PERIO REVIEW

What is the name given to the alveolar bone when referring to a radiograph?

LAMINA DURA

During which growth phase is bacteria most susceptible to antibiotics?

LOG PHASE

Your four-month recall patient admits to not performing his daily oral hygiene lately because of a tight work schedule. Which of the following signs would tell you that this patient's periodontal disease has progressed?

LOSS OF ATTACHMENT

Which cell is responsible for "patrolling" the body?

LYMPHOCYTES

The FIRST radiographic sign of periodontal disease is

Lack of alveolar crest

What is the most significant fact about Sharpey's fibers?

They are those portions of the principal fibers that insert into the bone and cementum

Tooth #3 can have which of the following furcations?

mesial, buccal, and distal

Smoking has been determined to be a risk factor for periodontal disease. This means

smokers who develop periodontal disease are more likely to lose bone and have more severe disease

Protease is a bacterial product that contributes to which bacterial virulence characteristic?

tissue destruction

A patient should give written consent to continue dental treatment if the treatment extends beyond:

1 YEAR

Decreased estrogen can increase the rate of overall bone resorption by what percentage per year?

1%

Which of the following mg/dl is considered to be borderline hyperglycemia?

150- 240 mg/dl

In areas of undisturbed plaque, most mineralization occurs within_______

2 DAYS / 48 HOURS

A person is classified as having AIDS when their CD4 count is less than

200

Research evidence suggests that a proper interval for periodontal maintenance is

3 - 4 MONTHS

Which of the following osseous defects is ideal for a regenerative procedure?

3 WALL DEFECT

Which periodontal surgery is the most common procedure for reducing pocket depth?

Gingivectomy

Periodontal pocket depths up to what measurement are usually related to a normal, healthy gingival sulcus?

3MM

The margin of the free gingiva is 3 mm coronal to the CEJ. The probing depth is 6 mm. What is the clinical attachment level?

3MM

The patient's probing depth is 3 mm, and measurements from the free gingival margin to the mucogingival line are 7 mm. How much attached gingiva remains?

4MM

An oral irrigator can penetrate up to how many millimeters in the gingival sulcus?

6MM

In a dental implant, the titanium post that protrudes through the tissues into the mouth is termed

ABUTMENT

Which of the following conditions is NOT considered to be a periodontal emergency according to the AAP?

AGGRESSIVE PERIO

Which of the following agents delivers minocycline into a gingival pocket?

ARESTIN

Tissue destruction characterized by probing depths of 2-3 mm with recession of 3-4 mm is termed in most of the mouth is termed

Advanced chronic generalized periodontal disease

A bacterial infection of the periodontium characterized by rapid destruction of the periodontal ligament, RAPID loss of supporting bone, high risk for tooth loss, and poor response to periodontal therapy is classified as:

Aggressive periodontitis

What are some potential treatment problems for a patient with Leukemia?

All choices are correct

Which of the following surgical procedures involves the use of a barrier membrane?

GTR

What is a fiberous covered abnormal mass of fatty material located in the intima of an artery called?

Atheroma

Which assessment finding indicates that a patient's periodontal disease is progressing?

Attachment loss increasing over time

What is the most common means of calculus attachment to enamel?

Attachment to the pellicle

What is the primary etiology of periodontal diseases?

BACTERIAL PLAQUE

Gingival disease can manifest itself in many ways. The first sign of gingival disease is

BLEEDING

What is the best indicator to determine if the inflammatory processes is active?

BLEEDING / BOP

Malpositioned teeth, overhanging margins of restorations, and tooth morphology may cause increased accumulation of dental plaque in specific areas. This may contribute to the development of gingivitis.

BOTH ARE TRUE

Treatment plans should include all options given to the patient and all risks are explained to the patient orally and in writing. The patient signs the chart stating that he/she understands the treatment and risks

BOTH ARE TRUE

What is the hormone secreted by a adipocytes that can causes inflammation & endothelial dysfunction?

Resistin

Although bacteria initiate periodontitis, host-modifying risk factors influence the severity & extent of the disease.

Both parts of the statement are true

Although smoking is preventable and modifiable, it is still considered a systemic condition.

Both parts of the statement are true

Although bleeding on probing indicates periodontal involvement, bleeding may not be evident in smokers because of the effects smoking has on the microvascular system.

Both the statement and the reason are correct and related

Gingivitis and periodontitis share all characteristics EXCEPT one. Which one is the exception?

CAL

Which third of the tooth has a large proportion of acellular cementum?

