PERIO LECTURE NOTES Flashcards
(103 cards)
1
Q
ATTACHEMNT loss precedes bone loss by
A
6-8 MONTHS
2
Q
true or false
CAL is measured clinically occurs before radiographic evidence of bone loss is observed
A
true
3
Q
study of Sri Lakan tea laborers showed what
A
the study showed that wihtout any oral hygiene and no dental care, there is 0.2 mm of bone per year lost on the facial and about 0.3 mm of bone per year lost on the proximal surface when periodontal disease goes untreated
4
Q
MECHANISMS OF BONE DESTRUCTION
A
factors the cause bone resorption are derived form bacterail palque and the host. biofilm induce the differentiation of bone progentitos cell into osteoclast. the host produces PROSTAGLANDINS
5
Q
interleukin 1
interleukin -beta
interleukin 6
tumor necrosis factor alpha
A
they contribute to induce bone resorption
6
Q
. Buttressing bone formation is a;
A. congenital abnormality
B. occurs endosteally
C. occurs periosteally
D. due to trauma from occlusion
A
D. due to trauma from occlusion
7
Q
.In response to traumatic occlusal forces ,alveolar bone has
A. Osteoblasts in areas of tension and osteoclasts in areas of pressure
B. Osteoclasts in areas of tension and osteoblasts in areas of pressure
C. Osteoid in areas of tension and osteoblasts in areas of pressure
D. Afunctional atrophy
A
Osteoblasts in areas of tension and osteoclasts in areas of pressure
8
Q
Intrabony defects are;
A. one walled defects
B. two walled defects
C. three walled defects
D. combination of above
A
C. three walled defects
9
Q
list systemic disorders that can lead to bone destruction and hence bone loss?
A
osteoporosis
hyperparathyroidism
leukemia
10
Q
it is the most common pattern of bon loss in periodntal disease
A
horizontal bone loss.
often linked with suprabony pcokets
11
Q
vertical or angular bone defect
A
Occur in an angular or oblique direction leaving a hollowed-out trough in the bone alongside the root.
Base of the defect is located apical to the surrounding bone.
Usually associated with an infrabony pocket
Surgical exposure is the only sure way to determine the presence and configuration of vertical osseous defects
12
Q
most common osseous defect
A
interdental osseous crater; 2 wall defect
13
Q
words sued to describe osseous topogrpahy
A
fenestrations
dehescene
14
Q
dehiscence is often found onstly on
A
mandibular canines
15
Q
fenestrations is found mostly on
A
maxillary first molars
16
Q
Disuse atrophy
A
Nonfunction and hypo function of teeth (hypo occlusion).
Microscopic appearance = PDL fibers are arraigned in a loose functional arrangement. No principal fibers are demonstrable. Only loosely organized connective tissue present.
17
Q
Hyper function
A
functional adaptation in which additional structural elements are formed on cementum and bone to withstand added forces. See a thickened Lamina dura, buttressing bone formation, osteosclerosis and cementum spurs. Periodontal ligament fiber bundles become thickened and functionally orientated.
18
Q
PERIODONTAL OCCLUSAL TRAUMA
A
degenerative lesion (pathology) that develops when occlusal or other forces exceed the adaptive capacity of the supporting periodontal tissues.
Circulatory changes produced in supporting tissues Breakdown of periodontal ligament fibers Bone Resorption Widening of periodontal ligament space Mobility of teeth
19
Q
what is tooth mobility
A
a measure of horizontal or vertical displacement created by the examiners force.
20
Q
class I mobility
A
movement less than 1 mm
21
Q
class II
A
movement with 1-2mm
22
Q
class II
A
movemnt greater than 2mm and/or depressibility if tooth. (moves in axial direction)
23
Q
- Which of the following is the antibiotic of choice to treat a periodontal abscess?
A. Metronidazole- for aggressive periodontitis
B. Acyclovir- Used for Acute herpetic gingivostomatitis 3 days of symptoms
C. Tetracycline
D. Doxycycline- for Moderate/chronic periodontitis
E. Augmentin (from slides - says first drug of choice
A
Answer: Augmentin (from slides - says first drug of choice)
24
Q
- Your patient has a history of bulimia and GERD. WHich of the following types of “wasting
teeth “presentations is most likely to be observed clinically with your patient?
