Mosby's Review Chapter 14: Periodontics
25. Which of the following conditions can cause periodontitis as a manifestation of systemic disease? (Select all that apply.) a. Diabetes mellitus b. Chédiak-Higashi syndrome c. Papillion-Lefèvre syndrome d. Cardiovascular disease e. Leukemia
A and D. Diabetes mellitus, especially if poorly controlled, is a risk factor for periodontitis; the condition is associated with gingivitis because diabetes can impair host response. Bacterial plaque biofilm toxins invoke an immune response that also can contribute to tissue destruction. Diabetes mellitus does not, however, cause periodontitis. Cardiovascular disease has been associated with periodontal disease as a potential risk factor, but it does not cause periodontal disease. The classification of periodontal disease—that is, periodontitis as a manifestation of systemic disease—includes rare conditions that actually cause periodontal destruction.
22. Which of the following tissue consist(s) nonkeratinized epithelium? (Select all that apply.) a. Crevicular epithelium b. Attached gingiva c. Interdental papilla d. Junctional epithelium e. Marginal gingiva
A and D. The crevicular and junctional epithelium are comprised of nonkeratinized squamous cell epithelium.
19. Which radiographic findings will MOST LIKELY be seen in dental plaque-induced gingivitis? (Select all that apply.) a. A thin periodontal ligament space b. Slight changes in the lamina dura c. Condensing osteitis d. Normal lamina dura and crestal bone e. Slight fuzziness at the alveolar crest
A and D. The lamina dura and crestal bone and a thin periodontal ligament space will most likely appear normal in gingivitis. The periodontium appears normal on a radiograph in plaque-induced gingivitis because changes within the periodontium in cases of gingivitis most commonly are confined to the soft tissue, and soft-tissue changes are not visible radiographically.
18. Which of the following conditions can be determined by radiographic examination? (Select all that apply.) a. Extent and severity of bone loss b. Height of crestal bone c. Widening of the periodontal ligament space d. Presence of pseudopockets e. Presence of dental calculus on lingual surfaces
A, B, and C. Although radiographs tend to underestimate actual bone loss, they are used to estimate the extent and severity of alveolar bone loss in relation to the CEJ and root length, particularly on the interproximal surfaces. The height of crestal bone is seen radiographically, whereas buccal and lingual bone is often obscured by teeth. The periodontal ligament space normally is a thin radiolucent line surrounding the root of the tooth; widening of the ligament can be seen radiographically as a wider radiolucent area adjacent to one or more tooth surfaces.
36. Which of the following are necessary for new attachment after periodontal surgery? (Select all that apply.) a. Thorough removal of bacterial irritants b. Immobilization of mobile teeth c. Shrinkage of the gingival margin d. Regeneration or generation of new tissues or parts e. Rapid apical growth of epithelium
A, B, and D. Thorough removal of bacterial irritants is necessary in periodontal therapy to arrest inflammation and allow tissues to heal. Splinting or otherwise immobilizing mobile teeth fosters stabilization and healing following periodontal surgery. Regeneration of new tissues and parts in the formation of a new attachment following periodontal surgery, which requires an adequate number of formative cells, including fibroblasts, cementoblasts, and osteoblasts, is essential.
30. Which of the following are possible causes of gingival recession? (Select all that apply.) a. Faulty toothbrushing b. Bacterial plaque biofilm c. Tissue response to medication d. Dental caries e. Periodontal disease
A, B, and E. Overzealous or improper toothbrushing, irritants produced by bacterial plaque biofilm, and periodontal disease can all cause of gingival recession.
44. Which factors determine the severity of chronic periodontitis? (Select all that apply.) a. Extent of attachment loss b. Immune response c. Hormonal changes d. Vitamin C deficiency e. Frequency of periodontal maintenance therapy
A, B, and E. The extent of attachment loss defines the severity of the disease. Slight loss is defined as 10% to 15% of the root length; moderate loss is 20% to 30%; advance or severe is greater than 30%. The patient's immune response affects how slowly or rapidly tissue is destroyed in relation to the bacterial irritants produced by bacterial plaque and production of related inflammatory mediators. Frequency of maintenance procedures is directly related to progression of the disease as frequent care is required to maintain health after successful periodontal therapy.
