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Part II > Perio3 > Flashcards

Flashcards in Perio3 Deck (73):
1

A/An ? of the saliva causes precipitation of calcium phosphate salts by lowering the precipitation constants.
• decrease in the pH
• increase in the pH
• decrease in the viscosity
• increase in the viscosity

increase in the pH

2

The sulcular epithelium is a:
• thick, keratinized stratified squamous epithelium without rete pegs
• thick, nonkeratinized stratified squamous epithelium with rete pegs
• thin, keratinized nonstratified squamous epithelium with rete pegs
• thin, nonkeratinized stratified squamous epithelium without rete pegs

thin, nonkeratinized stratified squamous epithelium without rete pegs

3

Dental plaque is composed primarily of:
• microorganisms
• water
• minerals
• tissue cells

microorganisms

4

The source of mineralization for supragingival calculus is:
• desquamated epithelial cells
• gingival crevicular fluid
• phosphatases formed by bacterial plaque
• saliva

saliva (whereas, the serum transudate called gingival crevicular fluid furnishes the minerals for subgingival calculus)

5

Saliva from the parotid gland flows over the facial surfaces of the maxillary molars through ? duct, whereas the orifices of ? duct and ? duct empty onto the lingual surfaces of the mandibular incisors from the submandibular and sublingual glands, respectively.

• Stensen
• Wharton
• Bartholin

6

Specific bacteria are implicated in periodontal disease and are commonly found at the site of infection. The Red complex bacteria consist of the following. Select all that apply.
• porphyromonas gingivalis
• tannerella forsythia
• treponema denticola
• eikenella corrodens

• porphyromonas gingivalis
• tannerella forsythia
• treponema denticola

7

Nearly all human oral bacteria exhibit, ? cell-to-cell recognition of genetically distinct cell types.
• adhesion
• pleomorphism
• coaggregation
• organization

coaggregation

8

Within nanoseconds after vigorously polishing the teeth, a thin, saliva-derived layer called ?

the acquired pellicle

9

The process of plaque formation can be divided into three major phases?

1. The formation of the pellicle on the tooth surface
2. Initial adhesion and attachment of bacteria
3. Colonization and plaque maturation

10

Early or young plaque consists primarily of:
• filaments
• cocci
• rods
• vibrios

cocci (Streptococcus mutans and sanguis)
after 2 days filamentous form increase

11

Calculus (both supragingival and subgingival) located on interproximal surfaces can be seen on bite-wing radiographs as ?

interproximal spurs

12

The inorganic components of plaque are predominantly ?, with trace amounts of other minerals, including sodium, potassium, and fluoride

calcium and phosphorus

13

At least two-thirds of the inorganic component of calculus is crystalline in structure. Of the four main crystal forms, which one is more common in the mandibular anterior region?
• magnesium whitlockite
• brushite
• octcalcium phosphate
• hydroxyapatite

brushite
[• magnesium whitlockite (posterior region)
• hydroxyapatite every where]

14

When evaluating an osseous defect, the only way to determine the number of walls left surrounding the tooth is by:
• periodontal probing
• radiographs
• exploratory surgery
• testing for mobility

exploratory surgery

15

Angular defects are classified on the basis of:
• the number of osseous walls that were destroyed by periodontal disease
• the number of osseous walls left surrounding the tooth
• the number of osseous walls that will remain after surgery
• periodontal probe readings

the number of osseous walls left surrounding the tooth

16

The two most critical parameters for the prognosis of a periodontally involved tooth are ?

