Assignment #4 1. Acutesdm.siue.edu/studentexams/applied/periodontics/dape... · Assignment #4 1....

1995-1997 Board Reviews

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DAPE 761–Periodontology Dr. Dwight E. McLeod November 19, 2004 Name ____________

Assignment #4

1. Acute (abscess anug)

1. A 15-year-old, who has necrotizing ulcerative gingivitis, has a history of no other gingival problems. For this patient, which of the following treatments is contraindicated?

A. Local Debridement B. Antibiotic Therapy *C. Topical Steroid Therapy D. Chemotherapeutic Oral Rinses 2. Which is the first treatment of choice for a patient with uncomplicated ANUG? A. Vigorous scaling plus curettage B. Systemic antibiotics C. Chlorhexidine rinses *D. Gentle debridement 3. A diagnosis of acute necrotizing ulcerative gingivitis is best made by which of the following? A. Exfoliative Cytology B. Biopsy of the Tissue C. Psychological Profile D. Bacteriologic Examination *E. Clinical Signs and Symptoms 4. In what disease are aggregates of spirochetes found in the gingiva? A. Juvenile Periodontitis B. Desquamative Gingivitis *C. Acute Necrotizing Ulcerative Gingivitis D. Refractory Periodontitis 5. Which of the following drugs are routinely indicated in the treatment of ANUG in a patient without systemic

involvement? A. Antiviral agents B. Antibiotics C. Steroids D. B and C only *E. none of the above

2. Bone (morphology, grafts, anatomy)

6. In health, bone is constantly undergoing both resorption and formation. In periodontitis, only bone resorption

occurs. A. Both statements are TRUE. B. Both statements are FALSE. *C. The first statement is TRUE, the second is FALSE. D. The first statement is FALSE, the second is TRUE. 7. Osteoplasty is a procedure that involves the A. use of an autograft. B. use of an alloplastic material. C. removal of tooth-supporting bone. *D. removal of non-tooth supporting bone.


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8. Positive bone architecture refers to *A. alveolar bone that is more coronal interdentally than facially or lingually. B. alveolar bone that is more apical interdentally than facially or lingually. C. alveolar bone that has undergone even resorption over a long period of time. D. a bone pattern that results after osseous grafting. 9. Each of the following osseous defects would be classified as infrabony EXCEPT one. Which one is this

EXCEPTION? A. A trough *B. A dehiscence C. A hemiseptum D. An interdental crater 10. Which of the following is not an infrabony defect? A. Interdental crater B. Hemiseptum *C. Dehiscence D. Three-walled 11. What characterizes freeze dried bone allografts? A. Usually rejected by the host B. Exfoliated after a short time period C. Contains viable cells with osteogenic potential *D. Eventually replaced by host bone 12. Freeze dried bone allografts are decalcified because A. the product is made safer. *B. calcium may block bone morphogenetic protein. C. without decalcification the product is difficult to manipulate. D. all of the above. 13. What is the process by which a bone graft material is capable of promoting osteogenesis? A. Contact inhibition *B. Osteoinduction C. Osteoconduction D. Guided tissue regeneration 14. Which of the following has the greatest osteoinductive potential? *A. Hip marrow B. Osseous coagulum C. Contiguous autograft D. Maxillary tuberosity autograft 15. A 50-year-old patient with fibrotic deep pockets and multiple bone defects undergoes periodontal surgery. The

dentist reflects the tissue, and debrides the two- and three-walled defects, scales and root planes. What is the next immediate step?

A. Treat the adjacent bone with citric acid and place a bone graft B. Treat the adjacent bone with tetracycline and place an occlusive membrane *C. Decortification of the adjacent bone and placement of a bone graft D. Any of the above procedures are acceptable 16. A graft between individuals of the same species but with nonidentical genes is called A. xenograft. *B. allograft C. autograft. D. isograft.


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17. A freeze-dried decalcified bone graft taken from a human donor and placed in a periodontal defect in another patient is termed an

*A. allograft. B. autograft. C. isograft. D. alloplastic graft. 18. Which of the following bone donor grafts has the greatest osteogenic potential? A. Xenograft B. Alloplast *C. Allograft D. B and C have very similar osteogenic potential 19. Which type of bony defect has the greatest potential for regeneration? *A. A narrow three walled defect B. A wide three walled defect C. A four walled (circumferential) defect D. A one walled hemiseptal defect 20. Hydroxyapatite (HA) can be utilized when all but one of the following are expected: *A. osteoinduction. B. excellent tissue compatibility. C. osteoconduction. D. encapsulation by collagen. 21. A graft between different species is referred to as a *A. xenograft. B. allograft. C. autograft. D. isograft.