A. Attrition- occlusal wear due to functional contact with opposing teeth. Habits
B. Abfraction- abnormal occlusal loading due to bruxism causing tooth flexure and
microfracturing in the CERVICAL AREA
C. Abrasion
D. Erosion occurs in acidic environment
E. None of the above
A
Answer:Erosion occurs in acidic environment
Intrinsic factors for erosion include GERD, bulimia, chronic alcoholism, and pregnancy - SA
25
n order to ensure the patient has profound anesthesia to effectively scale, root plane and
debride #3, which of the following nerves will require local anesthesia
Answer:PSA, MSA, GP
26
```
4- The angle used to insert a Gracey curette into a periodontal pocket for scaling is usually
A. 150-180 degrees
B. 45-90 degrees
C. 0-40 degrees
D. 95-120 degrees
E. None of the above
```
Answer: 0- 40 degrees (CUZ INSERTION)
Curettes are inserted into the periodontal pocket toe first. The curette is inserted at a 0 degree
angle and then the working angle is established.-SA
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5. Which of the following is caused by an autoimmune destruction of desmosomes leading to
skin and mucosal ulcers that persist for weeks or months?
A. Pemphigus
B. Pemphigoid- autoimmune to the structural components of the basement membrane
C. Aphthous ulcersD. Erythema multiforme-drug induced, hemorrhagic crusting at vermillion border
E. Lupus erythematosus- butterfly malar rash, conjunction sjogrens syndrome
Answer:Pemphigus
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6. A sharp curette reflects light. A dull curette burnishes calculus on a root surface.
A. The first statement is false. The second statement is true
B. The first statement is false. The second statement is false
C. The first statement is true. The second statement is true.
D. The first statement is true. The second statement is false.
Answer: FALSE, TRUE
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7. Comprehensive periodontal treatment planning is always done in phase 1
(nonsurgical/disease control) of the periodontal treatment plan. Periodontal maintenance is the
same as prophylaxis.
E. The first statement is false. The second statement is true
F. The first statement is false. The second statement is false
G. The first statement is true. The second statement is true.
H. The first statement is true. The second statement is false.
Answer: False, False
| False is right Periodontal maintenance is not the same as prophylaxis DS
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8. What is the biggest problem associated with periodontal maintenance that contributes to
recurrence of disease and tooth loss in the long-term?
A. Cost
B. Aging
C. Distance
D. Philosophical beliefs
E. Compliance
Answer: E - Compliance
31
9. You suspect your patient has primary occlusal trauma because you not areas (miswritten on
exam) of widened PDL on the FMX. How would you describe the cervical lesions depicted?
A. Erosion
B. Abrasion
C. Abfraction
D. Attrition
E. None of the above
Answer:Abfraction
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10. Which of the following oral hygiene methods or products, when applied properly and used
exclusively, could still result in a persistently high plaque score?
A. C- flossing method
B. Motorized (powered) toothbrush
C. Bass method of tooth brushing
D. waterpik/waterfloss
Answer:waterpik/waterfloss
33
11. You are doing a comprehensive periodontal examination. Teeth #18-20 have 5-6 mm
periodontal probing depths. What statement BEST describes how probing depth is measured
clinically (i.e. What are your landmarks for measuring probing depth)?
A. Measured from the free gingival margin to the mucogingival junction
B. Measured from the CEJ to the base of the probleable crevice
C. Measured from epithelial attachment to the alveolar crest
D. Measured from CEJ to alveolar crest
Answer: Measured from free gingival margin to base of probalance crevice
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12. Two patients of the same age both have 25% periodontal bone loss, but Patient A has
abundant calculus deposits while Patient B has little plaque or calculus. Which patient has the
better periodontal prognosis? Patient A or Patient B?
A. Patient B
B. Patient A
Answer: Patient B
| Wish all these questions were like this lol
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```
13. Which of the following conditions demonstrate a malar rash and often occurs along with
Sjogren’s syndrome?