29. Which condition should be suspected when a radiolucent area on a radiograph occurs lateral to the root of a tooth with a 7-mm probing depth? a. Periodontal abscess b. Pyogenic granuloma c. Occlusal traumatism d. Periapical abscess e. Mucogingival problem
A. A periodontal abscess is an acute exacerbation of a chronic infection within the periodontal ligament; therefore, it most frequently occurs lateral to the tooth; it also appears as a radiolucent area because its contents are less dense than the adjacent alveolar bone and root (i.e., exudate and granulation tissue).
32. At a reevaluation appointment with a client 4 weeks after completion of nonsurgical periodontal therapy, the hygienist notes localized gingival inflammation and bleeding in the proximal surfaces of the molars. Periodontal probing depths of 5 mm remain unchanged, corresponding to the localized inflammation, but are reduced to 2 to 4 mm in most areas. Plaque control is acceptable. What is the MOST probable explanation for these findings? a. Residual dental calculus deposits are present. b. Plaque removal was absent for the past 24 hours. c. Systemic disease influencing host response is present. d. Plaque removal was enhanced immediately before the appointment.
A. Because residual deposits prevent healing following nonsurgical periodontal therapy, residual deposits are likely the reason for this localized inflammation. The patient's self-care is acceptable, so it is not likely associated with the areas that did not respond to treatment.
1. Recession is noted in the mandibular anterior region, and the attached gingiva measures 0.5 mm, requiring evaluation by a dentist or periodontist. If periodontal surgery is indicated, a mucogingival surgery would be performed to correct this condition. a. Both statements are TRUE. b. Both statements are FALSE. c. The first statement is TRUE; the second statement is FALSE. d. The first statement is FALSE; the second statement is TRUE.
A. Both statements are true, but the second statement is false. Gingival recession requires evaluation by a dentist or periodontist for possible need for surgical correction when inadequate attached gingiva or a mucogingival problem exists. Periodontal plastic surgery or mucogingival surgery would be required for this condition; a gingivectomy is indicated for removal or excision of excess tissue, for example, medication-induced gingival overgrowth.
17. Tooth mobility and fremitus can be signs of occlusal trauma because trauma can result in lateral resorption of bone. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.
A. Both the statement and the reason are correct and related. This is because both tooth mobility and fremitus, terms that refer to movement of the tooth within the socket, can signs of occlusal trauma. Mobility refers to movement when buccal-lingual lateral pressure or vertical pressure is applied to a single tooth that is not occluded, whereas fremitus refers to movement when teeth are occluded and moved in protrusive and lateral directions. Both are caused by excessive trauma causing destruction of ligament fibers, appearing as a widened space radiographically and lateral bone resorption. These clinical findings are not related to the apical migration of bone in occlusal trauma; the apical migration of bone and connective tissue, or attachment loss, is a hallmark of periodontitis.
39. A female patient, age 40 years, returns for periodontal maintenance therapy every 3 months for 1 year after nonsurgical periodontal treatment for chronic periodontitis. The inflammation has been resolved, and periodontal probing depths have decreased from 5 or 6 mm to 4 mm or less in most treated areas, with the exception of the distal surface of tooth #15, where the probing depth has increased from 4 to 6 mm. Radiographs reveal no change on tooth #15 distal. All the following explains this finding EXCEPT a. continuing clinical attachment loss. b. error in periodontal probing technique. c. calculus deposits affecting accuracy of initial reading. d. inaccessibility and poor visibility in pocket areas. e. increased inflammation of the gingival tissues.
A. Continuing attachment loss of 2 mm is unlikely in slowly progressive, chronic periodontitis; also, it would appear radiographically as a change in bone density, morphology, or height.
40. All the following factors could limit a recommendation for dental implants EXCEPT a. complete edentulism. b. tobacco habit. c. osteoporosis. d. head and neck radiation therapy.
A. Dental implants can be recommended to support an overdenture for replacement of missing teeth in complete edentulism.
35. All the following are substances produced by the host response to bacterial plaque biofilm EXCEPT a. lipopolysaccharide (LPS). b. matrix metalloproteinase (MMP). c. cytokines. d. interleukin-1 (IL-1). e. prostaglandin E2 (PGE2).
A. Lipopolysaccharides (LPSs) are endotoxins produced by plaque biofilm bacteria; they irritate the tissues and evoke a host response.
50. Occlusal trauma can result in all the following EXCEPT a. periodontal pockets. b. attrition of the tooth. c. temporomandibular joint discomfort. d. fractured teeth and restorations.