3. Diagnosis (laboratory tests, probing)

22. Which of the following tests is based on the ability of complementary nucleotide strains to bind? A. ELISA B. Latex Agglutination *C. DNA Probe D. Immunofluorescence 23. Which of the following indices is used to evaluate periodontitis? A. Papillary Bleeding Index B. The Navy Plaque Index C. OHI-S *D. Periodontal Disease Index (Ramfjord) 24. Which of the following microscopic techniques permits specific identification of plaque microorganisms? A. Phase Contract Microscopy *B. Immunofluorescent Microscopy C. Darkfield Microscopy D. Light Microscopic Examination of a Gram Stain 25. The loss of periodontal attachment is determined by measuring the distance between the A. gingival margin and the cementoenamel junction. B. gingival margin and the bottom of the periodontal pocket. *C. cementoenamel junction and the bottom of the periodontal pocket. D. gingival margin and the most coronal portion of the connective tissue attachment.


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26. The gingival margin on the lingual surface of tooth #27 is 1 mm. apical to the CEJ and the probing depth is 3 mm. What is the attachment loss in this area?

A. 1 mm B. 2 mm C. 3 mm *D. 4 mm 27. The clinical appearance of hereditary gingival fibromatosis is very similar to phenytoin overgrowth of the gingival

tissue. Which of the following best distinguishes the two diseases? A. Biopsy B. Cell culture C. Blood tests D. Periodontal probing *E. Medical history 28. Which of the following can't be evaluated during a clinical periodontal examination? A. Tooth Mobility B. Gingival recession C. Gingival hyperplasia *D. Bony dehiscence or fenestration 29. What is the likely cause of a 5 mm probing depth on the facial aspect of tooth #22? A. Occlusal trauma *B. Calculus on the root surface C. Toothbrushing trauma D. An abfraction lesion 30. PST is a newly developed genetic test that is aimed at screening patients who are at risk for developing

periodontal disease. PST screens for abnormally high levels of which one of the following inflammatory mediators?

A. Immunoglobulins B. Lipopolysaccharides *C. Interluekin - 1 D. Platele derived growth factors

4. Drugs (antibiotics, NSAIDS, antiplaque)

31. A dentist would like to prescribe antibiotics for a female patient who is about to undergo periodontal therapy. Why must this dentist inquire about her use of oral contraceptives?

A. Oral contraceptives interfere with the excretion of antibiotics. B. Oral contraceptives increase the allergenic potential of antibiotics, especially penicillin. C. Several oral contraceptives decrease the effectiveness of antibiotics. *D. Several antibiotics decrease the effectiveness of oral contraceptives. 32. Antimicrobial periodontal treatment can be successful in reducing pocket depth. This reduction primarily occurs

through A. resection. *B. shrinkage. C. regeneration. D. reattachment.


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33. Which of the following antibiotics reaches high levels in gingival fluid (4 to 10 times its concentration in serum) after oral administration?

A. Erythromycin *B. Minocyclline/doxycycline C. Metronidazole D. Penicillin 34. Which of the following antibiotics has anticollagenase activity? A. Erythromycin *B. Tetracycline C. Metronidazole D. Penicillin 35. Which of the following periodontal diseases is the most likely candidate for treatment with antibiotics? A. Advanced adult periodontitis B. Acute gingivitis C. Chronic gingivitis *D. Refractory periodontitis 36. Periostat is a low dose (20 mg) doxycycline tablet that was recently approved by the FDA as an adjunct to

subgingival scaling and root planing. Periostat is effective because of it’s A. antimicrobial effects. *B. inhibition of tissue destructive enzymes. C. antiphagocytic effects. D. antipyretic and analgesic effects.

5. Endo-Perio

37. Upon mastication, a patient has severe pain in a mandibular first molar. Clinical examination reveals furcal bone loss, a sinus tract that is draining through the sulcus, normal interproximal bone height, and no response to vitality testing. The treatment of choice is

A. root canal therapy only. B. periodontal therapy only. C. periodontal therapy first, then root canal therapy, should the lesion not resolve. *D. root canal therapy first, then periodontal therapy, should the lesion not resolve. 38. Which of the following is most likely to indicate that the cause of tooth pain is of periodontal origin? *A. Sensitivity to lateral percussion with a deep tortuous pocket B. Sensitivity with chewing C. History of sensitivity to cold D. History of previous pain in the area

6. Etiology (other than plaque-tobacco, food impaction, calculus, teeth flutings-grooves)

39. Which of the following mesial root surfaces are unlikely to be thoroughly cleaned with the use of dental floss? A. Maxillary central incisor B. Mandibular first premolar *C. Maxillary first premolar D. Mandibular first molar 40. Calculus is clinically significant because it is rough, retains plaque, and A. disrupts epithelial cell membranes. B. increases mouth odors. *C. absorbs harmful, toxic chemicals. D. increases fremitus and mobility.