A. Aphthous ulcers
B. Lupus erythematosus
C. Pemphigus
D. Pemphigoid
E. Erythema multiforme
```
Answer: Lupus erythematosus
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```
14. The following characteristics describes which periodontal instrument: Designed for area
specific usage, face of the blade is offset at 70 degrees to the lower shank, has 2 cutting edges
but only 1 is used.
A. Gracey
B. file
C. chisel
D. Universal curette
E. None of the above
```
gracey
37
```
15. The Gracey curettes are characterized by which of the following: SELECT ALL THAT
APPLY—---------- see ppt slide above
A. Site specific usage, rounded tip
B. Rounded tip
C. Pointed tip
D. 2 functional cutting edges
```
: Site specific usage, rounded tip (CHECK- should be correct tho)
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16. Which of the following is/are accurate regarding Re-Evaluation?
A. Re-evaluation is a comprehensive periodontal evaluation
B. Re-evaluation is like a post-op visit, no need to record probing depths
C. Re-evaluation is the final procedure performed in phase I
D. Re-evaluation is ideally performed 4-6 weeks following SRP
Answer: Re-evaluation is a comprehensive periodontal evaluation agreed
Re-evaluation is the final procedure performed in phase I agreed
Re-evaluation is ideally performed 4-6 weeks following SRPnot sure about this
one -SA, this is correct -BJ → should be done 4-12 after SCRP - powerpoints
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17. Which of the following is characteristic of the initial lesion in the pathogenesis of periodontal
disease?
A. Clinical signs of gingival redness and edema are evident -early lesion
B. 60-70% collagen destruction occurs within lamina propria-early lesion (T lymphocytes) -
early lesion
C. C. Cellular infiltrate in the lamina propria is composed mainly of neutrophils
(PMNs)
D. Breakdown of collagen fiber attachment to the root
Answer: C. Cellular infiltrate in the lamina propria is composed mainly of neutrophils (PMNs)
choices A & B are early lesions
40
18. Which of the following chemotherapeutic products DOES NOT kill bacteria?
A. Actisite (tetracycline)-nonresorbable tetracycline fiber
B. Atridox (doxycycline in syringe gel)
C. Arestin (minocycline powder - syringe into pocket)
D. Periostat (doxycycline
```
A:Periostat (doxycycline) -candy- bacteriostatic not bacteriocidal
Ac
Periochip (Chlorhexidine chip, resorable) does kill bacteria
```
41
19. Which phase of treatment is also known as Bacterial Control or Disease Control phase?
a. Phase IV-periodontal maintenance
b. Phase II-surgical therapy
c. Phase I-simple operative restorative
d. Preliminary phase
e. Phase III -definitive treatments does NOT include simple operative/restorative
Answer: Phase I-simple operative restorative
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```
20. Which of the following is NOT a valid reason to prescribe antibiotics for a patient with a
periodontal abscess?
A. Cellulitis
B. Lymphadenopathy
C. Pain
D. Immunocompromised patient
E. Fever
```
A: C- Pain
43
21. According to Kwok and Caton, which of the following categories of prognosis is assigned to
a tooth that demonstrates a periodontal condition that is influenced by systemic factors that may
or may not be adequately controlled.
A. Questionable
B. Favorable
C. Hopeless
D. Unfavorable
questionable
44
favorable
| [kwak and caton classification system]
can be stabilized with comprehensive periodontal treatment. maintenance, and with less chance of future breakdwon
45
questionable
influenced by local and or systemic factors that may or may not be controlled; the peridontium can be maintained with proper care
46
hopeless prognosis
must be extracted
47
gracey currte
off-set angulation
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23. The Jacquet scaler has the following properties: Select all answers that apply:
A. Is also called a sickle scaler
B. Is a subgingival scaler
C. Has a pointed tip and triangular sides
D. Can be used more than 2 mm subgingivally
Answer: A & C
A - is also called a sickle scaler
C - Has a pointed tip and triangular sides
The sickle scaler used at Howard is called a Jacquette Scaler.
