Perio OT questions

Question 1

T/F: Patients with implants are instructed to not clean their implants in any way to avoid damaging them.

Answer 1

False

Question 2

T/F: The majority of patients keep all of their scheduled maintenance appointments.

Answer 2

False

Question 3

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.

Answer 3

True

Question 4

T/F: It takes an average of 4 weeks for periodontal tissues to heal after treatment.

Answer 4

True

Question 5

T/F: It is recommended to evaluate motivation of patient before surgery begins.

Answer 5

True

Question 6

T/F: Tissues associated with implants are more susceptible to breakdown than tissues associated with natural teeth.

Answer 6

True

Question 7

T/F: Removing supragingival plaque will change the microflora in perio pockets.

Answer 7

False

Question 8

T/F: Removing supragingival plaque will change the microflora in perio pockets.

Answer 8

True

Question 9

T/F: Removing supragingival plaque will change the microflora in perio pockets.

Answer 9

True

Question 10

T/F: Removing supragingival plaque will change the microflora in perio pockets.

Answer 10

False

Question 11

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

Answer 11

e. Periodontal infections have been linked to all of these systems

Question 12

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

Answer 12

e. All of the above

Question 13

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

Answer 13

b. First is true, second is false

Question 14

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

Answer 14

a. Severe, poor

Question 15

T/F: Periodontal treatment has been clearly shown to significantly improve both periodontal health and decrease the rate of adverse outcomes in pregnant females.

Answer 15

False

Question 16

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

Answer 16

d. All of the above

Question 17

Suprabony pocket­the base of the pocket is coronal to the level of the underlying bone, bone is horizontal

a. True
b. False

Answer 17

a. True

Question 18

T/F: Infrabony pockets­ the base of the pocket is apical to the level of the adjacent bone, bone loss is horizontal.

Answer 18

False

Question 19

T/F: Surgical pocket therapy can result in a healthy sulcus with or without gain of attachment.

Answer 19

True

Question 20

T/F: The most important variable for evaluating whether a pocket is progressive is the level of attachment.

Answer 20

True

The most important variable for evaluating whether a pocket (or deep sulcus) is progressive is the level of attachment-STRAIGHT FROM THE BOOK ☹

Question 21

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.

Answer 21

True

Question 22

T/F: A gingivectomy procedure eliminates suprabony pockets and provides access to bone.

Answer 22

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.

Question 23

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.

Answer 23

True

Question 24

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.

Answer 24

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

Question 25

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

Answer 25

All of the above may occur

Question 26

When should motivation and compliance be assessed?

Answer 26

Before initial therapy, after surgical therapy, and during recall appointment. --Older test says a. before initial therapy--

Question 27

Recall appointments are most effective every _________.

Answer 27

3 months

Question 28

What Gracey curette would be used on the distal of posterior teeth?

Answer 28

13/14 or 17/18 Crazy teenagers on the distals of posterior teeth

Question 29

What Gracey curette would be used on the mesial of posterior teeth?

Answer 29

11/12 and 15/16

Question 30

T/F: Once treated for perio disease, you are still susceptible for the rest of your life.

Answer 30

True

Question 31

T/F: Fluoride is inactivated by CHX.

Answer 31

True

Question 32

A 55 year old with blue-red gingiva and horizontal radiographic, 3mm bone loss from the CEJ has what ADA class of perio disease?

Answer 32

Class 2

Question 33

T/F: Bacteremia can be caused by chewing.

Answer 33

True

Question 34

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

Answer 34

All of the above

Question 35

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

Answer 35

c. False/true

Question 36

Periodontal dx may reoccur because of: a. Inadequate removal of local factors b. Microorganism still in soft tissues c. A and B

Answer 36

c. A and B

Question 37

What is the Glickman’s classification for through and through opening with recession?

Answer 37

Class IV

Question 38

What does nosocomial mean?

Answer 38

Hospital-acquired

Question 39

Bite guards are used as tx for:

Answer 39

Parafunctional habits

Question 40

What is the association between periodontal disease and acute respiratory infection? a. Subgingival plaque harbors PRPs b. Nosocomial infection are in both

Answer 40

a. Subgingival plaque harbors PRPs

Question 41

T/F: Removing the risk factors of periodontal disease will cause the disease to disappear.

Answer 41

False

Question 42

Gingival index is used to measure: a. Gingival inflammation b. Gingival bleeding c. Plaque accumulation d. Gingival recession

Answer 42

a. Gingival inflammation

Question 43

Violation of biological width will cause: a. Self-limiting bone loss b. Bone loss

Answer 43

b. Bone loss

Question 44

Biological width does not include which of the following: a. Alveolar Bone b. Junctional epithelium c. Connective tissue d. none

Answer 44

a. Alveolar bone

Question 45

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%!)

Answer 45

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

Question 46

T/F: Improvement of periodontal bone level is not proven as a result of molar uprighting.

Answer 46

True

Question 47

Attached gingiva moves about __% extruded distance.

Answer 47

80%

Question 48

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

Answer 48

All of the above are true

Question 49

An isolated “window” in the bone covered only by periosteum and gingiva is called a:

Answer 49

Fenestration Some bone is left, covered only by periosteum and gingiva.