• mobility
• attachment loss (which is most critical)

17

Suprabony pockets are associated with ? loss. They are not interaosseous.

horizontal bone

18

The principal differences between intrabony and suprabony pockets are the relationship of the soft tissue wall of the pocket to the alveolar bone, the pattern of bone destruction, and the direction of the transseptal fibers of the periodontal ligament.
In intrabony pockets, the base of the pocket is apical to the crest of the alveolar bone, and the pocket wall lies between the tooth and the bone.
• both statements are true
• both statements are false
• the first statement is true, the second is false
• the first statement is false, the second is true

both statements are true

19

Which type of pocket is formed by gingival enlargement without destruction of the underlying periodontal tissues?
• gingival pocket
• periodontal pocket
• suprabony pocket
• intrabony pocket

gingival pocket

20

Furcation involvements:
• Grade I:
• Grade II:
• Grade III:
• Grade IV:

• Grade I: is incipient bone loss
• Grade II: is partial bone loss (cul-de-sac)
• Grade III: is total bone loss with through-and-through opening of the furcation
• Grade IV: is similar to Grade III, but with gingival recession exposing the furcation to view

21

In intrabony pockets:
• the bone loss is vertical in nature
• the bone loss is horizontal in nature
• transseptal fibers are horizontal
• supracrestal fibers follow the normal bone contour

the bone loss is vertical in nature

22

Bone grafts effectiveness in treating furcations?

have relatively little

23

? is used to treat Grade II furcations with good success

guided tissue regeneration

24

which tooth has the poorest prognosis following furcation involvement therapy?

maxillary second molars

25

Drug-induced gingival enlargement consists of a pronounced hyperplasia of the connective tissue and epithelium.
Drug-induced gingival enlargement may occur in mouths with little or no plaque and may be absent in mouths with abundant deposits.
• both statements are true
• both statements are false
• the first statement is true, the second is false
• the first statement is false, the second is true

both statements are true

26

When using the periodontal probe to measure pocket depth, the measurement is taken from the:
• base of the pocket to the CEJ
• free gingival margin to the CEJ
• junctional epithelium to the margin of the free gingiva
• base of the pocket to the mucogingival junction

junctional epithelium to the margin of the free gingiva

27

the most reliable indicator of the presence of gingival or periodontal inflammation?

bleeding

28

How should a periodontal probe be adapted in an interproximal area?
• it should be parallel to the long axis of the tooth at the point angle
• it should be parallel to the long axis of the tooth at the contact area
• it should touch the contact area and the tip should angle slightly beneath and beyond the contact area
• it should be perpendicular to the long axis of the tooth in front of the contact area

it should touch the contact area and the tip should angle slightly (approximately 10°) beneath and beyond the contact area

29

How should the periodontal probe be inserted into the sulcus?
• perpendicular to the long axis of the tooth
• with a firm pushing motion
• with a short oblique stroke
• parallel to the tooth surface

parallel to the tooth surface (with firm, gentle pressure)

30

The clinical probing depth is always shorter/greater ? than the histologic sulcus or pocket depth. Probing accuracy is only within +/- 1 mm

greater

31

Furcation areas can be best evaluated with ?

the curved #2 Nabers probe

32

The tip of the probe should always be kept in contact with ?, thus preventing soft tissue injury

the tooth not the gingiva

33

If you should meet resistance after inserting the periodontal probe into the sulcus, you should:
• remove the probe and reinsert it in a different spot
• lift the probe away from the tooth and attempt to move it apically
• force the probe beyond the obstruction
• remove the probe and select one with a narrower diameter
• record the measurement where the probe stopped

lift the probe away from the tooth and attempt to move it apically (This is usually calculus. Gently lift the probe away from the tooth, placing it against the tissue wall of the pocket and attempt to proceed apically again)

34

Which of the following is the most common error when performing periodontal probing?
• using the wrong type of probe
• incorrectly reading the periodontal probe
• excessively angling the probe when inserting it interproximally beyond the long axis of the tooth
• forgetting to also probe the lingual of every tooth

excessively angling the probe when inserting it interproximally beyond the long axis of the tooth (This will give greater probe readings than are actually present)

35

If a patient is at risk for subacute bacterial endocarditis, does he or she needs to be premedicated before performing periodontal probing?

yes

36

The most accepted theory to the cause of root sensitivity is the:
• quantum theory
• hydrodynamic theory
• chemiosmotic theory
• bayer's theory

hydrodynamic theory (indirect innervation caused by dentinal fluid movement in the tubules, which stimulates mechanoreceptors in the pulp)

37

To reduce the sensitivity to thermal change after removal of a periodontal dressing, it is best to ?

keep the roots free of plaque

38

Toothbrush trauma (abrasion) usually occurs on:
• centrals and laterals
• canines and premolars
• second and third molars
• first and second molars

canines and premolars (that are the most prominent in the dental arch)

39

Hard tissue damage from oral hygiene procedures is mainly due to ?, whereas gingival lesions can be produced by ?