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24. Your patient has “generalized moderate chronic periodontitis”. His medical history is noncontributory. He has a negative social history. What would be the best regimen of adjunctive
antibiotic therapy to use in the treatment of his periodontal disease?
a. Doxycycline
b. Metronidazole
c. Penicillin
d. Amoxicillin
e. None
A: A-Doxycycline
50
25. Which of the following is/are accurate regarding prognosis? (More than one answer)
A. It is assigned at the beginning and cannot be changed
B. McGuire and Nunn classification is based on initial presentation
C. It is influenced by the clinicians previous experience
D. Kwok and Caton classification is based on likely treatment outcome
E. It can be re-evaluated based on response to treatment
Answer: B. McGuire and Nunn classification is based on initial presentation
C. It is influenced by the clinicians previous experience
D. Kwok and Caton classification is based on likely treatment outcome
E. It can be re-evaluated based on response to treatment
51
26. Which of the following is/are accurate regarding Maintenance (Supportive) therapy? (More
than one answer)
A. One goal of maintenance therapy is to prevent further attachment loss
B. SPT involves localized scaling and root planing where inflammation persists
C. Maintenance therapy is also known as a Prophylaxis
D. SPT Is recommended every three months for a year following SRP
Answer: A. One goal of maintenance therapy is to prevent further attachment loss
B. SPT involves localized scaling and root planing where inflammation persists
D. SPT Is recommended every three months for a year following SRP
C is wrong. Maintenance therapy is not the same as prophylaxis don't know about A-DS
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27. Patient A is 50 years old while Patient B is 30 years old, however both demonstrate 25%
periodontal bone loss. Which patient has the better periodontal prognosis? Patient A or Patient
B
A. Patient A
B. Patient B
A: Patient A
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```
28. What is it called when slight rubbing of the skin results in exfoliation of its outermost layer?
A. Systemic lupus erythematosus
B. Nikolsky’s sign
C. Benign mucous membrane pemphigoid
D. Apthous ulcers
E. Desquamative gingivitis
```
Answer: Nikolsky’s sign - MB
Nikolsky's sign is positive when slight rubbing of the skin results in exfoliation of the skin's
outermost layer. The more technical term is acantholysis which is the loss of the normal
adhesion of the epithelial skin cells which allows for this sloughing-SA
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```
29. After evaluating the patient’s radiographs, which sextant demonstrates the poorest
prognosis?
A. Maxillary anterior sextant
B. Mandibular right posterior sextant
C. Maxillary right posterior sextant
D. Mandibular anterior sextant
E. Maxillary left posterior sextant
```
C. Maxillary right posterior sextant
55
30. Your patient is taking Nifedipine and presents with gingival enlargement. You notice on the
radiograph that the CEJ is approximately 2 mm from the alveolar crest. What type of pocket
would be associated with this clinical scenario?
A. Pseudo pocket
B. Suprabony pocket
C. Healthy sulcus
D. Infrabony pocket
E. None of the above
Answer: Healthy sulcus
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31. Using a dull curette may lead to operator fatigue, incomplete calculus removal, and shorter
use-life of the instrument. Before using a periodontal probe determine the incremental marking
scale.
F. The first statement is false. The second statement is false.
G. The first statement is true. The second statement is false.
H. The first statement is true. The second statement is true.
I. The first statement is false. The second statement is true.
Answer: True, true
57
```
32. Which of the following is most often used for confirmation of diagnosis for lesions that
present as desquamative gingivitis?
A. Immunofluorescence
B. Nikolsky's sign
C. Hematoxylin & eosin staining
D. Culture and sensitivity tests
E. Dark Field microscopy
```
Answer: Nikolsky's sign
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33. Which of the following is non-plaque-induced gingival disease?
A. Puberty or gingivitis - plaque induced
B. Pregnancy gingivitis plaque induced
C. Nifedipine-related gingival enlargement - plaque induced
D. Juvenile spongiotic gingival hyperplasia
Answer: Juvenile Spongiotic Gingival Hyperplasia (correct)- Agreed the etiology is
unknown. Below are plaque induces therefore can’t be correct answers. Calcium channel
blockers (nifidepine) are mentioned in the ppt slides too- SA
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```
34. Patients with which of the following should NOT be treated with ultrasonic instruments?
A. Infectious diseases
B. Deep periodontal pockets
C. Controlled diabetics
D. Edematous tissue
```
A: Infectious diseases
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35. Your patient has generalized 5-6mm periodontal pocket depth, generalized CAL of 3-4mm,
generalized subgingival calculus. The patient needs periodontal instrumentation. You are writing
out the treatment plan and treatment based on the diagnosis. What is the most approximate
periodontal instrumentation your patient needs for phase I therapy based on the clinical
presentation and diagnosis?