A. Occlusal trauma does not cause clinical attachment loss and bone loss which can cause periodontal pockets, although it can cause widened periodontal ligament and lateral bone resorption leading to fremitus and mobility.
34. Which of the following is an objective of periodontal reconstructive surgery? a. Improve the esthetics of the client's face. b. Create gingival contour and appearance acceptable to the client. c. Remove alveolar bone to improve contour and correct defects. d. Remove enlarged tissue to assist the client in daily plaque control. e. Promote regeneration of a new attachment.
A. Periodontal plastic and reconstructive surgery or mucogingival surgery would be indicated because of the need to restore keratinized, attached gingiva and cover the exposed root surfaces.
9. What change in alveolar bone on a dental radiograph indicates early loss of bone? a. Fuzziness in the crest of the bone b. Faint cup-shaped areas interproximally c. Vertical or angular defects d. Furcation involvement
A. The alveolar crest is the interproximal extension of the alveolar bone proper that outlines the tooth socket. The crest is seen as fuzzy or having reduced density in early alveolar bone loss.
16. Which of the following histologic changes in inflamed gingiva results in redness? a. Vasodilation within the gingival connective tissue b. Ulceration of the sulcular lining c. Lymphoid cell accumulation d. Collagenase destroying the lamina propria e. Alteration of fibroblasts in the connective tissue
A. Vasodilation that occurs within the connective tissue of the gingiva, or the lamina propria, as a result of inflammation can be clinically exhibited as redness or erythema.
23. Which of the following microbes is associated with necrotizing ulcerative gingivitis and periodontitis? a. Actinomyces viscosus b. Porphyromonas gingivalis c. Prevotella intermedia d. Treponema pallidum e. Capnocytophaga ochracea
C. Prevotella intermedia is a gram-negative anaerobe associated with necrotizing ulcerative gingivitis and periodontitis, as well as hormonal-associated gingivitis.
20. Oral examination findings for a 56-year-old woman with good general health status reports diabetes well controlled by medication and diet and taking hormonal therapy for symptoms of menopause. Clinical findings include localized 4- and 5-mm periodontal probing depths, with radiographic bone loss visible on teeth #3, #14, #19, #30, and #31; slight gingival inflammation in the mandibular anterior and molar regions; fair oral hygiene with generalized light deposits; and no active caries. On the basis of these findings, which of the following would be the MOST accurate preliminary diagnosis? a. Necrotizing ulcerative gingivitis b. Chronic periodontitis c. Dental plaque-induced gingivitis d. Localized aggressive periodontitis e. Hormone-associated gingivitis
B. Chronic periodontitis can occur at any age but most frequently occurs in adults; it commonly affects the posterior teeth in the early stages. Bacterial plaque and calculus deposits most commonly are commensurate with clinical findings.
45. How is clinical attachment loss measured with a periodontal probe? a. From the margin of the gingiva to the epithelial attachment b. From the cemento-enamel junction to the base of the pocket c. From the margin of the gingiva to the cemento-enamel junction d. From the cemento-enamel junction to the margin of the bone
B. Clinical attachment loss is measured from the cemento-enamel junction (CEJ) to the epithelial attachment at the base of the pocket because a normal connective tissue attachment approximates the CEJ, or is just subgingival to it, and the CEJ is a static reference point on the tooth.
33. Which of the following situations would be an indication for a gingivectomy? a. Edematous 5-mm pseudopocket b. Severe drug-influenced gingival enlargement c. Infrabony pocket of 6 mm on the distal aspect of tooth #30 d. Gingival recession that extends into the alveolar mucosa e. Periodontal abscess
B. Gingivectomy, gingivoplasty, or both are indicated to remove or recontour areas of enlarged, fibrotic tissues that are abnormal or unacceptable to the client, but the level of the epithelial attachment does not have to be repositioned.
6. In addition to professional dental hygiene care and proper oral hygiene measures, which of the following procedures or agents would address a client's chief concerns about "bad breath?" a. Selective stain removal b. Chlorine dioxide mouthrinse c. Tooth whitening d. Daily oral irrigation e. Daily fluoride mouthrinse
B. In addition to professional dental hygiene care and proper oral hygiene measures, chlorine dioxide mouthrinse would address the client's chief concern about oral malodor because it is effective in reducing volatile sulfur compounds that cause halitosis.
