Perio OT questions Flashcards
T/F: Patients with implants are instructed to not clean their implants in any way to avoid damaging them.
False
T/F: The majority of patients keep all of their scheduled maintenance appointments.
False
T/F: Patients who have SRP or perio surgery that improve but do not go to their maintenance appointments are 5.6X more likely to experience tooth loss.
True
T/F: It takes an average of 4 weeks for periodontal tissues to heal after treatment.
True
T/F: It is recommended to evaluate motivation of patient before surgery begins.
True
T/F: Tissues associated with implants are more susceptible to breakdown than tissues associated with natural teeth.
True
T/F: Removing supragingival plaque will change the microflora in perio pockets.
False
T/F: Removing supragingival plaque will change the microflora in perio pockets.
True
T/F: Removing supragingival plaque will change the microflora in perio pockets.
True
T/F: Removing supragingival plaque will change the microflora in perio pockets.
False
Periodontal infections have been linked to all of the following organ systems except for:
a. Cardiovascular b. Endocrine c. Reproductive d. Respiratory e. Periodontal infections have been linked to all of these systems
e. Periodontal infections have been linked to all of these systems
Periodontal disease is though to increase the risk for cardiovascular disease through which mechanism:
a. Increasing the viscosity of the blood by increased fibrinogen and overall white blood cell count
b. Perior dontal pathogens directly colonizing the athermatous plaque in atherosclerosis
c. Periodontal pathogensc aising alterations in coagulation, the vessel walls and platelet function
d. Causing systemic inflammation which then elevates acute-phase proteins such as C-reactive protein (CRP)
e. All of the above
e. All of the above
Periodontal disease has been associated with adverse cardiovascular conditions such as astheroscleorsis and myocardial infarction. Treating the perio condiction is known to decrease the risk of heart disease so all patients should have scaling and root planning
a. First is true, second is true
b. First is true, second is false
c. First is false, second is true
d. First is false, second is false
b. First is true, second is false
Although controversial, periodontal treatment can have a beneficial effect on glycemic control. This appears to be more apparent in patients with _____perio disease and relatively _____ glycemic control
a. Severe, poor
b. Mild, poor
c. Severe, good
d. Mild , good
a. Severe, poor
T/F: Periodontal treatment has been clearly shown to significantly improve both periodontal health and decrease the rate of adverse outcomes in pregnant females.
False
Which of the following are true regarding periodontal surgical techniques?
a. Increased accessibility to the root surface, making it possible to remove all irritants
b. Reduce or eliminate pocket depth, making it possible for the patients to maintain the root surfaces free of plaque
c. Reshape soft and hard tissue to attain a harmonious topography
d. All of the above
d. All of the above
Suprabony pocketthe base of the pocket is coronal to the level of the underlying bone, bone is horizontal
a. True
b. False
a. True
T/F: Infrabony pockets the base of the pocket is apical to the level of the adjacent bone, bone loss is horizontal.
False
T/F: Surgical pocket therapy can result in a healthy sulcus with or without gain of attachment.
True
T/F: The most important variable for evaluating whether a pocket is progressive is the level of attachment.
True
The most important variable for evaluating whether a pocket (or deep sulcus) is progressive is the level of attachment-STRAIGHT FROM THE BOOK ☹
T/F: New attachment techniques offer the ideal result because they eliminate/reduce pocket depth by reuniting the gingiva to the tooth at a position coronal to the bottom of the persisting pocket.
True
T/F: A gingivectomy procedure eliminates suprabony pockets and provides access to bone.
False
First part is true, but the second part is false (See below from book)
The gingivectomy technique may be performed for the following indications -Elimination of suprabony pockets, regardless of their depth, if the pocket wall is fibrous and firm.
Contraindications to gingivectomy include the following: -The need for bone surgery or examination of the bone shape and morphology.
T/F: The 30 day reevaluation exam/charting consists of reprobing and reexamining all pertinent findings that previously indicated the need for surgical procedure. Persistence of these findings confirms the indication for surgery.