A. Periodontal maintenance - phase IV
B. Polishing - no
C. Prophylaxis - no
D. Scaling and root planing
E. Scaling in the presence of gingival inflammation
scaling and root planning
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```
36. In which phase would definitive orthodontics and fixed prosthodontics be performed?
A. Phase IV
B. Phase II
C. Phase III
D. Preliminary
E. Phase I
```
phase III
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37. You are reviewing your notes in preparation for treating John tomorrow. He is 35 y/o. #3 has
the following probing depth (in mm): B: 3 2 8 P: 3 2 8 (from distal to mesial). What would be the
best instrument to use to treat #3 based on your diagnosis, the etiology and contributing
factor(s)?
A. 11/12 explorer
B. 330 bur on high speed
C. 11/12 gracey curette
D. 13/14 Gracey curette
E. None of the above
11/12 Gracey curette
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```
38. Necrotizing periodontal diseases may be strongly associated with which of the following?
A. Poor diet
B. smoking
C. stress
D. Poor oral hygiene
E. All
```
E. ALL
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39. Which of the following is correct regarding gingivitis?
A. Gingivitis develops in 2-3 weeks following cessation of oral hygiene
B. Gingivitis is accompanied by attachment loss
C. Gingivitis is irreversible
D. Gingivitis always progresses to periodontitis
E. Gingivitis causes mobility
Answer: Gingivitis develops in 2-3 weeks following cessation of oral hygiene
Agreed-SA
65
```
40. Which of the following is usually associated with calculus in a deep pocket?
A. Periodontal abscess
B. Pericoronal abscess
C. Gingival abscess
D. Peritonsillar abscess
E. Periapical abscess
```
Answer: Periodontal abscess (p sure correct, check pls)?????- agree mb
Yes. Periodontal abscess is defined as an infection located adjacent to the periodontal pocket
that may result in rapid destruction of the periodontal ligament and alveolar bone-SA
66
```
41. You have diagnosed your patient as having localized aggressive periodontitis. Which should
be your first choice of adjunctive antibiotic therapy used in conjunction with scaling and root
planing?
A. Metronidazole with PenVK
B. PenVK with Amoxicillin
C. Metronidazole with Amoxicillin
D. Doxycycline and ibuprofen
E. None of the above
```
Answer: Metronidazole with Amoxicillin
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```
42. According to MacGuire and Nunn, which of the categories of prognosis is assigned to a tooth that demonstrates approximately) 25 % periodontal attachment loss and Class I furcation involvement?
A. Good
B. Hopeless
C. Questionable
D. Poor
E. Fair
```
```
Answer: Fair
A. Good- control of etiologic factors
B. Hopeless- severe attachment loss
C. Questionable greater than 50%
D. Poor 50%
E. Fair 25%
```
68
```
43. A furcal involvement may be due to
A. Perforation
B. Occlusal discrepancy/occlusal trauma
C. Presence of an accessory canal
D. Cervical enamel pearl or projection
E. All of the above
Answer: All of the above
```
Answer: All of the above
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```
44. Which of the following timelines is/are correct?
A - 4 to 7 days
B - 2 to 4 days
C - 2 to 3 weeks
D - 14 to 21 days
```
Answer: B - 2 to 4 days - Initial Lesion,
A - 4 to 7 days - Early lesion,
D - 14 to 21 days - Established lesion
C - 2 to 3 weeks - Chronic Gingivitis
Agreed, Established lesion is associated with chronic gingivitis
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45. Both the 4R/4L curette and the Gracey 11/12 curette are universal curettes. The 4R/4L is
used primarily in the posterior and the Greacey 11/12 curette is used primarily in the anterior.
