Post Test Flashcards
Gingival fibers consist of:
A. Type I collagen
B. Type II collagen
C. Type III collagen
D. Type IV collagen
A. Type I collagen
NOTES:
Type 1: bONE
Type 2: car2lage
Type 3: Re3cular,iMMune
Type 4: Floor (basement membrane)
Tooth #8 has been restored with all porcelain crown with a plaque retentive subgingival margin producing inflammation. According to periodontal charting provided, what is the mid buccal PPD of this tooth?
PPD
Distobuccal: 3
Mid-buccal: ?
Mesiobuccal: 3
GR
Distobuccal: 0
Mid-buccal: 1
Mesiobuccal: -1
CAL
Distobuccal: 3
Mid-buccal: 4
Mesiobuccal: 2
A. 1mm
B. 2mm
C. 3mm
D. 4mm
C. 3mm
NOTES:
PPD + GR= CAL
PPD- Periodontal Pocket depth
GR- Gingival Recession
CAL- Clinical Attachment Loss
Which of the following is the least important diagnostic aid in recognizing the early stage of gingivitis?
A. Bleeding on probing
B. Gingival color
C. Pocket depth
D. Stippling of gingival tissue
D. Stippling of gingival tissue (NORMAL)
NOTES:
Absence of stippling is due to:
- normal variation
- inflammation
- edema of underlying connective tissue
In a healthy sulcus, which of the bacteria below are most abundant?
A. Actinobacillus Actinomycetemcomitans and Tanneralla Forsythia
B. Streptococcus and actinomyces species
C. Treponema and capnocytophagia species
D. Prevotella Intermidia and Porphyromonas Gingivalis
B. Streptococcus and actinomyces species
Gingivitis is most often caused by
A. A hormonal imbalance
B. Inadequate oral hygiene
C. Occlusal trauma
D. A vitamin deficiency
E. Aging
B. Inadequate oral hygiene
Which of the following needs to be evident in order to make a diagnosis of periodontitis?
A. Bleeding
B. Pocket depth of 5mm or more
C. Radiographic evidence of bone loss
D. A change in tissue color and tone
C. Radiographic evidence of bone loss
Which of the following is not correctly matched with regards to periodontal treatment plan?
A. Preliminary phase: Plaque control
B. Phase I: Mouth preparation
C. Phase II: Periodontal surgery
D. Phase III: Restorative
E. Phase IV: Maintenance
A. Preliminary phase: Plaque control
NOTES:
TREATMENT PLANNING
Phase 0: Preliminary: Extract, Emergency
Phase I: Non-Surgical Therapy
Phase II Surgical Therapy
Phase III: Restorative
Phase IV: Maintenance
In combined endodontic-periodontic lesion, it is generally wise to treat
A. The periodontic component first
B. The endodontic component first
C. Both components at the same time
D. Them any way you want
B. The endodontic component first
The attachment apparatus is composed of the following except one. Which one is the exception?
A. Periodontal ligament
B. Cementum
C. Alveolar bone
D. Gingiva
D. Gingiva
NOTES:
ATTATCHMENT APPARATUS
- PDL
- Cementum
- Alveolar bone
GINGIVAL APPARATUS
- Gingival fibers
- Epithelial fibers
Which of the following cell types contains a biologically active amine which is released in the inflammatory process and is active in causing vascular permeability?
A. Mast cell
B. Plasma cell
C. T-lymphocytes
D. B-lymphocytes
E. NOTA
A. Mast cell
Dental plaque is composed primarily of
A. Microorganisms
B. Water
C. Minerals
D. Tissue cells
A. Microorganisms
The source of mineralization for supragingival calculus is
A. Desquamated epithelial cells
B. Gingival crevicular fluid
C. Phosphatases formed by bacterial plaque
D. Saliva
B. 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.
When evaluating an osseous defect, the only way to determine the number of walls left surrounding the tooth is by
A. Periodontal probing
B. Radiographs
C. Exploratory surgery
D. Testing for mobility
C. Exploratory surgery
Which type of pocket is formed by gingival enlargements without destruction of the underlying periodontal tissues?