True
T/F: Periodontal surgery can produce profuse bleeding, especially during initial incisions and flap reflection. After flap reflection and removal of granulation tissue, bleeding disappears or is considerably reduced.
True
Periodontal surgery can produce profuse bleeding, especially during initial incisions and flap reflection. After flap reflection and removal of granulation tissue, bleeding disappears or is considerably reduced.
-STRAIGHT FROM THE BOOK
Which of the following may occur following routine periodontal surgical procedures
a. Persistant bleeding
b. Sensitivity to percussion
c. Swelling
d. Transient increase in tooth mobility
e. Feeling of weakness
f. Bacteremia
g. Tooth hypersensitivity
All of the above may occur
When should motivation and compliance be assessed?
Before initial therapy, after surgical therapy, and during recall appointment.
–Older test says a. before initial therapy–
Recall appointments are most effective every _________.
3 months
What Gracey curette would be used on the distal of posterior teeth?
13/14 or 17/18
Crazy teenagers on the distals of posterior teeth
What Gracey curette would be used on the mesial of posterior teeth?
11/12 and 15/16
T/F: Once treated for perio disease, you are still susceptible for the rest of your life.
True
T/F: Fluoride is inactivated by CHX.
True
A 55 year old with blue-red gingiva and horizontal radiographic, 3mm bone loss from the CEJ has what ADA class of perio disease?
Class 2
T/F: Bacteremia can be caused by chewing.
True
Which of the following cause gingival hyperplasia?
a. Ca channel blockers
b. Cyclosporine A
c. Na channel blockers
d. Nifedipine
e. Ca channel blockers and Na channel blockers
f. Cyclosporine A and Ca channel blockers
g. All of the above
All of the above
Bite guards are the primary treatment used for secondary occlusal trauma. They are usually used on the maxilla.
a. True/true
b. True/false
c. False/true
d. False/false
c. False/true
Periodontal dx may reoccur because of:
a. Inadequate removal of local factors
b. Microorganism still in soft tissues
c. A and B
c. A and B
What is the Glickman’s classification for through and through opening with recession?
Class IV
What does nosocomial mean?
Hospital-acquired
Bite guards are used as tx for:
Parafunctional habits
What is the association between periodontal disease and acute respiratory infection?
a. Subgingival plaque harbors PRPs
b. Nosocomial infection are in both
a. Subgingival plaque harbors PRPs
T/F: Removing the risk factors of periodontal disease will cause the disease to disappear.
False
Gingival index is used to measure:
a. Gingival inflammation
b. Gingival bleeding
c. Plaque accumulation
d. Gingival recession
a. Gingival inflammation
Violation of biological width will cause:
a. Self-limiting bone loss
b. Bone loss
b. Bone loss
Biological width does not include which of the following:
a. Alveolar Bone
b. Junctional epithelium
c. Connective tissue
d. none
a. Alveolar bone
Association of periodontal disease and stroke
a. 3x increase risk of stroke in pts w/ perio
b. 50% of stroke pts have dental infections (→ should be 25%!)
a. 3x increase risk of stroke in patients w/ perio
Ischemic cerebral infarction (stroke) is often preceded by systemic bacterial or viral infection. 25% of all stroke patients had significant dental infections. There is a 3-fold increased risk of stroke in subjects with periodontitis
T/F: Improvement of periodontal bone level is not proven as a result of molar uprighting.
True
Attached gingiva moves about __% extruded distance.
80%
Benefits of ortho for the perio patient include all of the following except:
Vertical tooth movements can improve certain bony defects (may eliminate surg need)
Forced eruption of a fractured tooth maintains resistance and retention form for restorative
Restore papilla by closing open embrasures Improve tooth position b/4 implants placed
All of the above are true
All of the above are true
An isolated “window” in the bone covered only by periosteum and gingiva is called a:
Fenestration
Some bone is left, covered only by periosteum and gingiva.
