Perio Chapters Review

What is supragingival calculus derived from?

saliva (ch 5, pg 74)

What is perhaps the most significant dentally related local factor strongly associated with an increased probability of developing periodontal disease?

the presence of established periodontal disease in sites already or previously affected by periodontitis (ch 5, pg 73)

T or F: calculus can form in the absence of bacteria

true (ch 5, pg 73)

T or F: calculus is always covered by plaque

true (ch 5, pg 73)

T or F: calculus contributes to the accumulation of plaque by having a porous surface

true (ch 5, pg 74)

For each type of severity and extent of periodontitis, select the correct definition or description from the list provided. (ch 8) Chronic Perio: 1. localized chronic perio 2. generalized chronic perio 3. mild chronic perio 4. moderate chronic perio 5. severe chronic perio Description: a. >(greater than) 30% of sites are affected b. 1 to 2 mm of clinical attachment loss c. < (less than) or equal to 30% of sites are affected d. 3 to 4 mm oc clinical attachment loss e. >(less than) 5 mm of clinical attachment loss

1. C 2. A 3. B 4. D 5. E

For each type of pocket listed, select the correct definition from the list provided. (ch 8) 1. gingival 2. suprabony 3. infrabony a. base of pocket located apical to the alveolar crest b. base of pocket located coronal to the alveolar crest c. marginal gingival enlargement with base of pocket at CEJ

1. C 2. B 3. A

Order the stages of pathogenesis of periodontitis. Match each letter with its proper sequence number. (ch 8) 1. 2. 3. 4. a. bone loss b. destruction of periodontal ligament fibers c. connective tissue attachment loss d. apical and lateral migration of the junctional (pocket) epithelium

1. C 2. D 3. A 4. B

For each feature listed, select the correct condition from the list provided... (ch 11) Feature: 1. apical radiolucency 2. trismus 3. dental caries 4. furcation defect 5. operculum 6. deep pocket 7. fluctuant Condition: a. periodontal abscess b. gingival abscess c. periapical abscess d. pericoronitis

1. C 2. D 3. C 4. A, C 5. D 6. A 7. A, B, C, D

CH 5 CASE STUDY: A 60 year old male is seen for the first time in the office as a new patient. The data is collected and first chart records of the dental and periodontal conditions are recorded. The dental records indicate gingival recession on the buccal of tooth #13, #14 and #15. There is a missing tooth for #19. There is mild interproximal subgingival calculus in the posterior regions and supragingival calculus on the lingual of #23, 24, 25 and 26. 1. Which factor is a contributory local factor for biofilm retention? a. pocketing of 4mm + b. restorations on #14 and #15 c. supra and subgingival calculus d. age 60 years old 2. What impact does the missing #19 have as a contributory factor? a. food impaction site to retain more plaque b. possible occlusal trauma for rotated #18 c. open contacts harder to cleanse d. all of the above 3. Supra and subgingival calculus removal has what effect on periodontal disease? a. removes the causal factor b. smooth tooth surface is less biofilm retentive c. removal opens more areas for recession d. periodontal fibers will regenerate

1. C, supra and subgingival calculus 2. D, all of the above 3. B, smooth tooth surface is less biofilm retentive

Order the development of periodontitis as it occurs. Match each letter with its proper sequence number. (ch 8) 1. healthy gingiva a. destruction of PDL filbers 2. initial lesion b. apical and lateral migration of the JE 3. established lesion c. destruction of gingival fibers 4. advanced lesion d. bone resorption e. formation of the periodontal pocket f. PMNs present g. plasma cell predominate

1. F 2. C, F 3. C, F 4. A, B, D, E, G

From the following list, select the items associated with treatment of pericoronitis (ch 11) a. irrigation b. extraction of 3rd molar c. removal of operculum d. placement of arestin e. systemic antibiotics if lymphadenopathy is present