CERVICAL 3RD

Malformations of heart structure existing at birth

CONGENTIAL HEART DISEASE

Disease of the blood vessels supplying the heart muscle

CORONARY HEART DISEASE

Mary Martha has class II and class V carious lesions on number 3. Her dentist recommends a crown to restore structure to the tooth. Which periodontal surgery should her doctor recommend before placing the crown?

CROWN LENGTHING

Disease of the blood vessels supplying the brain

Cerebrovascular Disease

As you are probing, your probe is stopped by a ledge of calculus. What action should you take?

Gently angle the probe around the calculus

Which antimicrobial mouth rinse is available by perscription in a 0.12% solution in the U.S.?

Chlorhexidine

Description of the gingiva uses all of the following categories EXCEPT:

Clarity

Blood clots in the leg veins, which can dislodge and move to the heart and lungs

DEEP VEIN THROMBOSIS & PULMONARY EMBOLISM

Which interdental aid is recommended for a patient with type I embrasure spaces throughout the mouth?

DENTAL FLOSS

What is the first defense in a legal malpractice suit?

DOCUMENTATION

Which cell is the connection between the natural immune response and the acquired immune response?

Dendritic cells

What is the most obvious result of vasodilation in gingival tissues?

EDEMA

What is the term given to abnormal accumulation of fluid in cells, tissues, or cavities of the body, resulting in swelling?

EDEMA

Which risk factor is associated with necrotizing ulcerative gingivitis?

EMOTIONAL STRESS

Which of the following is NOT a goal of nonsurgical periodontal therapy?

Eliminate the need for daily self-care

What are the primary hormones with the most fluctuation during puberty?

Estrogen and testosterone

Compliance is defined as the:

Extent to which a patient's behavior coincides with medical advice

A periodontal classification of a case type III always indicates that the disease process is active.

FALSE

Gingival modifications associated by medications eventually result in periodontal destruction.

FALSE

Healing by new attachment differs from healing by reattachment in that new attachment occurs in the absence of disease.

FALSE

Insulin-dependent diabetes is more prevalent than non-insulin-dependent diabetes.

FALSE

Periodontal emergencies are always related to a pre-existing periodontal disease.

FALSE

Stage 1 gingivitis has visible clinical signs? T/F

FALSE

Successful periodontal debridement always results in the complete removal of all cementum from a root surface exposed due to embedded calculus. T/F

FALSE

Systemic antibiotics are acceptable adjunct for mild to moderate gingivitis.

FALSE

The endodontic abscess originates in the periodontium, while the abscess of the periodontium originates from pulp of the tooth.

FALSE

The implant-to-connective tissue interface for a dental implant is the same as the connective tissues with a natural tooth.

FALSE

Tooth number three has the following probing pockets: DB 6 2 3 MB DL 5 2 3 ML Radiographically, #3 has a vertical boney defect on the distal aspect with a large piece of calculus deep within the defect. Because #3 has a deep pockets (CAL) and radiographic bone loss, the whole tooth is considered having periodontal disease.

FALSE

Because of plaque's pathogenicity and its ability to colonize easily in areas that are protected, irregular tooth morphology can be an initiator of the disease process.

FALSE -Local factors do not initiate the disease process. In this situation, it was the plaque's pathogenicity that initiated the disease process.

A window-like defect in the normal bone structure covering the surface of the root is called a dehiscence. The dehiscence is a significant structure in periodontal disease.

First statement is false; second statement is true.

The first radiographic evidence of periodontal destruction is:

Fuzziness of crestal bone

Subgingival calculus receives mineralization from:

GCF

Tooth #30 can be accessed on the facial surface into the furcation, but not on the lingual surface. What grade of furcation is this?

GRADE II

What is the etiologic factor for primary herpetic gingivostomatitis?

HERPES SIMPLEX TYPE 1

Which of the following is NOT a type of healing after periodontal surgery?

Healing by the use of dog saliva

What is the attachment mechanism for cells to adhere to a tooth?

Hemidesmosomes

Different substances involved in bone resorption include all except one:

Hyaluronidase is an enzyme that catalyzes the hydrolysis of hyaluronic acid, the 'cement material' of connective tissues; it is produced by various pathogenic bacteria, enabling them to spread through tissue

Which immunoglobulin is most likely to be found in saliva?

IGA

Which of the following is the most effective means for cleaning exposed root concavities?

INTERDENTAL BRUSH

Which of the following best describes an osseous defect that is apical to the junctional epithelium, and is usually found with vertical bone loss?

Infrabony defect

What is the most common malignancy in an AIDS patient?