Fusion of the cementum and alveolar bone with obliteration of the periodontal ligament is termed:
Ankylosis
Picture with edematous gums, very red at margins: what is it and what to treat it with?
a. ANUG – self-limiting
b. ANUG – treat with antibiotics
c. LAP
b. ANUG - treat with antibiotics
Gingival margins of restorations are associated with all of the following except:
a. Increased flow of GCF
b. recession
c. optimal periodontal health
d. enhanced gingival inflammation
e. increased plaque accumulation
c. optimal periodontal health
What does “B” indicate in the picture?
a. calculus
b. cementum
c. biofilm/plaque
d. none of the above
c. biofilm/plaque
The main source for mineralization of subgingival plaque is:
a. GCF
b. saliva (supragingival plaque)
c. leukocytes
d. erythrocytes
a. GCF
Plaque initiates inflammation → causes pocket formation → provides sheltered area for accumulation → causes increased GCF providing minerals that turn subG plaque to calculus → enhance plaque
Compared to a healthy sulcus, the plaque flora of a periodontally involved pocket has:
a. less spirochetes
b. less gram positive rods
c. more spirochetes
d. more spirochetes and more gram negative rods
e. more gram negative rods
f. none of the above
d. more spirochete and more gram negative rods
Healthy gingival sulcus contains:
Gram neg
anaerobes
Motile rods
gram + bacteria, mainly cocci
gram + bacteria, mainly cocci
A smoker’s decreased resistance to periodontal disease may be related to the following except:
a. impaired phagocytic function of neutrophils
b. reduced serum level of IgG
c. enhanced gingival blood flow
d. depressed number of T lymphocytes
c. enhanced gingival blood flow
- Smoking causes more attachment loss, bone loss, furca involvement, deeper pockets, supragingival calculus. -Smoking causes decreased PMN chemotaxis, decreased PMN phagocytosis, decreased ability of PMNs to kill bacteria after phagocytosis by oxidative burst -smokers have LESS gingival inflammation and LESS BOP. This is known as disease masking.
T/F: BOP can frequently be observed in patients w/ stage 1 lesions (initial lesion).
False
T/F: Leukemia can be associated with gingival enlargement.
True
Pocket formation starts at what stage of lesion?
a. III, established lesion
b. II, early lesion
c. IV, advanced lesion
d. I, initial lesion
c. IV, advanced lesion
Know prominent the lesion stages of gingival inflammation:
1 = initial lesion, major cell is PMN, 24 days of plaque accumulation, subclinical
2 = early lesion, major cell is lymphocyte, 47 days of plaque accum, BOP
3 = established lesion, major is plasma cell, 1421 days of plaque accum, rete peg, CHRONIC
4 = advanced lesion, 21+ days, POCKET FORMATION
T/F: Diffuse gingivitis affects the gingival margin, the attached gingiva, & the interdental papilla.
True
The predominant immune cells of a stage III lesion are the:
a. Lymphocytes
b. Plasma cells
c. PMNs
d. Dentritic cells
b. Plasma cells
The patient has: [picture with max&mand diastema and very red gingiva]
a. Marginal gingivitis
b. Papillary gingivitis
c. Diffuse gingivitis
d. Mild gingivitis
c. Diffuse gingivitis
The base of an infrabony pocket is
a. Coronal to the bone crest
b. Apical to the bone crest
c. At the level of the bone crest
b. Apical to the bone crest
Types of Pockets:
a. Gingival: pseudopocket from soft tissue enlargement
b. Periodontal: true pocket from tissue destruction
i. Suprabony – base of the pocket is coronal to the bone crest → horizontal bone loss
ii. Infrabony/Intrabony – base of pocket is apical to the bone crest and the pocket lies between the bone and tooth. → vertical bone loss
T/F: Inflammation follows the cementum.
False, it follows the blood vessels.
Transeptal fibers of gingiva are the only ones left in diseased area.
T/F: Pus associated with a pocket is related to the severity of periodontal disease.
False, it is not related to perio disease severity. Only reflects the nature of inflammatory changes in the pocket wall.