• abrasive dentifrices
• the toothbrush alone

40

Gingival clefts?

narrow grooves that extend from the crest of the gingiva to the attached gingiva

41

Trauma from toothbrushing may result in the following?

• Recession of the marginal gingiva
• Lacerations of the soft tissues including the attached gingiva and the alveolar mucosa
• V-shaped notches in the cervical areas of teeth
• Gingival clefts

42

The most important factor in the control of hypersensitive roots among patients with periodontal disease after gingival recession has exposed the cervical portions of teeth is:
• prescription of home fluoride rinses
• minimal removal of tooth structure during root planing
• the application of desensitizing agents that contain fluoride
• thorough daily plaque control

thorough daily plaque removal (using a soft brush (this will help desensitize the root surface by allowing remineralization of the root surface)

43

The most common cause of gingival recession is ?

abrasion (tooth injury). This type of recession is common on the left canines of right-handed persons (or right canines of left-handed persons).

44

When extensive scaling and root planing must be performed, the best approach would be:
• a series of appointments set up to scale and root plane a segment or quadrant of teeth at a time (thoroughly and completely)
• gross debridement (sub-and supragingival) of the entire mouth, followed by a series of appointments for fine scaling and polishing
• perform everything in a single appointment
• none of the above

a series of appointments set up to scale and root plane a segment or quadrant of teeth at a time (thoroughly and completely)

45

There is potential for ? in a deep pocket when only a superficial scaling is performed

abscess formation

46

Clinical evaluation of the soft tissue response to scaling and root planing, including probing, should not be conducted earlier than ? weeks postoperatively

2 weeks (Until then, gingival bleeding on probing can be expected, even when calculus has been completely removed)

47

In root planing, ideally, the working stroke should begin at ?

the apical edge of the junctional epithelium (the base of the pocket)

48

Which of the following presents the most difficulty in performing a thorough scaling and root planing?
• mesial surfaces of maxillary premolars
• proximal surfaces of mandibular incisors
• trifurations of maxillary molars
• distal surfaces of mandibular molars

trifurations of maxillary molars (Mesial surfaces of maxillary premolars and the proximal surfaces of mandibular incisors are most likely to have flutings)

49

Some degree of curettage is done unintentionally when scaling and root planing are performed; this is called inadvertent curettage.
Curettage accomplishes the removal of the chronically inflamed granulation tissue that forms in the lateral wall of the periodontal pocket.
• both statements are true
• both statements are false
• the first statement is true, the second is false
• the first statement is false, the second is true

both statements are true

50

The best criterion to evaluate the success of scaling and root planing is ?

no evidence of bleeding on probing

51

? are removed during root planing.

Cementum, dentin, and calculus

52

? refers to the ability to distinguish degrees of roughness and smoothness on the tooth surface

Tactile sensitivity

53

? is also frequently performed on recall visits as a method of maintenance treatment for areas of recurrent inflammation and pocket depth.

Curettage (Curettage does not eliminate the causes of inflammation. Therefore, curettage should always be preceded by scaling and root planing)

54

The main objective of root planing is:
• to remove chronically inflamed tissues
• to change the bacterial microflora
• to remove etiologic agents from the root surface
• to eliminate pockets

to remove etiologic agents from the root surface (main objective of root planing and scaling)

55

Maximum shrinkage after gingival curettage can be expected from tissue that is:
• fibrotic
• edematous
• fibroedematous
• formed within an intrabony pocket

edematous (better than fibrous hyperplasia)

56

• Gracey #1-4
• Gracey #5-6
• Gracey #7-10
• Gracey #11-12
• Gracey #13-14

• Gracey #1-4: anterior teeth
• Gracey #5-6: anterior teeth and premolars
• Gracey #7-10: posterior teeth: facial and lingual surfaces
• Gracey #11-12: posterior teeth: mesial surface
• Gracey #13-14:posterior teeth: distal surface