Kaposi's Sarcoma

Leukemia is characterized by an abnormal increase in which type of blood cell?

Leukocytes/WBC

Which type of cell is a phagocyte?

MACROPHAGE

Which teeth are most commonly associated with pericornitis?

MD 3RD MOLARS

Which of the following leukocytes does AGEs bind to resulting in a hyper-immune state.

Monocytes and macrophages

Which of the following is a characteristic of the progression of periodontal disease?

Motile organisms

A patient has presented at the office with a chief complaint of bleeding gums and a fetid odor. Upon examination, you see gray necrotic gingiva with punched-out papillae. This patient most likely has

NUG

The acronym NUG stands for which of the following?

Necrotizing ulcerative gingivitis

Your patient presents with a "chief complaint" of stained teeth. On completion of the oral assessment you note generalized BOP, recession and slight bone loss. What is the FIRST treatment you would schedule for the patient?

OHI, thorough periodontal debridement to "prepare your teeth for bleaching."

Which osseous surgery involves removing bone?

Osteoectomy

Who should be involved in determining which devices and aids a patient uses for plaque control?

PATIENT, RDH, DDS

Which of the follow products is a gelatin chip that contains chlorhexidine?

PERIOCHIP

What are the predominate immune cells present in stage 3 gingivitis?

PLASMA CELLS

What is the main defense cell released in acute phase of inflammation?

PMNs

Which of the following is NOT a biomechanical factor in determining the prognosis of an implant?

PUPPIES

Porphyromonas gingivalis are:

Pathogenic bacillus bacteria that are prevalent in many chronic periodontal diseases

When considering a decision for referral to a specialist in periodontics which of the following types of patients should normally be referred?

Patients with severe aggressive periodontitis

Which bacteria has been shown to induce platelet aggregation and activation?

S. sanguis

The most common site for maxillary supragingival calculus is by which salivary duct?

STENSON'S DUCT

Which statement best defines periodontitis?

Periodontitis is an inflammation of the periodontium, which is characterized by apical migration of the junctional epithelium with associated loss of attachment and crestal alveolar bone

Disease of blood vessels supplying the arms and legs

Peripheral Artery Disease,

Thrombocytopenia is a deficiency of ________________

Platelets

Name ONE bacterial species commonly associated with chronic periodontitis.

Porphyromonas gingivalis, Treponema denticola, Prevotella intermedia, Streptococcus intermedius, Campylobacter rectus, Streptococcus sanguinis, Streptococcus oralis, Tannerella forsythenis, Fusobacterium nucleatum, Eubacterium

A pocket formed by gingival enlargement without apical migration of the junctional epithelium is referred to as a ______________.

Pseudopocket

Which dental implant monitoring method is MOST critical in determining healthy osseointegration?

RADIOGRAPHIC EVALUATION

Which of the following does B12 aids in the formation of?

RBC

The end point for periodontal debridement is which of the following?

RETURN SOFT TISSUE TO HEALTH

Damage to the heart muscle and heart valves caused by streptococcal bacteria

RHEUMATIC HEART DISEASE

Your periodontal three month maintenance recall patient has been stable for over a year, confirmed by no additional attachment loss over the generalized 2-3mm that resulted from the disease process and the subsequent NSPT. Besides the possibility of periodontal disease recurrence, what other oral disease condition to you have to constantly assess for?

ROOT CARIES

Which of the following treatments best removes endotoxins from the root surface?

ROOT DEBRIDEMENT

Peroxides, superoxides and hydroxyl radicals are examples of what type of free radicals that play a role in obesity as a multiple-risk-factor syndrome?

Reactive Oxygen Species

The primary goal of periodontal treatment today is

Reducing the biofilm burden to a level compatible with health

Which of the following conditions is associated with gingival health?

Small amounts of GCF

Which type of dentifrice fluoride is therapeutic for gingival inflammation?

Stannous fluoride

In which phase of bacterial growth is the number of newly formed cells equal to the number of dying cells?

Stationary

The most common type of bacterium on the dorsum of the tongue and other soft tissues in a healthy mouth is:

Streptococci

Which bacteria is NOT associated with periodontal disease that is exacerbated by smoking?

Streptococcus sanguis -Microbial species specifically associated with gingival health**

Which type of calculus is the anti-calculus agent pyrophosphates effective on?

Supragingival calculus

What is the name of the necrotizing periodontal disease given to WWI soldiers?

TRENCH MOUTH

Bacterial respiration may occur both anaerobically and aerobically.

TRUE

During treatment of a periodontal abscess, drainage of the pus is a critical step.