A. Gingival pocket
B. Periodontal pocket
C. Suprabony pocket
D. Infrabony pocket
A. Gingival pocket
NOTES:
PERIODONTAL POCKET/ TRUE POCKET
- There is loss of attachment.
PSEUDOPOCKET/ GINGIVAL POCKET
- Gingiva migrates coronally but there is no clinical attachment loss.
SUPRABONY POCKET/ SUPRACRESTAL/ SUPRA ALVEOLAR
- The base of the pocket is more coronal than crest of alveolar bone (horizontal pattern of bone loss)
INFRABONY POCKET/SUBCRESTAL/ INTRA ALVEOLAR (Vertical bone loss)
- The base of pocket is more apical than base of alveolar bone.
Furcation involvements have been classified a grade I, II III, and IV according to then amount of tissue destruction. Grade II is:
A. Incipient bone loss
B. Partial bone loss (cul-de-sac)
C. Total bone loss with through and through opening of the furcation
D. Similar to the above, but with gingival recession exposing the furcation view
B. Partial bone loss (cul-de-sac)
NOTES:
Grade I
– Incipient bone loss.
– Furcation probe can feel the depression of the furcation opening.
Grade II (Cul-de-sac)
– Partial bone loss.
– Probe tip enters under the roof of furcation.
Grade III
– Total bone loss with through and through opening of the furcation. The furcation entrance is not visible clinically.
Grade IV
– Grade III furcation where the furcation entrance is visible clinically.
Toothbrush trauma (abrasion) usually occurs on
A. Central laterals
B. Canine and premolars
C. Second and third molars
D. First and second molars
B. Canine and premolars
Antibiotics which may be applied directly into periodontal pockets include the following, except
A. Minocycline
B. Doxycycline
C. Amoxicillin
D. Arrestin
E. Artidox
C. Amoxicillin
Which Gracey curette is used for root debridement and planning distal surface of 16
A. 1/2
B. 5/6
C. 15/16
D. 13/14
E. 9/10
D. 13/14
NOTES:
GRACEY CURRETTES
1/2, 3/4= ANTERIORS (M,D,B,L)
5/6 = ANTERIORS & PREMOLARS (M,D,B,L)
7/8, 9/10= POSTERIOR (B,L)
11/12, 15,16= POSTERIOR (M)
13/14, 17,18= POSTERIOR (D)
The earliest sign of gingival inflammation is
A. Loose gingival adaptation
B. Erythema
C. Loss of stippling
D. Bleeding on probing
D. Bleeding on probing
Your examination reveals a probing depth of 7mm on the midbuccal aspect of tooth 14. The gingival margin is 2mm apical to the CEJ. How much attachment loss has been there on the midbuccal of this tooth?
A. 7mm
B. 9mm
C. 5mm
D. 6mm
B. 9mm
Localized aggressive periodontitis is confined in
A. Molar area
B. First molar and incisor
C. Premolar and Molar
D. Anterior and 1st molar
B. First molar and incisor
A periodontal pocket that is 6mm deep and has the junctional epithelium located coronal to the cemento-enamel junction is a(n)
A. Pseudopocket
B. Infrabony pocket
C. Bifurcation involvement
D. True periodontal pocket
E. None of the above
A. Pseudopocket
NOTES:
PERIODONTAL POCKET/ TRUE POCKET
- There is loss of attachment.
PSEUDOPOCKET/ GINGIVAL POCKET
- Gingiva migrates coronally but there is no clinical attachment loss.
SUPRABONY POCKET/ SUPRACRESTAL/ SUPRA ALVEOLAR
- The base of the pocket is more coronal than crest of alveolar bone (horizontal pattern of bone loss)
INFRABONY POCKET/SUBCRESTAL/ INTRA ALVEOLAR (Vertical bone loss)
- The base of pocket is more apical than base of alveolar bone.
