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BDS4/5 > Perio formative > Flashcards

Perio formative Flashcards

1
Q

Which of the following options may NOT be needed to decide on a suitable perio treatment plan?

a. Medical history
b. Assessment of plaque and plaque retentive factors
c. Radiographs
d. Probing
e. Assessment of gingival/periodontal inflammation

A

e. Assessment of gingival/periodontal inflammation

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2
Q

What is the aim of initial phase of perio treatment?

a. Improve appearance of gingivae
b. Reduce all pockets <4mm
c. Remove infected cementum
d. Avoid gingival recession
e. Reduce causes of periodontal disease

A

e. Reduce causes of periodontal disease

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3
Q

When obtaining consent for treatment of periodontitis which of the following options is NOT appropriate?

a. Explain side effects
b. Assume most adults can make an informed choice about preference for treatment
c. Provide information about periodontal disease
d. Explain nature of the proposed treatment options
e. Assume that the patient wishes to retain all teeth with disease

A

e. Assume that the patient wishes to retain all teeth with disease

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4
Q

Which of the following medical conditions usually influences treatment planning for periodontitis?

a. Asthma
b. Osteoporosis
c. Coronary heart disease
d. Valvular heart defects (Infective endocarditis)
e. Cardiac conduction defects (But if they have a pace maker, then can’t use ultrasonic scaler?)

A

d. Valvular heart defects (Infective endocarditis)

e. Cardiac conduction defects (But if they have a pace maker, then can’t use ultrasonic scaler?)

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5
Q

Complete the following statement: “In a periodontal maintenance programme following partially successful perio treatment…”

a. …Plaque control should be assessed at each visit
b. …A 6PPC should be recorded at each visit
c. …Mobility should be assessed at each visit
d. …Recession should be assessed at each visit
e. …Supra-gingival scaling should be provided at each visit

A

a. …Plaque control should be assessed at each visit

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6
Q

When is a conventional gingivectomy contra-indicated?

a. When plaque control is good
b. When pockets >7mm
c. Base of the pocket is coronal to the muco-gingival junction?
d. When pockets are intra-bony
e. When pockets are supra-bony

A

d. When pockets are intra-bony

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7
Q

What are the advantages of conventional gingivectomy?

a. Post-op recession is minimised
b. Plaque control is improved
c. Eliminate false pockets
d. All root surfaces are accessible
e. Normally performed by inexperienced clinician

A

c. Eliminate false pockets

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8
Q

When perio flap surgery is compared with a conventional gingivectomy, which of the following statements is INCORRECT?

a. Usually more keratinised gingiva is lost when using gingivectomy than flap surgery
b. Both techniques can reduce inflammation
c. Flap surgery may be indicated in a wider range of cases than gingivectomy
d. Post-op bleeding is more likely to occur with flap surgery than gingivectomy
e. More gingival recession would be expected after a gingivectomy than flap surgery

A

d. Post-op bleeding is more likely to occur with flap surgery than gingivectomy

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9
Q

Correctly complete the following statement: “In apical positioned flap surgery…”

a. …A mattress suture is usually used
b. …A pack may be used to retain the flap in the new position
c. …Post-op aesthetics are usually excellent
d. …Patients are less likely to experience dentine hypersensitivity than with replaced flaps
e. …The palatal gingivae is the gingivae most easily repositioned

A

b. …A pack may be used to retain the flap in the new position

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10
Q

“Replaced flap surgery…”

a. …May reduce pocketing more than apically positioned flap surgery
b. …Prevents recession
c. …Usually results in more gain of clinical attachment than apically repositioned flap surgery
d. …Requires the use of a continuous suture for optimum healing
e. …Is the technique of choice when plaque control is poor

A

c. …Usually results in more gain of clinical attachment than apically repositioned flap surgery

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11
Q

Which of the following is INCORRECT about intra-bony defects?

a. Recession is more likely to occur after treatment of a 1-walled defect than a 3-walled defect
b. A 3-walled defect may be an indication for regenerative surgery
c. Intra-bony lesions are common in localised juvenile periodontitis
d. Bony infill is more likely to occur after treatment of a 1-walled defect than a 3-walled defect
e. Intra-bony lesions may appear on radiographs as vertical bone loss

A

d. Bony infill is more likely to occur after treatment of a 1-walled defect than a 3-walled defect

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12
Q

Complete the statement: “A furcation involvement…”

a. …May be the only clinical sign of a combined perio and endo lesion
b. …Usually measured with a WHO probe
c. …Classified as a grade 3 if a probe can detect 3mm of horizontal attachment loss in the furcation
d. …Of grade 2 is best treated with a conventional gingivectomy
e. …Of an upper molar is usually clearly visible on radiographs