A, B, C and E

From the following list, select the items associated with formation of a periodontal abscess... (ch 11) a. pre-existing untreated advanced periodontitis b. from an endodontic infection where there are lateral canines c. deep pocket associated with furcation involvement d. inadequate or partial periodontal debridement e. patients with diabetes mellitus

A, B, C, D and E

From the following list select the items associated with NUG. (ch 9) a. pain b. bleeding c. papillary necrosis d. fever e. emotional distress f. prevotella intermedia g. porphyromonas gingivalis h. spirochetes

A, B, C, E, F, H

From the following list, select the items that have been a proven cause-and-effect relationship with periodontitis. (ch 6) a. obesity b. diabetes c. pre-term low birth weight babies d. cardiovascular disease e. chronic kidney disease f. alcoholic liver cirrhosis

a & b

Necrotizing ulcerative gingivitis may be the first clinical sign of an underlying systemic disease such as ... (ch 9) a. HIV b. diabetes c. osteoporosis d. kidney failure

a. HIV

From the following list, select the bacteria associated with a periodontal abscess... (ch 11) a. Porphyromonas gingivalis b. Prevotella intermedia c. fusobacterium nucleatum d. staphylococcus aureus

a. Porphyromonas gingivalis b. Prevotella intermedia c. fusobacterium nucleatum

Which of the following bacterium present in NUG patients may penetrate periodontal tissues? (ch 9) a. Treponema denticola b. Prevotella intermedia c. Fusobacterium species d. Streptococcus sanguis

a. Treponema denticola

The latest classification of periodontitis is based on all of the following factors except one. Which is the exception? (ch 8) a. age of patient b. clinical presentation c. radiographic survey d. historical data e. microbial profile

a. age of patient

The hormonal changes associated with pregnancy cause an increased incidence of gingival disease because these changes are associated with an increase in sex hormone levels. (ch 6) 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 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

Which one of the following periodontal diseases is described by having inflammation of the gingiva without loss of clinical connective tissue attachment? (ch 7) a. dental plaque induced gingivitis b. chronic periodontitis c. aggressive periodontitis d. refractory periodontitis e. necrotizing ulcerative gingivitis

a. dental plaque induced gingivitis

Which of the following features occurs first after 2 to 4 days of plaque accumulation? (ch 7) a. dilation of blood vessels in the lamina propria b. destruction of connective tissue by collagenase c. influx of plasma cells d. phagocytosis of bacteria by macrophages

a. dilation of blood vessels in the lamina propria

Which of the following conditions is a concern in immunosuppressed necrotizing ulcerative disease patients? (ch 9) a. fungal infection b. heart problems c. stunting of growth d. protozoa infection

a. fungal infection

Which of the following treatments is used for a patient with a gingival abscess? (ch 11) a. identify and remove the cause b. use of systemic antibiotics c. use of systemic analgesic d. placement of controlled-drug antimicrobial such as arestin

a. identify and remove cause

Which periodontal lesion, according to the classification of Page and Schroeder, is characterized by chronic gingival inflammation and the initial presence of PMN's? (ch 7) a. initial b. early c. established d. advanced

a. initial

Which one of the following reasons makes calculus an important local etiologic factor for periodontal diseases? (ch. 5) a. it is porous and can provide a reservoir for bacteria b. it directly irritates the epithelial lining of the pocket c. minerals cause breakdown in the epithelial attachment d. the presence of lipoogliosaccharides causes the tissues to erode

a. it is porous and can provide a reservoir for bacteria

From the following list, select the items associated with a gingival abscess. (ch 11) a. popcorn kernel b. deep periodontal pocket c. partially erupted 3rd molar d. firm, pink gingiva e. treat by debridement f. treat with antibiotics

a. popcorn kernel and e. treat by debridement

Today most oral contraceptives do not cause gingival inflammation because of the lower levels of hormones used. (ch 7) a. statement and reason are correct b. statements and reason are false c. statement is true but reason is false d. statement is false but reason is true

a. statement and reason are correct

A periodontal pocket forms when...? (ch 8) a. the junctional epithelium migrates apically and laterally from the tooth surface b. gingival fibers proliferate c. bacteria multiply in the pocket d. alveolar bone loss occurs

a. the junctional epithelium migrates apically and laterally from the tooth surface