Biofilm found on the tooth surface is termed as:
A. Dental caries
B. Saliva
C. Gingival Crevicular fluid
D. Dental plaque
D. Dental plaque
Which class of bony defect responds the best to regenerative therapy?
A. Trough
B. Hemiseptal
C. Shallow crater
D. None of the above
A. Trough
NOTES:
Higher number of walls, Higher success rate after procedure.
One Wall – “hemiseptal”
Two Wall – “Osseous Crater”
Three Wall – Trough
Four Wall – Circumferential (Exception because example is: EXTRACTION SITE)
An 18 year-old woman has good oral hygiene with only minute traces of supragingival calculus. Gingival tissue exhibit no inflammatory edema, stippling is evident, and there is no gross color change. Probing reveals 5-8mm pockets around maxillary and mandibular incisors and first molars. No appreciable bone loss is evident elsewhere in the mouth.
A. Gingivitis
B. Periodontitis
C. Desquamative gingivitis
D. Juvenile periodontitis
E. Generalized idiopathic bone resorption
D. Juvenile periodontitis
The normal alveolar crest of the bite wing radiograph is usually
A. At the cementoenamel junction
B. 1-2mm apical to the cemento enamel junction
C. 1-2mm coronal to the cementoenamel junction
D. 1-2mm below the apex of the tooth
B. 1-2mm apical to the cemento enamel junction
Patient with which of the following should not be treated with ultrasonic instruments?
A. Controlled diabetes
B. Edematous tissue
C. Deep periodontal pockets
D. Infectious disease
D. Infectious disease
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 the 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
Which of the following are part of preliminary phase therapy?
I. Treatment of emergencies
II. Extraction of hopeless teeth
III. Plaque control
IV. Removal of calculus
A. I, II, and III
B. II, III, and IV
C. I and II only
D. II and IV only
C. I and II only
The predominant inflammatory cells in the periodontal pocket are
A. Lymphocytes
B. Plasma cells
C. Neutrophils
D. Macrophages
C. Neutrophils
Which type of periodontal disease most often requires antibiotic therapy?
A. Gingivitis
B. Localized aggressive periodontitis
C. Localized chronic periodontitis
D. Generalized chronic periodontitis
B. Localized aggressive periodontitis
NOTES:
Aggressive Periodontitis- AA
- A. Actinomycetemcomitans
- Antibiotics
What is the primary treatment objective of guided tissue regeneration?
A. Formation of long junctional epithelium
B. Promoting growth of epithelial cells
C. Coronal movement of the PDL
D. Reducing inflammation
A. Formation of long junctional epithelium
Patients who have undergone radiation therapy to the head and neck are more susceptible to caries and periodontal disease; however, xerostomia is not a problem in these patients.
A. Both parts of the statement are TRUE.
B. Both parts of the statement are FALSE.
C. The first part of the statement is TRUE; the second part is FALSE.
D. The first part of the statement is FALSE; the second part is TRUE.
E. The parts of the statement are unrelated.
C. The first part of the statement is TRUE; the second part is FALSE.
What is the most important factor in determining prognosis of a tooth affected by periodontal disease?
A. Bleeding on probing
B. Clinical attachment loss
C. Probing pocket depth
D. Alveolar bone loss
B. Clinical attachment loss
What are the characteristic of the primary colonizer 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
The primary difference between gingivitis and periodontitis is
A. Bone infection
B. Depth of pockets
C. Lack of stippling of the gingival
D. Apical migration of junctional epithelium beyond the CEJ
D. Apical migration of junctional epithelium beyond the CEJ
From which of the following is the periodontal ligament derived?