A. The first statement is false. The second statement is false.
B. The first statement is true. The second statement is false.
C. The first statement is true. The second statement is true.
D. The first statement is false. The second statement is true.
A: False, false
| 4R/4L is universal posterior, gracey 11/12 is site specific mesial posteriors
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```
46. In the preferred sequence of dental therapy, what phase of treatment immediately follows
Phase I?
A. Phase IV
B. Phase II
C. Phase III
D. preliminary
```
Answer:Phase IV
Immediately after completion of phase I therapy, the patient should be placed on the
maintenance phase (phase IV) to preserve the results obtained and prevent any further
deterioration and recurrence of disease. While on the maintenance phase, with its periodic
evaluation, the patient enters into the surgical phase (phase II) and the restorative phase (phase
III) of treatment.-SA
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47. Why were vertical bitewing radiographs exposed versus horizontal bitewing radiographs for
this patient ?
A. BOP
B. Suspected interproximal caries
C. Less radiation exposure
D. Increased image of alveolar bone in relationship to CEJ
E. More comfortable for the patient
Answer: D - Increased Image of Alveolar Bone Relationship to CEJ
73
48. You are reviewing your notes in preparation for treating Jhon tomorrow. He is 13 y/o #14
has the following probing depths (in mm ): B: 3 2 6 P : 7 3 4. You remembered the tissues
appeared cyanotic (purplish/blue) on the distal of #14. What is contributing to the probing depths
noted on the distal #14?
A. Caries
B. Age
C. Calculus
D. None of the above
Answer: Calculus
74
49. Which of the following organisms is associated with plaque-induced gingival diseases?
A. Neisseria gonococcus - non plaque induced
B. Treponema pallidum - non plaque induced
C. Histoplasmosis - non plaque induced
D. Actinomyces viscosus- root caries
E. Herpes simplex virus 1 - non plaque induced
Answer: Actinomyces viscosus- root caries
75
50. Which of the following is characteristic of the early lesion in the pathogenesis of periodontal
disease?
A) T-lymphoctes are predominant in the inflammatory infiltrate
B) This lesion is reconginzed clinically as chronic gingivitis
C) Collagen destruction within the attachment apparatus
D) It shows increased vasoconstriction and decreased vascular permeability
A: Collagen destruction within the attachment apparatus
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51. Which of the following is correct regarding periodontal abscesses?
A. Emergency treatment involves periodontal flap surgery and bone grafting
B. Deep Periodontal pockets and angular bone defects can be found in gingival abscesses
C. Foreign body entrapment could lead to all three types of periodontal abscesses
D. Arestin, locally delivered antimicrobial, is an adequate antibiotic to trat the abscess
A: foreign body impact
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```
52. Which of the following is usually associated with a large carious lesion?
A. Gingival Abscess
B. Periocoronal abscess
C. Perapical abscess
D. Peritonsillar abscess
E. Periodontal abscess
```
pulpal abscess
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53. In which phase of dental treatment would periodontal surgery be performed?
A. Phase II
B. Phase III
C. Preliminary Phase
D. Phase I
E. Phase IV
```
A: Phase II
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```
54. In which phase in maintenance therapy ( Supportive Periodontal Treatment) performed?
A. Phase IV
B. Phase III
C. Phase II
D. Phase I
E. Preliminary Phase
```
Answer: Phase IV
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55. Your patient is 22. He’s a 2nd year dental student taking final exams during the COVID 19
pandemic. There is uncertainty as to when clinical and laboratory classes will resume. He is
dealing with stress and anxiety. He has not been sleeping well or eating a proper diet. He has
started smoking. Based on his periodontal diagnosis, what gingival characteristic BEST
describes the interdental papillae between #6 to #8?
A) Festooned
B) Bulbous and Edematous
C) J-Shape cleft
D) Cratered and punched out
E) None of the above
A: Cratered n punch
81
```
56. In which dental treatment would an acute periodontal abscess be treated?
A) Surgical
B) Maintenance
C) Surgical
D) Initial
E) Preliminary
```
A: Preliminary
| Correct, preliminary phase = acute problems
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57. Which of the following is/are accurate regarding modulation therapy?