Which one of the following bacteria is found in high numbers in pregnancy gingivitis? (ch 7) a. Porphyromonas gingivalis b. Prevotella intermedia c. Actinomyces viscous d. Aggregatibacter actinomycetemcomitans e. Streptococcus sanguis

b. Prevotella intermedia

Which one of the following sources accounts for the mineralization of subgingival calculus? (ch. 5) a. salivary proteins b. crevicular fluid c. dental plaque d. acquired pellicle

b. crevicular fluid

Which of the following lesions does clinical inflammation first appear? (ch 7) a. initial b. early c. established d. advanced

b. early

A gingival abscess is localized to the... (ch 11) a. periapical area b. gingival margin c. periodontal pocket d. pericoronal area

b. gingival margin

Both necrotizing ulcerative gingivitis and necrotizing ulcerative periodontitis are currently categorized under the classification of... (ch 9) a. acute necrotizing disorders b. necrotizing ulcerative diseases c. chronic periodontitis d. aggressive periodontitis

b. necrotizing ulcerative diseases

Which one of the following concerns should the dental hygienist be aware of in patients taking bisphosphonates? (ch 6) a. diabetes b. osteonecrosis of the jaw c. stroke d. hypertension e. respiratory disease

b. osteonecrosis of the jaw

A prominent sign of NUG is... (ch 9) a. high fever b. punched-out interdental papillae c. gingival abscess formation d. alveolar bone loss

b. punched-out interdental papillae

The distinguishing feature between NUP and NUG is... (ch 9) a. amount of gingival bleeding b. recession and alveolar bone loss c. number of bacteria present in pocket d. intensity of pain

b. recession and alveolar bone loss

Which of the following statements about smoking and periodontal disease is true? (ch 6) a. smoking dramatically affects the oral microflora b. smoking cessation is beneficial to periodontal health c. past effects of smoking on the periodontium are usually reversible d. current smoker have a low level of tooth mobility e. smokeless tobacco does not increase the incidence of periodontal disease

b. smoking cessation is beneficial to periodontal health

Smoking affects the periodontium by which one of the following mechanisms? (ch 6) a. decreasing the number of melanocytes b. suppressing the immune system c. altering the metabolism of fibroblasts d. increasing the amount of fibrotic tissue e. decreasing the number of periodontal pathogens

b. suppressing the immune system

From the following list, select the items associated with patient management of an acute periodontal abscess without lymphadenopathy. (ch 11) a. local delivered antibiotics b. supragingival scaling c. incision and drainage d. leave alone until it becomes chronic e. systemic antibiotics

b. supragingival scaling and c. incision and drainage

Which one of the following shows evidence exists to support the concept of a genetic predisposition to periodontal disease? (ch 6) a. presence of a specific type of bacteria b. increased levels of bacterial enzymes in the blood c. association of periodontitis with certain transmitted traits d. transmission of bacteria through saliva from mother to child

c. association of periodontitis with certain transmitted traits

From the following list, select the items associated with gingivitis. (ch 7) a. occurs primarily in children b. extensive attachment loss c. bone loss does not occur d. primary risk factors include pathogenic bacteria and calculus e. mild to moderate attachment loss f. risk factors include poor oral hygiene and endocrine conditions

c. bone loss does not occur AND f. risk factors include poor oral hygiene and endocrine conditions