46. In which area of the mouth would the width of the attached gingiva be expected to be the narrowest? a. Mandibular anterior area b. Mandibular premolar areas c. Maxillary molar areas d. Lingual of the maxillary teeth
B. The width of the attached gingiva varies from 1.8 to 4.5 mm and is the narrowest in the premolar regions because of the frenal attachments found on the gingiva in this area.
28. Which of the following indicates that periodontitis is present rather than gingivitis? (Select all that apply.) a. Widened periodontal ligament space on radiographs b. Periodontal probing depth of 4 mm or greater c. Clinical attachment loss d. Apical migration of the alveolar bone e. Bleeding on probing
C and D. Gingivitis involves the gingiva and the soft tissue attachment of the gingiva to the tooth. Apical migration and loss of periodontal attachment, including connective tissue and bone, is the key characteristic of periodontitis, indicating progression from gingivitis to periodontitis.
41. Which of the following materials could be used in curettes for maintaining dental implants? (Select all that apply.) a. Stainless steel b. Carbon steel c. Plastic resin d. Titanium
C and D. Plastic resin and titanium are the most commonly used material for maintenance of dental implants because they cause less surface alteration in the titanium implant surface.
24. Which of the following types of drugs have been associated with fibrotic gingival overgrowth? (Select all that apply.) a. Oral contraceptives b. Antidepressants c. Calcium channel blockers d. Antihistamines e. Anticonvulsants
C and E. Certain calcium channel blockers, as well as some anticonvulsants and immunosuppressants, can cause fibrotic gingival enlargement because of the stimulation of fibrin in tissue.
14. Which one of the following bacteria are predominant in supragingival plaque biofilm associated with gingivitis? a. Chromogenic bacteria b. Gram-negative anaerobic bacteria c. Aerobic and facultative bacteria d. Gram-positive Streptococcus spp.
C. Aerobic and facultative bacteria predominate in supragingival plaque associated with gingivitis.
21. Which of the following antimicrobial and antigingivitis agent is the LEAST effective? a. Essential oils b. Chlorhexidine gluconate c. Chlorine dioxide d. Cetylpyridinium chloride e. Stannous fluoride
C. Chlorine dioxide is an effective antimicrobial; however, chlorhexidine gluconate is the most effective and substantive it is most effective in reducing halitosis rather than plaque biofilm and gingivitis.
8. Which of the following would be the BEST indicator of treatment success at the reevaluation appointment 4 to 6 weeks after initial periodontal therapy? a. Relatively free of plaque biofilm b. Stable periodontal probing depths c. Absence of gingival inflammation and bleeding d. No re-formed dental calculus deposits
C. Gingival condition would be the best indicator of treatment success or failure at the 1-month reevaluation appointment following initial periodontal therapy. This is because resolution of inflammation indicates adequate debridement and oral hygiene on the basis of this client's host response, and continued inflammation indicates the need for additional treatment.
43. Which of the following classifications of periodontal disease would be characterized by clinical attachment loss in the first molars and incisors in an adolescent patient with fair plaque control? a. Hormonal-influenced gingivitis b. Localized chronic periodontitis c. Localized aggressive periodontitis d. Necrotizing ulcerative periodontitis
C. Localized aggressive periodontitis is characterized by bilateral angular bone loss in the permanent first molars and incisors; the localized form also is most commonly associated with scanty plaque and calculus deposits; it most commonly occurs in individuals younger than 30 years, although it can occur at any age.
10. After thorough periodontal debridement is performed, which is the first inflammatory cell to respond to avoidable resultant irritation of the gingiva? a. B lymphocytes b. Plasma cells c. Neutrophils d. T lymphocytes e. Macrophages
C. Neutrophils or polymorphonuclear leukocytes, are the first inflammatory cells to respond to injury or irritation, or to virulent bacteria present in plaque biofilm.
7. Which of the following periodontal therapies would be BEST recommended for a patient who presents with probing depths of 3 to 5 mm, slight bone loss detected on the radiographs, and a history of infrequent dental hygiene care? a. Regenerative periodontal surgery b. Gingival curettage c. Nonsurgical periodontal therapy d. Oral prophylaxis e. Periodontal maintenance therapy
C. Nonsurgical periodontal therapy (NSPT) would be recommended for this case as an initial therapy because of the presence of chronic periodontitis, probing depths, inflammation, and deposits.