A. 20mg doxycycline dosage inhibits enzymes, cytokines and osteoclasts
B. 20mg doxycycline is given b.i.d. For up to 9 months
C. 20mg doxycycline is marked under the brand name Periostat
D. 20mg doxycycline kills the periodontal bacteria
A: A. 20 mg doxycycline inhibits enzymes, cytokines, B. Is given b.i.d, C. Periostat
Shouldnt it be 100mg of doxycycline?
83
58. Which of the following are correct regarding the clinical changes that occur in gingivitis?
a. Gingival morphology changes from knife edged to rolled or enlarged
b. Gingival attachment to the tooth is lost and true pockets develop
c. Gingival color changes from pink to red (erythematous)
d. Gingival surface texture changes from strippled to smooth
e. Gingival consistency changes from firm to spongy
Answer: A. Gingival morphology changes from knife edged to rolled or enlarged
C. Gingival color changes from pink to red (erythematous)
D. Gingival surface texture changes from strippled to smooth
E. Gingival consistency changes from firm to spongy
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59. Which of the following is NOT known to predispose a tooth to gingival recession?
A. Occlusal trauma
B. Thin bony housing
C. Frenum attachment
D. Dehiscence
E. Tooth position
```
A - Occlusal Trauma
85
60. Which of the following forms of lichen planus is most common and demonstrates Wickhams
Striate ?
A. Erosive- also most common but not Wickhams
B. Atrophic
C. Papillary
D. Erythematous
E. Reticular
Answer:Reticular
86
61. What type of bony architecture associated with periodontal disease is characterized by a
denuded area that extends up through the marginal bone ?
A. Fenestration
B. Dehiscence
C. Interdental osseous crater- most common osseus bone defect, common in posterior
regions
D. Exostosis
E. None of the above
A Dehiscence
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62. When determining the working end of a curette, the instrument is held so that the terminal
shank is perpendicular to the floor and the edge that is lower or closer to the floors is the
working end. When testing for instrument sharpress , a sharp instrument will slide along a test
stick.
A. The first statement is false. The second statement is false.
B. The first statement is true. The second statement is false.
C. The first statement is true. The second statement is true.
D. The first statement is false. The second statement is true.
A: D-True, False
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63. Which of the following chemotherapeutics is NOT a biodegradable product and thus would
require a 2nd appointment for its removal ?
A: Periostat (doxycycline)
B: Periochip (chlorhexidine)
C. Arestin (minocycline)
D. Atridox (doxycycline)
E. Actisite (Tetracycline, nonresorbable tetracycline fiber -powerpointsBJ)
Answer: E. Actisite (Tetracycline, nonresorbable tetracycline fiber -powerpointsBJ
89
64. Which of the following is the antibiotic of choice to treat necrotizing periodontal disease ?
A. Metronidazole (think…Nec..hurts when taking the Metro,BJ)
B. Augmentin- first choice for perio abscess
C. Acyclovir- for herpetic gingivostomatitis
D. Tetracycline- for aggressive periodontitis
E. Doxycycline- for chronic periodontitis
Metronidazole
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65. Topical NaF gel should stay in the patient's mouth for how long?
A. 30 minutes
B. 1 minute
C. 30 seconds
D. 4 minutes
E. 10 minutes
```
A: 4 minutes
91
NaF varnish
5% NaF varnish advantages over 4-min in-office application
highre concentration of fluoride
best for patient for high risk for caries
can be applied without prior oral prophy
92
APF 1.23% (Acidulated fluoride)
Contraindicated with porcelain, composite, glass ionomer restorations, or sealants because acid (pH 3.5) will etch restorations
Raising the acidity increases the fluoride uptake by the enamel
Applied every 6-months in-office
Indicated for patients taking medications that have a high sugar content on a long-term basis
93
```
66. Your patient has ANUG. How much horizontal bone loss do you expect to see?
A. 2mm
B. 3mm
C. 1mm
D. none
E. Not enough information to answer
```
answer: none
94
67. Which of the following accounts for most of the cases of desquamative gingivitis?
a. Lichen planus
b. Aphthous ulcers
c. Erythema multiforme
d. Necrotizing stomatitis
e. Pemphigus vulgaris
Answer: A. Lichen planus - sa + mb agree
E. Pemphigus vulgaris
Why would this not be lichen planus? - SA; I also think its Lichen planus- in class stated it is