A

a. …May be the only clinical sign of a combined perio and endo lesion
b. …Usually measured with a WHO probe

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13
Q

Complete the statement: “A root resection…”

a. …Can be safely undertaken in the presence of plaque
b. …Is usually the treatment of choice for a molar with confluent roots
c. …Should only be considered if RCT is possible
d. …Is usually the treatment of choice for grade 1 furcation involvement
e. …Is treatment of choice for a 3-walled intra-bony defect

A

c. …Should only be considered if RCT is possible

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14
Q

Which of the following is NOT an aetiological factor for recession?

a. Generalised severe adult periodontitis
b. A Traumatic tooth brushing technique
c. Ageing
d. Plaque-related gingival inflammation
e. Thin gingival tissues

A

c. Ageing

d. Plaque-related

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15
Q

Correctly complete: “Recession of the gingival margin…”

a. …Occurs most commonly when gingival tissues are thick
b. …Always requires treatment
c. …Rarely involves inter dental papilla
d. …Commonly occurs labially when related to the prominent position of teeth in the alveolus
e. …Occurs in the absence of inflammation

A

d. …Commonly occurs labially when related to the prominent position of teeth in the alveolus

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16
Q

Complete the statement: “Recession usually results in…”

a. …Persistent dentine hypersensitivity
b. …An increase in clinical crown height
c. …A decrease in clinical crown height
d. …A compromised prognosis for a tooth
e. …Root caries

A

b. …An increase in clinical crown height

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17
Q

Which of the following treatments has NO place in the initial management of recession?

a. OHI
b. Smoking cessation advice
c. Dietary advice
d. Monitoring recession with dated study casts
e. Scaling

A

c. Dietary advice

d. Monitoring

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18
Q

Correctly complete: “A free gingival graft…”

a. …Is the usual treatment of choice for coverage of exposed roots
b. …Derives blood supply from donor site
c. …May increase zone of attached gingivae
d. …Usually treatment of choice for aesthetic complaints
e. …Rarely facilitates a local improvement in the efficacy of OH

A

c. …May increase zone of attached gingivae

d. …Usually treatment of choice for aesthetic complaints

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19
Q

Correctly complete: “Predictable surgical coverage of exposed roots…”

a. …Usually requires a pedicle graft
b. …Rarely improved with free CT graft
c. …Occurs most frequently when recession defects are wide
d. …Most easily achieved with double papilla flap
e. …Usually requires apically positioned flap

A

a. …Usually requires a pedicle graft
b. …Rarely improved with free CT graft
c. …Occurs most frequently when recession defects are wide
d. …Most easily achieved with double papilla flap

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20
Q

Correctly complete: “Gingivitis during pregnancy…”

a. …Increases loss of perio attachment
b. …Caused by hormones
c. …Best treated by plaque control
d. …Usually less hyperaemic than other types of gingivitis
e. …Rarely noticed by patients

A

c. …Best treated by plaque control

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21
Q

Correctly complete: “A pregnancy epulis…”

a. …Usually develops from the lingual gingivae
b. …May regress without treatment post-partum
c. …Should be surgically removed during the first trimester of pregnancy
d. …Rarely responds to improvements in plaque control
e. …Compromised of highly organised mature fibrotic tissue

A

b. …May regress without treatment post-partum

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22
Q

22) Which of the following has been proven to be correct?
a. Periodontitis causes premature birth
b. Periodontitis causes cardiovascular disease
c. Periodontitis correlates positively with diabetic control
d. Periodontitis correlates inversely with smoking tobacco
e. Periodontitis correlated positively with cardiovascular disease

A

a. Periodontitis causes premature birth
b. Periodontitis causes cardiovascular disease
c. Periodontitis correlates positively with diabetic control
d. Periodontitis correlates inversely with smoking tobacco
e. Periodontitis correlated positively with cardiovascular disease

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23
Q

Which of the following is most likely to increase in tobacco smokers?

a. Deep pockets
b. BOP
c. Bone mineral density
d. Clinical improvement after non-surgical periodontal treatment
e. Clinical improvement after surgical periodontal treatment

A

a. Deep pockets

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24
Q

Which of the following drugs is NOT related to gingival overgrowth?

a. Amlodipine
b. Phenytoin
c. Bendroflumethiazide
d. Cyclosporine
e. Nifedipine

A

c. Bendroflumethiazide

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25
Q

Which best applies to drug-related gingival overgrowth?