38. Periodontal dressings also minimize client discomfort. These dressings make the placement of sutures unnecessary in some cases. a. Both statements are TRUE. b. Both statements are FALSE. c. The first statement is TRUE; the second statement is FALSE. d. The first statement is FALSE; the second statement is TRUE.
C. The first statement is true and the second statement is false. Periodontal dressings are placed over the surgical area like an oral bandage to protect the wound and cover newly exposed root surfaces, thereby decreasing dentinal hypersensitivity and increasing client comfort. Sutures are placed for wound closure and their indication is not related to the placement of a periodontal dressing.
2. Smoking is a major risk factor for periodontal disease. Light, moderate, and heavy smokers are all at equal risk for more severe periodontal destruction than nonsmokers. a. Both statements are TRUE. b. Both statements are FALSE. c. The first statement is TRUE; the second statement is FALSE. d. The first statement is FALSE; the second statement is TRUE.
C. The first statement is true, and the second statement is false. Smoking is a major risk factor for periodontal disease because it affects the immune response to bacterial plaque biofilm. Heavy smokers have more severe periodontal destruction than light smokers.
4. Systemic antibiotics are recommended in treatment of aggressive periodontitis. Locally-delivered, sustained-released antibiotics should be considered in the care plan when generalized chronic periodontitis is present. a. Both statements are TRUE. b. Both statements are FALSE. c. The first statement is TRUE; the second statement is FALSE. d. The first statement is FALSE; the second statement is TRUE.
C. The first statement is true, and the second statement is false. Systemic antibiotics are recommended for initial treatment of aggressive periodontitis. Localized delivery of antibiotics is contraindicated for generalized inflammation and periodontal pockets, and systemic antibiotics are not recommended in the initial treatment of periodontitis.
51. At a reevaluation appointment following thorough periodontal debridement, what does generalized severe inflammation and bleeding in the presence of localized plaque biofilm indicate? a. A need for more frequent periodontal maintenance therapy b. Poor self-care to control plaque biofilm c. A possible undiagnosed systemic disease d. Residual calculus present
C. The generalized inflammation does not correspond to the plaque biofilm deposits present and is severe; therefore, an undiagnosed or untreated systemic disease is suspected. A referral for medical evaluation is indicated.
5. An oxygenating mouthrinse would be beneficial for a patient with halitosis because these mouthrinses are the most effective in reducing bacterial plaque biofilm. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.
C. The statement is correct, but the reason is not correct. An oxygenating mouthrinse is effective for reducing halitosis; however, the most effective antimicrobial rinse for reducing bacterial plaque biofilm and gingivitis is chlorhexidine.
26. Which of the following BEST describes the sulcular epithelium? a. Keratinized epithelium b. Basal cell epithelium c. Squamous cell epithelium d. Simple cuboidal epithelium e. Parakeratinized epithelium
C. The sulcular epithelium is a nonkeratinized, squamous cell epithelial tissue.
48. Which of the following changes would result in pocket reduction after periodontal debridement in an edematous pocket? (Select all that apply.) a. Reattachment b. New attachment c. Longer junctional epithelium d. Shrinkage of the gingival margin e. Downward growth of the junctional epithelium
C. and D. Regeneration—growth and differentiation of new cells and intercellular substances to form or re-form tissues or parts of the same type as the precursor is the primary means of healing following nonsurgical periodontal therapy, creating a longer junctional epithelium. Shrinkage of the gingival margin may also contribute to pocket reduction, especially when edematous tissue is present.
3. Which of the following devices would be MOST effective for plaque biofilm removal in the mandibular anterior region when recession has resulted in open embrasure spaces? a. Dental floss b. Dental tape c. Oral irrigation d. Interproximal brush
D. An interdental brush is an effective plaque-removal device for interproximal deposits. This device is particularly useful where recession and larger embrasure spaces exist.
52. What does bleeding on periodontal probing indicate? a. Loss of crestal bone b. An increase in gingival vasculature c. Fibrosis in the connective tissue d. Ulceration of crevicular epithelium e. Apical migration of junctional epithelium
D. Bleeding upon probing results when bacterial plaque byproducts cause micro-ulcerations in the crevicular lining of the sulcus of pocket.
37. All the following are advantages of controlled (sustained-release) drug delivery over systemic drug administration in periodontal therapy EXCEPT a. less concern about client adherence throughout indicated time frame. b. site-specific antimicrobial action in periodontal pocket. c. high concentration delivered to the site of infection. d. can be used when periodontal infection is generalized or severe.