Question 50

Fusion of the cementum and alveolar bone with obliteration of the periodontal ligament is termed:

Answer 50

Ankylosis

Question 51

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

Answer 51

b. ANUG - treat with antibiotics

Question 52

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

Answer 52

c. optimal periodontal health

Question 53

What does “B” indicate in the picture? a. calculus b. cementum c. biofilm/plaque d. none of the above

Answer 53

c. biofilm/plaque

Question 54

The main source for mineralization of subgingival plaque is: a. GCF b. saliva (supragingival plaque) c. leukocytes d. erythrocytes

Answer 54

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

Question 55

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

Answer 55

d. more spirochete and more gram negative rods

Question 56

Healthy gingival sulcus contains: Gram neg anaerobes Motile rods gram + bacteria, mainly cocci

Answer 56

gram + bacteria, mainly cocci

Question 57

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

Answer 57

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.

Question 58

T/F: BOP can frequently be observed in patients w/ stage 1 lesions (initial lesion).

Answer 58

False

Question 59

T/F: Leukemia can be associated with gingival enlargement.

Answer 59

True

Question 60

Pocket formation starts at what stage of lesion? a. III, established lesion b. II, early lesion c. IV, advanced lesion d. I, initial lesion

Answer 60

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

Question 61

T/F: Diffuse gingivitis affects the gingival margin, the attached gingiva, & the interdental papilla.

Answer 61

True

Question 62

The predominant immune cells of a stage III lesion are the: a. Lymphocytes b. Plasma cells c. PMNs d. Dentritic cells

Answer 62

b. Plasma cells

Question 63

The patient has: [picture with max&mand diastema and very red gingiva] a. Marginal gingivitis b. Papillary gingivitis c. Diffuse gingivitis d. Mild gingivitis

Answer 63

c. Diffuse gingivitis

Question 64

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

Answer 64

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

Question 65

T/F: Inflammation follows the cementum.

Answer 65

False, it follows the blood vessels. Transeptal fibers of gingiva are the only ones left in diseased area.

Question 66

T/F: Pus associated with a pocket is related to the severity of periodontal disease.

Answer 66

False, it is not related to perio disease severity. Only reflects the nature of inflammatory changes in the pocket wall.

Question 67

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.

Answer 67

False/True

Question 68

Pt comes in after Phase I Therapy and is treatment planned for Surgery Phase. Pt has 45% MOL score. What do you do?

Answer 68

Give more OH instruction, do SRP/cleaning again, re-evaluate

Question 69

T/F: Smokers are at increased risk for attachment loss.

Answer 69

True Deeper and more residual pockets than non-smokers. No difference in plaque or BOP scores.

Question 70

During which treatment phase can extractions of hopeless teeth be performed?

Answer 70

Phase I therapy

Question 71

How do you measure the depth of the periodontal pocket? (from the ____ to the ____)

Answer 71

From the FGM to the JE.

Question 72

According to the Miller scale, 1mm of horizontal movement and can be depressed is what mobility class?

Answer 72

Class III mobility

Question 73

T/F: In Miller Classification of Recession, Class II and III have recession extending to or beyond the MGJ.

Answer 73

True Miller Class IV - Recession to or beyond the MGJ and severe loss of bone and soft tissue and or sever tooth malposition

Question 74

T/F: You can use fingers to evaluate tooth mobility.

Answer 74

False

Question 75

Pathologic migration of teeth is commonly found in _________ chronic periodontitis. a. Mild b. moderate c. Severe d. None of the above

Answer 75

c. Severe

Question 76

T/F: A crossectional study can be used to determine incidence.

Answer 76

True

Question 77

What is not a symptom of a patient with GAP? a. Weight loss b. Depression c. …can’t remember the wrong choice!!! d. malaise

Answer 77

c. Can't remember, different than the other 3

Question 78

Localized Aggressive Periodontitis is usually characterized by:

Answer 78

Elevated levels of A.a.

Question 79

T/F: Localized aggressive periodontal disease has limited plaque or calculus.

Answer 79

True

Question 80

T/F: A.a. is 90% of the bacteria in localized aggressive periodontitis.

Answer 80

True

Question 81

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

Answer 81

c. ANUP

Question 82

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…

Answer 82

c. Plaque accumulation initiates gingivitis, which may progress to periodontitis

Question 83

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

Answer 83

b. The presence of clinically detectable attachment loss

Question 84

The main etiology of gingival abscess is:

Answer 84

Food impaction

Question 85

A patient with advanced adult periodontitis is classified as: a. I b. II c. III d. IV e. V

Answer 85

d. IV

Question 86

What is a cementum bound product from bacteria can be removed from root surface during root planning?

Answer 86

Endotoxin

Question 87

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

Answer 87

e. All of the above can be used to clean implants | air polisher=best way to clean

Question 88

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

Answer 88

c. Osteoclasts

Question 89

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

Answer 89

d. 6 months

Question 90

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

Answer 90

d. None of the above

Question 91

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

Answer 91

b. 3 mm

Question 92

What is the most common form of periodonitis and what is its primary etiologic factor?

Answer 92

Most common -> chronic periodontitis Primary etiologic factor -> plaque