A. Dental sac
B. Dental papilla
C. Enamel organ
D. Hertwig’s epithelial root sheath
A. Dental sac
NOTES:
Enamel organ: Enamel, HERS
Dental sac/ follicle: Cementum, PDL, Alveolar bone (Attachment apparatus)
Dental Papilla: Dentin, Pulp
All corners of a periodontal flap should be
A. Sharp
B. Rounded
C. It doesn’t matter whether the corners of a periodontal flap are sharp or rounded
D. None of the above
B. Rounded
Calculus is detrimental to the gingival tissue 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
Which of the following factors is most important in determining the amount of pocket shrinkage after scaling and root planing?
A. Depth of the pocket
B. Type of instrument used
C. Underlying bony topography
D. Systemic health of the patient
E. Degree of edema in the tissue
E. Degree of edema in the tissue
Hemisection is most likely to be performed on
A. Mandibular first and second premolars.
B. Maxillary first and second molars
C. Maxillary canines
D. Mandibular molars with buccal and lingual class II and III furcation involvements.
D. Mandibular molars with buccal and lingual class II and III furcation involvements.
Mediators produced as part of the host response that contribute to tissue destruction include all of the following except one. Which one is the exception?
A. Free radicals
B. Proteinases
C. Prostaglandin
D. Cytokines
A. Free radicals
NOTES:
Matrix Metalloproteinase (MMPs)
- It is considered as the most important proteinase involved in the destruction of periodontal tissues.
Prostaglandins
- are produced from arachidonic acid of cell membranes in response to cyclo-oxygenases (COX 1 and COX 2).
- Trigger osteoclast (bone resorption)
Cytokines
- Important signaling molecules released from cells.
Interleukin I – important in bone resorption.
Interleukin 8 – important in attracting inflammatory cells (Chemotactic), it releases histamine
Tumor Necrosis Factor – is important in activating macrophages
Water irrigation device (oral irrigators) have been shown to
A. Eliminate plaque
B. Clean non-adherent bacteria and debris from the oral cavity more effectively than toothbrushes and mouth rinses
C. Disinfect pocket for up to 12 hours
D. Prevents calculus formation
B. Clean non-adherent bacteria and debris from the oral cavity more effectively than toothbrushes and mouth rinses
Which of the following presents the most difficulty in performing a thorough scaling root planing?
A. Mesial surfaces of maxillary premolars
B. Proximal surface of mandibular incisors
C. Trifurcation of maxillary molars
D. Distal surface of mandibular molars
C. Trifurcation of maxillary molars
The main objective of root planing is
A. To remove chronically inflamed tissues
B. To change the bacterial microflora
C. To remove etiologic agents from the root surface
D. To eliminate pockets
C. To remove etiologic agents from the root surface
Which of the following is the instrument of choice for removing deep subgingival calculus, for root planing altered cementum, and for removing the soft tissue lining the periodontal pocket?
A. Curette
B. Sickle scaler
C. Hoe
D. File
A. Curette
NOTES:
Sickle Scaler
- Used to remove supragingival deposits and deposits in shallow pockets
Chisel
- Remove gross deposits on the surfaces of anterior and premolars
Hoe
- Supragingival only, can cause scratches on root surfaces
- if used subgingivally - for planning and smoothening
- are used for scaling of ledges or rings of calculus
Curettes
- smoothening of root surfaces
- removal of subgingival deposit
Distal wedge surgery does NOT involved of which of the following technique?
A. Full thickness flap
B. Partial thickness flap
C. V-shaped incision in mandible
D. Parallel incision in maxilla
B. Partial thickness flap❌
A gingivectomy may be indicated for which of the following?
I. Phenytoin-induced enlargement
II. Hereditary gingival hyperplasia
III. Fibrotic gingival reaction to local irritant
IV. Edematous gingival reaction to local irritant
The correct answer is:
A. I, II
B. I, II, III
C. II, IV
D. III, IV
E. I, II, III, IV
B. I, II, III
Trauma from occlusion may cause alterations in which of the following periodontal tissue?
A. Epithelial attachment
B. Periodontal ligament
C. Alveolar bone
D. Cementum
The correct answer is:
A. I, II
B. I, II, IV
C. II, III
D. II, III, IV
E. III, IV
A. I, II