D. Controlled (sustained-release) drug delivery is site specific, and application is limited to a specified number of sites, depending on the drug selected; therefore, systemic antibiotics are used for generalized conditions warranting antibiotic therapy.
31. All the following are risk factors associated with periodontal disease EXCEPT one. Which one is the exception? a. Genetics b. Immunosuppression c. Hormonal changes d. Frequent fermentable carbohydrates in diet e. Poor oral hygiene
D. Frequent fermentable carbohydrates in the diet increase the risk for dental caries, not periodontal disease.
13. In clients of periodontitis, what is the first area to be involved in bone resorption? a. Facial and lingual aspects of supporting bone b. Cribriform plate or lamina dura c. Cancellous portion of supporting bone d. Cortical plate of the interdental septum e. Bone surrounding the apical area of the tooth
D. Given the pathway of inflammation through the periodontal structures, the cortical plate of the interdental septum is the first bony area to be affected by periodontitis.
12. Which of the following diagnostic procedures is MOST accurate for determining severity of periodontal attachment loss? a. Full-mouth digital radiographic survey b. Microbial testing of plaque biofilm c. Detection of pathologic tooth mobility or furcations d. Periodontal probing of all sulcular areas e. Determining presence or absence of bleeding on probing
D. Periodontal probing is the most accurate method of assessing the severity of periodontitis because the periodontal probe is the only instrument that can assess the level of connective tissue attachment to the tooth in relation to the cemento-enamel junction (CEJ) on all surfaces of the tooth; extent of loss of attachment or clinical attachment loss is the key measure of disease severity.
11. Which of the following changes result in a false or pseudo periodontal pocket? a. Apical migration of the junctional epithelium b. Apical migration of the gingival margin c. Resorption of the alveolar bone d. Swelling of the gingival margin without bone loss
D. Swelling of the gingival margin without bone loss results in a pseudopocket; true periodontal pockets are characterized by apical migration of the junctional epithelium, destruction of the connective tissue attachment, and bone loss.
49. Occlusal trauma causes clinical attachment loss and bone loss in patients with gingivitis. Occlusal trauma can contribute to attachment loss and bone loss surrounding teeth affected by periodontitis. a. Both statements are TRUE. b. Both statements are FALSE. c. The first statement is TRUE; the second statement is FALSE. d. The first statement is FALSE; the second statement is TRUE.
D. The first statement is false, and the second statement is true. Occlusal trauma does not cause clinical attachment loss and bone loss in patients with gingivitis, although it can cause widened periodontal ligament and lateral bone resorption, leading to fremitus and mobility. Occlusal trauma can contribute to attachment loss and bone loss surrounding teeth affected by periodontitis because the attachment is weakened and the excessive force causes mobility of the tooth in the socket.
47. Where is the lamina propria located in the periodontium? a. In the periodontal ligament b. In the alveolar bone c. At the cemento-enamel junction d. In the gingival mucosa
D. The lamina propria is located in the gingival mucosa beneath the epithelium. It is the connective tissue of the gingiva.
42. Which of the following findings would indicate a failed dental implant? a. Peri-implant inflammation b. Bleeding on provocation c. Alveolar bone loss d. Loosening of the prosthetic crown e. Mobility
E. An implant becomes mobile when excessive occlusal stress or bone loss has occurred; therefore, mobility can be a sign of failure; implants have no periodontal ligament and are ankylosed in bone allowing no mobility.
27. Which type of periodontal disease is characterized by gray, sloughing tissue, pain, and spontaneous bleeding with rapid connective tissue loss and exposed alveolar bone? a. Pericoronitis b. Periodontal abscess c. Necrotizing ulcerative gingivitis d. Aggressive periodontitis e. Necrotizing ulcerative periodontitis
E. Necrotizing ulcerative periodontitis (NUP) is characterized by gray, sloughing tissue exposed bone, pain, and spontaneous bleeding. The connective tissue destruction is so rapid that the gingiva is destroyed before apical migration of the bone, causing the bone to be exposed.
15. Which of the following types of cells are responsible for resorption of cementum and bone in periodontal destruction? a. Cementoblasts b. Fibroblasts c. Osteoblasts d. Cementoclasts e. Osteoclasts
E. Osteoclasts are primarily responsible for resorption of bone and cementum; cementoblasts are present but are few in number.