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41. The significance of an amalgam overhang as an etiologic agent in chronic periodontal disease has to do mainly with its role as

A. a mechanical irritant. *B. a plaque-retaining area. C. a non-deflecting tooth surface. D. an overcontoured tooth surface. E. a means of impingement on interproximal gingival fibers. 42. The inorganic materials found in supragingival calculus come from *A. saliva. B. serum. C. gingival fluid. D. food. 43. What is the most likely cause of vertical bone loss on the mesial surface of a mesially tilted second molar? A. Occlusal trauma B. Tooth position *C. Poor access for plaque removal D. Food impaction

7. Gingivitis (hyperplasia)

44. Gingivitis is often divided into stages. Which of the following correctly describes various stages? A. The initial stage starts 22 days after cessation of oral hygiene. B. The early stage demonstrates no collagen destruction. Dilated lymph vessels (lymphocytes) predominate. *C. The established lesion has plasma cells predominating with significant levels of immunoglobulins and migrating leukocytes in the junctional epithelium. D. All of the above stages are correctly described. 45. Which of the following represents the MOST common form of gingival periodontal disease seen in school-aged

children? A. Juvenile Periodontitis B. Localized Gingivitis C. Primary Herpetic Gingivostomatitis D. Necrotizing Ulcerative Gingivitis 46. Gingivitis does not progress in all cases to periodontitis, but periodontitis is always preceded by gingivitis. A. Both statements are true. B. Both statements are false. C. The first statement is true, the second is false. D. The first statement is false, the second is true. 47. The experimental gingivitis mode l (Loe, 1965) proves all the following except: A. gingivitis is reversible. B. gingivitis is associated with plaque accumulation. C. gingivitis, in most cases, proceeds to periodontitis. D. gingivitis is often manifested by bleeding gingiva. 48. How do you differentiate mild periodontitis from gingivitis in a patient with 3 to 4 mm probing depths? A. Attachment loss B. Extent of gingival inflammation C. Tooth mobility D. Furcation invasion


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49. What is the most common cause of gingival hyperplasia requiring surgical intervention? A. Medications taken by the patient B. Chronic gingival inflammation/excessive gingival stimulation C. Pregnancy gingivitis/hormones D. Idiopathic gingival hyperplasia (Hereditary gingival fibromatosis)

8. Microbiology-Immunology-Histology

50. The microbiota that predominate in a periodontal abscess are A. gram-negative, aerobic. B. gram-positive, aerobic. C. gram-positive, anaerobic. D. gram-negative, anaerobic. 51. Which of the following cell types predominate in gingival (crevicular) fluid? A. Mast Cell B. Macrophage C. Polymorphonuclear Leukocyte D. T-Lymphocyte E. Plasma Cell 52. Recent evidence implicates which of the following bacteria in the pathogenesis of juvenile periodontitis? A. Actinobacillus Actinomycetemcomitans B. Porphyromonas Eikenella C. Prevotella (Bacteroides) Rectus D. Fusobacterium Nucleatum 53. Early onset periodontitis is likely caused by which of the following organisms? A. Porphyromonas (Bacteroides) Gingivalis B. Actinomyces Viscosus C. Strept. Sanguis D. Fusiform Bacilli 54. Which cell is greatly increased in the progression from mild to severe gingivitis? A. B-Lymphocyte B. Mast Cell C. Eosinophyl D. Plasma Cell 55. Which organism, during Pregnancy, increases as the flora becomes more anaerobic and there is an elevation in

systemic levels of estradiol and progesterone? A. Streptococcus Mutans B. Prevotella. Intermedia C. Porphyromonas Gingivalis D. A. Actinomycetemcomitans 56. Crevicular (sulcular) epithelium is nonkeratinized. Another example of nonkeratinized tissue is A. marginal gingiva. B. attached gingiva. C. the gingival col. D. outer epithelium.