T/F (both): Studies have shown clinical features such as contour, color, consistency, and BOP are indications of potential attachment loss. Subsequent BOP are indications of potentional inflammation and attachment loss.
False/True
Pt comes in after Phase I Therapy and is treatment planned for Surgery Phase. Pt has 45% MOL score. What do you do?
Give more OH instruction, do SRP/cleaning again, re-evaluate
T/F: Smokers are at increased risk for attachment loss.
True
Deeper and more residual pockets than non-smokers.
No difference in plaque or BOP scores.
During which treatment phase can extractions of hopeless teeth be performed?
Phase I therapy
How do you measure the depth of the periodontal pocket? (from the ____ to the ____)
From the FGM to the JE.
According to the Miller scale, 1mm of horizontal movement and can be depressed is what mobility class?
Class III mobility
T/F: In Miller Classification of Recession, Class II and III have recession extending to or beyond the MGJ.
True
Miller Class IV - Recession to or beyond the MGJ and severe loss of bone and soft tissue and or sever tooth malposition
T/F: You can use fingers to evaluate tooth mobility.
False
Pathologic migration of teeth is commonly found in _________ chronic periodontitis.
a. Mild
b. moderate
c. Severe
d. None of the above
c. Severe
T/F: A crossectional study can be used to determine incidence.
True
What is not a symptom of a patient with GAP?
a. Weight loss
b. Depression
c. …can’t remember the wrong choice!!!
d. malaise
c. Can’t remember, different than the other 3
Localized Aggressive Periodontitis is usually characterized by:
Elevated levels of A.a.
T/F: Localized aggressive periodontal disease has limited plaque or calculus.
True
T/F: A.a. is 90% of the bacteria in localized aggressive periodontitis.
True
55 y/o patient comes in with necrosis, cratered gingiva, fever, lymphadenopathy, and disease is associated with Candidiasis…
a. NUP
b. NUG
c. ANUP
d. ANUG
c. ANUP
Which of the following is true?
a. Plaque accumulation initiates gingivitis, which will progress to periodontitis
b. Plaque accumulation initiates periodontitis directly
c. Plaque accumulation initiates gingivitis, which may progress to periodontitis
d. Plaque accumulation…
c. Plaque accumulation initiates gingivitis, which may progress to periodontitis
The one clinical difference b/w gingivitis and periodontitis is:
a. The presence of clinically detectable plaque and calculus
b. The presence of clinically detectable attachment loss
c. The presence of clinically detectable bacteria
b. The presence of clinically detectable attachment loss
The main etiology of gingival abscess is:
Food impaction
A patient with advanced adult periodontitis is classified as:
a. I
b. II
c. III
d. IV
e. V
d. IV
What is a cementum bound product from bacteria can be removed from root surface during root planning?
Endotoxin
Which of the instruments can NOT be used to clean implants?
a. Floss and Guaze
b. Titanium and plastic tip ultrasonics
c. Plastic curette
d. Air-power abrasion
e. All the above can be used to clean implants
e. All of the above can be used to clean implants
air polisher=best way to clean
Which of these is not in the sulcus?
a. Bacterial cells
b. PMNs
c. Osteoclasts
d. Plaque stuff
e. All the above are in the sulcus
c. Osteoclasts
You have ortho, how many months do you need to wait after ortho to do other stuff b/c the PDL takes time to attach…
a. 3 months
b. 4 months
c. 5 months
d. 6 months
d. 6 months
need surgery on an anterior tooth with a deep osseous defect and vertical bone loss, what is the BEST method to use?
a. Modified Widman
b. APF with osseous resection
c. Gingivectomy
d. None of the Above
d. None of the above
How many mm apical to bone can a fracture extend but still be restored?
a. 1 mm
b. 3 mm
c. 4 mm
d. 5 mm
b. 3 mm
What is the most common form of periodonitis and what is its primary etiologic factor?
Most common -> chronic periodontitis
Primary etiologic factor -> plaque