TRUE

Individuals with well-controlled diabetes have no more periodontal disease than persons without diabetes.

TRUE

One possible cause of the abscess of the periodontium is blockage of the orifice (or opening) of an existing periodontal pocket.

TRUE

Patient compliance is dependent on patient motivation.

TRUE

People with poorly controlled diabetes have a poorer response to treatment , more rapid reoccurrence of deep pockets, and less long term response to treatment.

TRUE

Periodontal pathogens can destroy bone much more rapidly along a dental implant than along a natural tooth.

TRUE

Smoking is a greater risk factor for inflammatory periodontal tissue destruction than obesity.

TRUE

Surgery is necessary when the periodontitis cannot be controlled with nonsurgical periodontal therapy alone.

TRUE

Visceral adipose tissue has been shown to be metabolically more active and to secrete far greater amounts of cytokines and hormones compared with subcutaneous adipose tissue.

TRUE

When normal occlusal forces exacerbate the damage to a previously damaged periodontium from periodontitis, secondary occlusal trauma has occurred.

TRUE

Within the continuous progression of periodontal disease, a patient can experience episodic bursts of rapid attachment loss.

TRUE

You (the student) are extremely happy to have a guest speaker so you do not have to hear Mz. Martin babble on and on incoherently for once (hint: true).

TRUE

Pregnancy does not cause gingivitis however, pregnancy can increase caries risk due to calcium resorption by the fetus.

The 1st part of the statement is true, the 2nd part is false

What is the source of nutrition for cementocytes?

The PDL space.

What is the primary risk indicator for the future of a child's oral health?

The mother's oral hygiene

Periodontal maintenance is a term that refers to treated periodontitis patients. The term is normally not appropriate to use for healthy patients but may be used for patients treated for various types of gingivitis.

The first statement is true and the second statement is false

Bleeding on probing is considered a clinical indication of active periodontal disease. Lack of bleeding on probing always means there is health in the periodontium.

The first statement is true, the second statement is false

The more root surface a tooth has, the more support is provided by the pdl. Therefore tooth #18 has more periodontal support than tooth #15.

The first statement is true, the second statement is false

Bleeding on probing is considered a clinical indication of active periodontal disease. Lack of bleeding on probing always means there is health in the periodontium.

The first statement is true, the second statement is false.

How is body mass index calculated?

The ratio of body weight in kg divided by the square of body height in meters

Which of the following is true in a patient with refractory periodontitis?

There can be a rapid loss of attachment even after intensive therapy

A positive Mantoux test is an example of what type of immune hypersensitivity reaction?

Type IV: Delayed

As a clinician, the best way to protect yourself from contracting HIV from a patient is through which of the following?

Universal precautions

Which of the following factors could explain why fibrotic tissue with attachment loss may not bleed?

Vasoconstriction due to scarring

What is the initial response of gingival tissue to the presence of microorganisms?

Vasodilation of blood vessels

Which type of cholesterol is MOST responsible for converting macrophages into lipid-laden foam cells?

Very low-density lipoprotein

What is the 2nd phase in wound healing?

WOUND CLEANSING

What are first periodontal fibers to be lost as a result of periodontal disease?

alveologingival

Matilda the Mouth Breather has porcelain-fused-to-metal crowns on all her maxillary anterior teeth. Upon clinical examination, you notice #s 6 and 7 have a 2mm gap between them. You also notice a large chunk of what you presume to be some kind of mystery meat. When you extract the said mystery meat, Matilda's tissue spontaneously bleeds quite heavily. Without thinking, you take a deep breath from your nose only to reveal an odor not of this planet confirming your suspicion that the piece of meat has been there at least 2 weeks. What is (are) the local contributing factors to Matilda's localized oral condition?

a. Food impaction b. Improperly contoured restorations c. Mouth breathing d. Inadequate oral home care E. ALL FACTORS contribute to Matilda's condition***

Which of the following structures is non-keratinized?

a. Interdental papilla b. Attached gingiva c. Hard palate d. Sulcular epithelium***

Clinical manifestations of smoking include which of the following?

a. Similar plaque index scores as non-smokers b. More calculus than non-smokers c. All the choices can be clinical manifestations of smokers*** d. Fibrotic tissue e. Increased melanin pigmentation

Which bacterial species is NOT associated with chronic periodontitis?

a. Streptococcus mutans - S. mutans bacteria are important in the intial caries lesion, not in periodontal disease

Nicotine can enter the bloodstream through:

a. The lungs b. Skin c. All choices are correct*** d. Mucous membrane