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57. Which of the following species is a usual constituent of floras that are associated with periodontal health? A. Camphylobacter recta B. Eubacterium nodatum C. Porphyromonas gingivalis D. Streptocossus gordonii 58. Which of the following has been associated with localized juvenile periodontitis? A. Cyclic eosinophilia B. Lysis of neutrophils C. Increased phagocytosis D. Neutrophil chemotactic defects 59. Which of the following pathogenic bacteria also invade the periodontal tissues? A. Porphyromonas gingivalis (PG) B. Actinobacillus actinomycetemcomitans C. Fusobacterium Nucleatum D. Bacteroides forsythus E. Both A and B 60. Which cells of the periodontium are considered to have the greatest progenitor ability? A. Junctional epithelial cells B. Periodontal ligament cells C. Odontoblasts D. Gingival fibroblasts

9. Mucocutaneous Disorders (Desquamative, Lichen Planus, BMMP)

10. Mucogingival Defects-Recession-Surgery

61. Which of the following areas of the mouth has the widest zone of attached gingiva? A. Molars>premolars>anteriors B. Anteriors>molars>premolars C. Premolars>anteriors>molars D. Molars>anteriors>premolars 62. A narrow zone of attached gingival tissue appears around a tooth that has no recession. Which of the following

best describes this zone? A. It is an indication for a gingival graft B. It is a common, easily treated condition C. It is likely to produce future recession D. It might not require treatment 63. The lateral sliding flap procedure is contraindicated when A. there is inadequate donor tissue. B. the patient is allergic to penicillin. C. there is inadequate tissue at the recipient site. D. gingival recession has exceeded three millimeters. 64. The Free Gingival Graft survives during the first 24 hours by A. diffusion of fluid from the host bed. B. fluids remaining in the donor tissue. C. new blood vessels forming from the underlying connective tissues. D. severed blood vessels in the surface area connecting with blood vessels in the donor material.


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65. What is the most predictable procedure for increasing the zone of attached gingiva? A. Edentulous ridge pedicle graft B. Double pedicle graft C. Horizontal sliding graft D. FGG (free gingival graft) 66. To increase anterior mandibular vestibular depth, the surgeon places the mucosal graft directly on A. periosteum. B. bone. C. mucosa. D. muscle. 67. Which is most related to initiation of root caries in the elderly? A. Gingival recession B. Defective restoration C. Erosion D. Attrition 68. Following the placement of a free mucosal graft, the graft epithelium undergoes A. dysplasia. B. orthokeratinization. C. formation of hypokeratinized granules. D. desquamation. 69. What is vital to the success of the free gingival graft? A. Immobilization B. Large fibrin clot C. Thin flap with periosteum covering bone D. Use of ice and NSAID's to minimize swelling 70. Which artery are you likely to sever in obtaining a subepithelial connective tissue autograft? A. Facial B. Greater palatine C. Lingual D. Incisive foramen 71. In a state of gingival health, the narrowest width of keratinized gingival tissue is usually found on the facial aspect

of which of the following teeth? A. Mandibular central incisors B. Mandibular first premolars C. Maxillary second premolars D. Maxillary central incisors 72. After a free gingival graft, the primary source of nutrition for the graft during the first 24 hours is the A. primary vascular anastomosis. B. residual nutrients within the graft. C. diffusion of nutrients from the underlying connective tissue. D. diffusion of nutrients from adjacent vessels of the periodontal ligament. 73. Which of the following is the procedure of choice in obtaining root coverage when gingival recession has occurred on the facial surface of a tooth with interproximal bone and soft tissue in its original position? A. Free gingival graft (FGG) B. Connective tissue graft C. Gingivectomy D. Modified Widman Procedure E. Gingival curettage


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74. It is desirable to have a large blood clot between a free gingival graft and the underlying periosteum because the clot will encourage vasculization of the overlying graft.

A. Both statements are TRUE. B. Both statements are FALSE. C. The first statement is TRUE, the second is FALSE. D. The first statement is FALSE, the second is TRUE. 75. The distance from the marginal gingiva to the mucogingival junction is 5mm and the probing depth in this area is

7mm. Which of the following is acceptable treatment? A. A soft tissue autograft B. An apically positioned flap C. A laterally positioned flap D. A double papillae flap 76. Which procedure is best performed in an area with inadequate attached gingiva and a frenum that retracts the

marginal gingiva? A. Frenectomy B. Free gingival graft with frenum removal C. Connective tissue graft D. Rotated papilla graft E. Double papilla flap 77. During the healing of a free gingival graft A. sloughing of the donor epithelium occurs. B. the graft is initially maintained by a transudate from the host vessels. C. revascularization of the grafts starts by the second or third day. D. at the donor site, epithelium migrates from the edges of the wound. E. all of the above

11. Occlusion (splinting)

78. The lesion of occlusal trauma, when superimposed on normal periodontal structures, usually results in the formation of periodontal pockets. The lesion is reversible when the offending force is removed.