All of the following anatomic factors may predispose a site to periodontal disease except one. Which one is the exception? (ch. 5) a. tooth position b. furcation area c. crown surface d. root surface

c. crown surface

Which periodontal lesion, according to the classification of Page and Schroeder, is characterized by chronic gingival inflammation and the presence of plasma cells? (ch 7) a. initial b. early c. established d. advanced

c. established

All of the following medications are contributing risk factors in causing gingival enlargement except one. Which one is the exception? (ch 7) a. phenytoin b. cyclosporine c. ibuprofen d. nifedipine e. valproate

c. iburpofen

Which of the following is occurring when a pocket entrance is "opened" with a probe or curet on a tooth with an acute periodontal abscess? (ch 11) a. transformation of the epithelium into connective tissue b. conversion of the acute abscess into a gingival abscess c. incision and drainage d. laceration of the fistula tract

c. incision and drainage

Which one of the following mechanisms explains how increased stress adversely affects the periodontium? (ch 6) a. increases in subgingival pathogenic b. increases in estrogen levels results in gingivitis c. less compliance with home care of teeth and gums d. shifts in the concentration of available endotoxins

c. less compliance with home care of teeth and gums

Which of the following cells are inhibited when a patient is taking a bisphosphonate for osteoporosis? (ch 6) a. fibroblast b. osteoblast c. osteoclast d. cementoblast e. odontoblast

c. osteoclast

Which one of the following statements describes a patient with necrotizing periodontal disease? (ch 9) a. higher prevalence in females than males b. higher incidence of skin lesions c. pain is a prominent feature d. geographic distribution shows a higher prevalence in the eastern US

c. pain is a prominent feature

On which of the following surfaces do palatogingival grooves usually appear? (ch. 5) a. lingual surfaces of mandibular lateral incisors b. lingual surfaces of mandibular central incisors c. palatal surfaces of maxillary lateral incisors d. palatal surfaces of maxillary central incisors e. palatal surfaces of maxillary canines

c. palatal surfaces of maxillary lateral incisors

Which of the following conditions describes a localized purulent infection within the tissues surrounding the crown of a partially erupted tooth? (ch 11) a. gingival abscess b. periodontal abscess c. pericoronal abscess d. periapical abscess

c. pericoronal abscess

During the disease process, the junctional epithelium turns into....? (ch 7) a. alveolar bone b. periodontal ligament c. pocket epithelium d. sulcular epithelium e. oral epithelium

c. pocket epithelium

What is considered the most important local contributing factor to developing periodontal disease?

calculus (ch 5, pg 73)

what is subgingival calculus derived from?

crevicular fluid and any inflammatory exudates (ch 5, pg 75)

Which one of the following bacteria is found in high numbers in localized aggressive periodontitis? (ch 8) a. Prophyromonas gingivalis b. Prevotella intermedia c. Actinomyces viscous d. Aggregatibacter actinomycetemcomitans (Aa) e. Streptococcus sanguis

d. Aggregatibacter actinomycetemcomitans (Aa)

Which of the following diseases must be differentiated from NUG? (ch 9) a. herpes simplex 2 b. primary herpetic gingivostomatitis c. canker sores d. acquired immunodeficiency syndrome

d. acquired immunodeficiency syndrome

Which periodontal lesion, according to Page and Schroeder, is characterized by attachment loss and bone resorption? (ch 8) a. initial b. early c. established d. advanced

d. advanced

All of the following factors are responsible for bone loss except one. Which is the exception? (ch 8) a. prostaglandins b. endotoxins c. B cells d. hyaluronidase

d. hyaluronidase

Which one of the following forms of periodontitis is associated with a chemotactic defect in the polymorphonuclear leukocytes or macrophages? (ch 8) a. dental plaque induced gingivitis b. chronic periodontitis c. puberty gingivitis d. localized aggressive periodontitis e. drug influenced gingivitis

d. localized aggressive periodontitis

Which one of the following reasons explains the finding of supragingival calculus on the linguals of the mandibular incisors? (ch. 5) a. difficulty in cleaning the area with a TB b. inability of efficient salivary flow to that area c. presence of the parotid duct d. presence of Warton's duct

d. presence of warton's duct

Radiographic evaluation of calculus is an effective diagnostic method

false, only about 45% of surfaces with clinically visible calculus are detected radiographically (ch 5, pg 74)