75% of the time - mb, correct-BJ from lecture
95
```
68. Which of the following is NOT associated with increased gingival bleeding?
A. Bleeding disorders
B. Local plaque retentive factors
C. Hormones
D. Medications
E. Occlusal trauma
```
Answer: Occlusal trauma
| The answer is occlusal trauma - SA See slide below; agree mb
96
69. Your patient is a 79-year old African American female. She reports she has not had a dental
check-up for several years. Her chief complaint: “My teeth have not been cleaned in a long time
and are in bad shape.” She suffered from a stroke four years ago which left her with some
paralysis on her right side. She has difficulty with home care. She is in recovery for alcoholism.
She is a non-smoker. Her plaque score is 90%. Generalized probing depths are 2-10 mm.
Generalized mobility (grade 2-3). Generalized furcations (grade 2-3). Based on her periodontal
diagnosis, all of the following microorganisms will MOST likely be identified in this patient’s
microflora (plaque biofilm) except one. What is the Exception?
A. T. forsythia
B. T. denticola
C. P. gingivalis
D. C. Albicans
E. P. Intermedia
```
A: C. Albicans -mb, correct NA, MH → correct because Albicans for yeast/fungi -BJ
A. T. forsythia Red complex
B. T. denticola Red complex check
C. P. gingivalis Red complex check
D. C. Albican
E. P. Intermedia check Orange comple
```
97
```
70. Biologic width is approximately______ mm. FILL IN THE BLANK
A. 0
B. 1
C. 2
D. 3
E. 4
```
A: C. 2mm
98
71. Patient is a 55-year old white Caucasion malle, 5’10” and weighs 130 lbs. He has been HIV
positive for 20 years. His recent CBC panel indicated: CD4 T-lymphocyte count at 200,
neutrophils at 400 cells uL (neutropenia). He is currently on HAART antiviral drug cocktail. He
has been referred to you for years. He’s never had periodontal treatment. His chief complaint “I
have canker sores frequently which are painful and burn. My tongue sometimes has sores on
it, and I have a bas taste most of the time. There is a bad odor coming from my mouth. My
gums bleed spontaneously sometimes. Which of the following BEST classifies the periodontal
disease represented in the patient?
A. Aggressive periodontitis
B. Refractory periodontitis
C. Necrotizing ulcerative periodontitis (key word is PAINFUL!, red on powerpoint -BJ)
D. Chronic periodontitis
E. Plaque induced gingivitis
A: Necrotizing ulcerative
99
72. Which of the following is characteristic of the established lesion in the pathogenesis of
periodontal disease?
A. Neutrophils (PMNs) are predominant in the inflammatory infiltrate
B. The lesion is diagnosed clinically as chronic periodontitis
C. T-lymphocytes are predominant in the inflammatory infiltrate
D. b- lymphocytes and plasma cells are predominant in the inflammatory infiltrate
A: B- lymphocytes and plasma cells are predominant in the inflammatory infiltrate
100
```
73. #25 has a probing depth of 3mm(mid facial) with 4mm of recession. What is the CAL?
A. 7 mm
B. 4 mm
C. 12 mm
D. 1 mm
E. 3 mm
```
A: A-7mm
| PD + Recession = CAL
101
74. Vertical bone loss may be associated with aggressive periodontitis. Vertical bone loss is the
most common pattern of bone loss associated with periodontitis.
A. The first statement is true. The second statement is true.
B. The first statemtne is false. The second statement is true
C. The first statement is false. The second statement is false
D. The first statement is true. The second statement is false
A: TRUE, FALSE
102
74. Vertical bone loss may be associated with aggressive periodontitis. Vertical bone loss is the
most common pattern of bone loss associated with periodontitis.
A. The first statement is true. The second statement is true.
B. The first statemtne is false. The second statement is true
C. The first statement is false. The second statement is false
D. The first statement is true. The second statement is false.
A: TRUE, FALSE
103
```
75. What BEST describes the osseous defect in the mandibular defect in the mandibular right
posterior periapical radiograph #31
A. Erosion
B. Infrabony
C. Intraosseous
D. Horizontal
E. Receded
```
A: Infrabony