a. Unchanged by improving supra-gingival plaque control
b. Unchanged by improving sub-gingival plaque control
c. Normally treated with electro-surgery
d. Only treated with resective surgery
e. Common in organ transplant patients

A

e. Common in organ transplant

26
Q

Select the condition more likely to occur in a diabetic patient with average BGL <7.5mM than in a diabetic patient with average BGL >7.5mM

a. Acute lateral periodontal abscess
b. Severe adult chronic periodontitis
c. Periodontal health
d. Labial gingival recession
e. Acute ulcerative gingivitis

A

c. Periodontal health

NB: This is in a “well-controlled” diabetic patient, not the other way around

27
Q

Which of the following has NOT been associated with increased periodontal breakdown?

a. Idiopathic neutropenia
b. Downs syndrome
c. HIV infection
d. Ehlers-Danlos syndrome
e. Hereditary gingival-fibromatosis

A

e. Hereditary gingival-fibromatosis

28
Q

Which clinical feature is NOT found in both gingivitis and periodontitis?

a. Pockets >3mm
b. BOP
c. Swollen gingivae
d. Crestal bone loss
e. Red gingivae

A

d. Crestal bone loss

29
Q

Correctly complete “SUB-gingival dental bio film usually contains…”

a.  A dozen species of bacteria
b. Predominantly gram +ve bacteria
c. Predominantly gram -ve bacteria
d. Significant levels of LPS
e. Abundant matrix of extracellular polysaccharide matrix

A

c. Predominantly gram -ve bacteria

30
Q

Correctly complete: “As plaque initially develops on a clean tooth surface…”

a. …Pioneer species include P.gingivalis
b. …It has no effect on gingival tissues
c. …Gram +ve bacteria increase in number
d. …Late colonising species depend predominantly on carbohydrates for energy
e. …Bacteria adhere to salivary lipids on the tooth surface

A

c. …Gram +ve bacteria increase in number

31
Q

Which of the following is correct?

a. Non-specific plaque hypothesis best explains pathogenesis of localised juvenile periodontitis
b. Specific plaque hypothesis best explains pathogenesis of severe adult chronic periodontitis
c. Ecological plaque hypothesis best explains why species in plaque change as plaque accumulates
d. Multiple pathogen hypothesis best explains why strictly anaerobic species increase as plaque accumulates
e. Non-specific plaque hypothesis best explains pathogenesis of acute ulcerative gingivitis

A

c. Ecological plaque hypothesis best explains why species in plaque change as plaque accumulates

32
Q

Which bacterial product cannot itself damage host tissue?

a. LPS
b. Collagenase
c. Propionic acid
d. H2S
e. Leukotoxin

A

a. LPS

c. Propionic acid

33
Q

Correctly complete: “In periodontitis the innate immune response to plaque does NOT include…”

a. …Phagocytes
b. …Complement activation
c. …Increased vascular permeability
d. …Presentation of plaque antigens to T-lymphocytes
e. …Neutrophil recruitment

A

d. …Presentation of plaque antigens to T-lymphocytes

34
Q

Correctly complete: “In an initial perio lesion after 24-48 hours of plaque accumulation…”

a. …GCF flow is unchanged
b. …JE is ulcerated
c. …Neutrophils are rarely detected in gingival biopsies
d. …Collagen loss is only seen around blood vessels
e. …Plasma cells are the dominant cell type

A

d. …Collagen loss is only seen around blood vessels

35
Q

Correctly complete: “In established perio lesions, after 2-3 weeks of plaque accumulation…”

a. …JE has migrated apically
b. …Number of blood vessels remains unchanged since initial lesion
c. …No destruction of perio ligament fibres
d. …Macrophages are the dominant cell type
e. …Clinically evident periodontitis

A

c. …No destruction of perio ligament fibres

36
Q

Which best applies to periodontitis?

a. Presence of inflammation is a good predictor or progressive attachment loss
b. Bacteria are commonly found invading periodontal tissues
c. True pockets are good predictors of progressive attachment loss
d. Absence of inflammation is a good predictor of an absence of progressive attachment loss
e. Controlling inflammation has no effect on the species of bacteria found in plaque

A

c. True pockets are good predictors of progressive attachment loss

37
Q

Correctly complete: “In adaptive (specific) immune responses to plaque…”

a. …Secretory IgA is the dominant class of antibody in GCF
b. …Plasma cells in chronically inflamed periodontium produce IL-1
c. …Antibodies do not function as opsonins
d. …Macrophages produce IgG antibodies specific to plaque bacteria
e. …Antibody specific to plaque antigens cannot be produced within the gingivae

