chlorhexidine
C. Patient-administered plaque control
D. Surgical intervention
C. Patient-administered plaque control
How many hours after brushing does it usually take for a mature dental plaque to reform?
A. 1–2
B. 5–10
C. 12–24
D. 24–48
D. 24–48
Placing the toothbrush bristles at a 45-degree angle on the tooth and pointing apically so the bristles enter the gingival sulcus describes which brushing technique?
A. Charter
B. Stillman
C. Bass
D. Roll
C. Bass
NOTES:
BASS
- 45 degrees angle to the teeth apically.
- Place the brush with filament tips directed into the gingival sulcus
STILLMAN
- 45 degrees angle to the teeth apically.
- Filaments are placed half in sulcus and half on the gingiva.
- Modified Stillman Technique: patients with progressing recession and exposed root
Roll
- Rolling method
CHARTER
- 45 degree angle pointing towards the occlusal surface.
- placing the filaments on the gingival margin.