57

Gracey curvettes are ?

mini-bladed curettes with a more curved blade

58

Ultrasonic instrumentation is accomplished with a:
• heavy touch and light pressure, keeping the tip perpendicular to the tooth surface and constantly in motion
• light touch and heavy pressure, keeping the tip parallel to the tooth surface and stationary
• light touch and light pressure, keeping the tip parallel to the tooth surface and constantly in motion
• heavy touch and heavy pressure, keeping the tip perpendicular to the tooth surface and stationary

light touch and light pressure, keeping the tip parallel to the tooth surface and constantly in motion

59

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?
• curette
• sickle scaler
• hoe
• file

curette

60

Subgingival root surface roughness does not seem to interfere with healing after scaling and root planing. Thus, it does not appear useful to ? after a clinically detectable smooth surface has been created with sonic or ultrasonic scaler

reinstrument root surfaces with hand instruments

61

• the lower shank of a Gracey curette is ?
• The lower shank of a universal curette would be ?

• parallel to the tooth surface being scaled
• tilted slightly toward the tooth

62

In magnetostrictive ultrasonic units the pattern of vibration of the tip is linear.
In piezoelectric ultrasonic units the pattern of vibration of the tip is elliptical.
• both statements are true
• both statements are false
• the first statement is true, the second is false
• the first statement is false, the second is true

both statements are false (The opposite of these)

63

Contraindications to the use of air-powered polishing devices are those patients with ?

respiratory illnesses, hemodialysis, hypertension, and infectious diseases

64

If a patient experiences sensitivity while being scaled with an ultrasonic scaling device, all of the following actions will be appropriate to counter this problem EXCEPT two. Which two are inappropriate?
• proceeding to another tooth and then returning to the sensitive tooth later in the appointment
• moving the instrument slower
• making necessary adjustments to the water spray
• turning up the power of the device
• using less pressure

• moving the instrument slower
• turning up the power of the device
(The opposite of these is true) (increase water flow to cool the tip)

65

Air is used to deflect the free gingival margin to detect:
• the CEJ
• smooth root surfaces
• subgingival calculus
• inflammation

subgingival calculus (saliva often conceals it)

66

The primary function of which instrument is to fracture or crush large deposits of tenacious calculus?
• hoe scalers
• files
• chisel scalers
• quetin furcation curettes

files

67

While scaling subgingivally, the tip of the curette breaks off. All of the following are appropriate actions to take to try and remove this tip EXCEPT one. Which one is the EXCEPTION!
• use a push stroke to force the tip out of the sulcus
• gently examine the gingival sulcus
• take a periapical radiograph of the area
• place the patient in an upright position

use a push stroke to force the tip out of the sulcus

68

It is impossible to carry out peridontal procedures efficiently with dull instruments.
A sharp instrument cuts more precisely and quickly than a dull instrument.
• both statements are true
• both statements are false
• the first statement is true, the second is false
• the first statement is false, the second is true

both statements are true

69

When sharpening, a wire edge is produced:
• only when using a coarse artificial stone
• when using a mounted ruby stone only
• when no oil is used for lubrication of the stone
• when the last stroke of the stone is drawn away from the cutting edge

when the last stroke of the stone is drawn away from the cutting edge

70

A curette designed to scale and root plane anterior will have a:
• short, straight shank
• long, straight shank
• short, angled shank
• long, angled shank

long, straight shank (contra angled shanks for the posterior)

71

The optimal internal angle between the face and the lateral surface of a universal curette and a Gracey curette is ? angle

70° to 80° (An instrument whose cutting edge is 90° or more will slip over calculus deposits and requires heavy lateral pressure to remove calculus deposits)

72

? are used selectively on line angles or negotiated with other strokes.
• vertical strokes
• oblique strokes
• horizontal strokes
• circular strokes

horizontal strokes

73

For subgingival insertion of a bladed instrument such as a curette, angulation should be as close to ? degree as possible. During scaling and root planing, optimal angulation is ? degrees

• 0 degree
• between 45 and 90