A

a. …Secretory IgA is the dominant class of antibody in GCF

38
Q

Which artery supplies blood to the PDL of the lower molars

a. Lingual artery
b. Buccal artery
c. Facial artery
d. Inferior alveolar artery
e. Mental artery

A

d. Inferior alveolar artery

39
Q

Correctly complete: “In apically positioned flap surgery, the vitality of the flap is maintained because…”

a. …Blood supply to the PDL is derived from intra-bony vessels
b. …Blood supply to the gingivae is derived from sub-periosteal vessels
c. …There is a plexus of capillaries beneath the JE in inflammation
d. …Blood supply to the gingivae is derived from supra-periosteal vessels
e. …Flap is reflected beyond muco-gingival junction

A

d. …Blood supply to the gingivae is derived from supra-periosteal vessels

40
Q

Correctly complete: “In the absence of sub-gingival scaling, a maintained reduction in plaque scores from 70% to 20%…”

a. …Rarely has an impact on BOP
b. …Can reduce BOP in some sites
c. …Can increase BOP in some sites
d. …Would usually be an indication for periodontal surgery
e. …Results in more gain of clinical attachment in deep pockets than shallow pockets

A

b. …Can reduce BOP in some sites

41
Q

Correctly complete: “6 months after effective sub-gingival root surface debridement of 7mm pockets and sustained improvements in oral hygiene…”

a. …Number of gingival vessels increases
b. …Permeability of gingival vessels increases
c. …GCF flow increases
d. …CT attachment levels increase
e. …Clinical attachment levels increase

A

e. …Clinical attachment levels increase

42
Q

Why should reassessment probing be delayed for at least 6 weeks after non-surgical periodontal treatment?

a. Probing sooner could overestimate the need for further treatment
b. Epithelial healing usually requires at least 6 weeks
c. Neutrophils are usually still present within gingivae up to 6 weeks after scaling
d. CT healing occurs more rapidly than epithelial healing
e. Probing sooner could overestimate the benefits of the non-surgical treatment

A

a. Probing sooner could overestimate the need for further treatment

43
Q

Correctly complete: “In evidence-based dentistry, the benefit of using bone grafts for perio treatment is…”

a. …Mobility of teeth with horizontal bone loss can usually be reduced
b. …Predictable
c. …Unpredictable
d. …Usually best with a 1-walled intra-bony bony defect
e. …To increase periodontal CT attachment to cementum

A

c. …Unpredictable

44
Q

What is the aim of GTR (Guided tissue regeneration?)

a. Increase healing by JE
b. Reduce volume of blood clot within surgical site
c. Allow diffusion of nutrients through a semi-permeable membrane
d. Allow selective re-population of the root surface by gingival CT
e. Allow selective re-population of the root surface by PDL cells

A

c. Allow diffusion of nutrients through a semi-permeable membrane
e. Allow selective re-population of the root surface by PDL cells

45
Q

During tooth development in humans, generation of the PDL is induced by which of the following?

a. IL-1
b. Enamel matrix proteins of porcine origin
c. TNF-
d. Autogenous enamel matrix proteins
e. Autogenously dentine matrix proteins

A

d. Autogenous enamel matrix proteins

46
Q

Correctly complete: “ANUG usually occurs…”

a. …Less frequently in smokers than non-smokers
b. …Most frequently in first decade of life
c. …Less frequently in patients with immune compromise than in patient with optimum immune function
d. …More frequently in patients under emotional stress than those not under stress
e. …Most frequently around molar teeth

A

d. …More frequently in patients under emotional stress than those not under stress

47
Q

Which of the following is more rarely found in patients with ANUG?

a. Ulceration of gingival papilla
b. Fever
c. Ulceration of free marginal papilla
d. Bleeding after marginal periodontal probing
e. Inadequate plaque control

A

b. Fever

48
Q

In ANUG which of the following is correct?

a. Lesions are predominantly colonised by Streptococci
b. Aa is usually found invading perio tissues
c. Species of spirochete are usually found invading perio tissues
d. Neutrophils are rarely found in lesions
e. Species of fusobacterium are rarely found in lesions

A

c. Species of spirochete are usually found invading perio tissues

49
Q

Which of the following treatments does NOT have a role in the initial management of ANUG?

a. OHI
b. Smoking cessation advice
c. A course of metronidazole
d. Scaling
e. Periodontal surgery

A

e. Periodontal surgery

50
Q

Correctly complete: “In patients with necrotising periodontitis…”

a. …Proximal attachment loss is rare
b. …Deciduous teeth are frequently affected
c. …Immune function is usually optimum
d. …Sequestration of bone is possible
e. …Recession is rarely detected

A

d. …Sequestration of bone is possible

51
Q

Correctly complete: “Primary acute herpetic gingiva-stomatitis…”

a. …Occurs most frequently in elderly patients
b. …Is caused by H.Zoster virus
c. …More commonly known as “cold sore”
d. …Usually causes fibrotic gingival overgrowth
e. …Usually causes ulceration of the oral mucosa

A

e. …Usually causes ulceration of the oral mucosa

52
Q

Which of the following is NOT consistent with diagnosis of acute lateral periodontal abscess?

a. Pus discharging through pocket
b. Pus discharging through a sinus on attached gingivae
c. A negative response to vitality testing
d. A positive response to vitality testing
e. Crestal bone loss on a radiograph

A

c. A negative response to vitality testing

53
Q

Which of the following statements is NOT correct?

a. Furcation involvement may be the only clinical sign of a perio-endo lesion of a primary endo origin.
b. A tooth with a perio-endo lesion of a primary perio origin is rarely the only tooth in the mouth with deep pockets
c. There are often accessory canals communicating between the pulp chamber and furcation roof
d. In a perio-endo lesion of primary perio origin, extraction it would rarely be an appropriate treatment option
e. In a perio-endo lesion of primary endo origin, root canal therapy should be completed before sub-gingival scaling

A

d. In a perio-endo lesion of primary perio origin, extraction it would rarely be an appropriate treatment option
e. In a perio-endo lesion of primary endo origin, root canal therapy should be completed before sub-gingival scaling

54
Q

Which of the following clinical signs is NOT consistent with a Perio Endo lesion on an anterior tooth?

a. Crestal bone loss
b. Apical bone loss
c. Deep pocket BOP
d. Positive pulpal response to vitality test
e. Deep pocket discharging pus

A

d. Positive pulpal response to vitality test

55
Q

Which of the following regarding CHX is correct?

a. Contains 0.5% of CHX gluconate (50 mg/ 10 mL dose)
b. Has no effect on HIV or hepatitis B virus
c. Does not effectively penetrate mature plaque
d. Kills gram negative bacteria but not gram positive
e. Rapidly cleared from oral cavity

A

c. Does not effectively penetrate mature plaque

56
Q

Which of the following is NOT a possible side effect of CHX rinsing?

a. Development of antimicrobial resistance
b. Extrinsic staining
c. Altered taste sensations
d. Mucositis
e. Parotid swelling

A

a. Development of antimicrobial resistance

57
Q

When would CHX rarely be recommended?

a. Following periodontal surgery
b. In treatment of patients with ANUG
c. In treatment of patients with pregnancy related gingivitis
d. Immediately before periodontal surgery
e. In the routine treatment of adult chronic periodontitis

A

c. In treatment of patients with pregnancy related gingivitis
e. In the routine treatment of adult chronic periodontitis

58
Q

Correctly complete: “locally applied antimicrobial preparations which are placed directly into pockets…”

a. …Are an effective alternative to root debridement
b. …When used as an adjunct to root debridement usually reduces pocketing by an additional 2 mm compared with root debridement alone
c. …When used as an adjunct to root debridement, usually reduces pocketing by an additional 0.5 mm or less
d. …Are a cost-effective method of managing chronic adult periodontitis
e. …Are the optimum treatment for patients with early onset (aggressive) periodontitis

A

c. …When used as an adjunct to root debridement, usually reduces pocketing by an additional 0.5 mm or less

59
Q

In periodontal therapy, which of the following about tetracycline is correct?

a. Improve clinical response of patients with early onset periodontitis to nonsurgical therapy when used systematically
b. They only act on bacteria and have no effect on host tissues
c. Not available as the active ingredient in locally applied preparations
d. Do not pass into GCF when given systematically
e. Usually effective against bacteria causing ANUG

A

a. Improve clinical response of patients with early onset periodontitis to nonsurgical therapy when used systematically

60
Q

Correctly complete: “in periodontal therapy, amoxicillin…”

a. …Would rarely be used for prophylaxis before scaling a patient with valvular heart disease
b. …Would not be used with metronidazole as an adjunct to root debridement in early onset periodontitis
c. …Can be used to treat a periodontal abscess if the drug of choice is contra-indicated
d. …Is not appropriate for prophylaxis in a patient with an artificial heart valve before periodontal probing
e. …Is an effective treatment for gingivitis

A

c. …Can be used to treat a periodontal abscess if the drug of choice is contra-indicated

BDS4/5 (3 decks)

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