A. Both statements are TRUE. B. Both statements are FALSE. C. The first statement is TRUE, the second is FALSE. D. The first statement is FALSE, the second is TRUE. 79. Traumatic occlusion causes gingival recession. Adjustment of the occlusion can halt or reverse gingival

recession. A. Both statements are TRUE. B. Both statements are FALSE. C. The first statement is TRUE, the second is FALSE. D. The first statement is FALSE, the second is TRUE. 80. In the absence of the plaque-associated inflammation, traumatic occlusion can cause a periodontal pocket to

form. Traumatic occlusion can alter the morphology of the bone that surrounds a traumatized tooth. A. Both statements are TRUE. B. Both statements are FALSE. C. The first statement is TRUE, the second is FALSE. D. The first statement is FALSE, the second is TRUE. 81. Which of the following is the most important reason for splinting teeth? A. To eliminate damaging forces on mobile teeth B. For comfort and function C. To reduce the occlusal forces D. All of the above


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82. In a healthy periodontium, occlusal trauma can result in A. increased alveolar bone volume. B. vertical loss of alveolar bone. C. loss of attachment of the gingival fibers. D. gingival recession. 83. Which of the following is most likely to cause vertical bone loss? A. Calculus B. Gingival recession C. Occlusal trauma D. Hyperparathyroidism 84. What is the main advantage of extracoronal splinting in periodontally involved teeth? A. Prevents the recurrence of periodontitis B. Eliminates occlusal trauma C. Conservation of tooth structure D. All of the above 85. Radiographic signs of trauma from occlusion include A. increased width of periodontal space, often with thickening of the lamina dura along lateral aspects of root, in apical areas and bifurcation areas. B. a vertical rather than horizontal destruction of the interdental septum. C. radiolucence and condensation of the alveolar bone. D. root resorption. E. all of the above. 86. The following statements are true regarding occlusal adjustment on a mobile tooth except: A. a wax indicator may be used if it is placed on the occlusal and incisal surfaces of the mandibular teeth. (Patient opens and closes then translucent areas are marked with pencil and wax removed.) B. mobile teeth should be stabilized with fingers so supracontacts will not be pushed aside. C. in some situations, it is necessary to adjust the opposing tooth. D. all of the above.

12. Ortho-Perio

87. When a fractured tooth is orthodontically extruded, A. the bone follows the tooth but the gingiva remains in its original position. B. the bone and gingiva stay in their original position. C. new bone forms and the gingiva follows. D. the bone remains in its original position but the gingival follows. 88. Which fiber group is responsible for relapse after orthodontic treatment? A. Gingival circular fibers B. Gingival transseptal fibers C. Periodontal ligament oblique fibers D. Periodontal ligament alveolar crest fibers


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89. A mandibular anterior tooth is in crossbite and has no attached gingiva and throughout the mouth there is gingival inflammation. There is an isolated infrabony defect with probing depth of 8 mm. Which is the best sequence of treatment?

A. 1. orthodontic treatment, 2. gingival graft, 3. resolve the inflammation, 4. surgically treat the infrabony defect B. 1. orthodontic treatment, 2. surgically treat the infrabony defect, 3. resolve the inflammation, 4. gingival graft C. 1. resolve the inflammation, 2. gingival graft, 3. orthodontic treatment, 4. surgically treat the infrabony defect D. 1. resolve the inflammation, 2. surgically treat the infrabony defect, 3. gingival graft, 4. orthodontic treatment

13. Periodontitis (Adult, Juvenile)

90. An 18-year-old woman has good oral hygiene and only minute traces of supragingival calculus. Her gingival tissues exhibit stippling, no inflammatory edema, and very little change in color. Probing reveals 5-8 mm pockets around maxillary incisors, mandibular incisors, and first molars. No appreciable bone loss can be seen elsewhere in her mouth. This condition should be diagnosed as which of the following?

A. Gingivitis B. Periodontitis C. Desquamative Gingivitis D. Localized Juvenile Periodontitis E. Generalized Idiopathic Bone Resorption 91. In early onset periodontitis, you are likely to see A. an increase in IgD. B. altered plasma cells. C. an increase in IgE and IgA. D. depressed neutrophil chemotaxis. 92. Adult periodontitis A. progresses at an equal rate in all affected sites throughout a patient's mouth. B. progresses slowly and continuously throughout an adult's life. C. is characterized by periods of attachment loss and longer periods without any attachment loss. D. is characterized by rapid attachment loss in the 4th and 5th decades of life and minimal

attachment loss during the 6th and 7th decades. 93. Localized Juvenile Periodontitis is characterized by A. vertical bone loss involving the posterior teeth. B. horizontal bone loss involving the posterior teeth. C. vertical bone loss involving the first molars and incisor teeth. D. horizontal bone loss involving the first molars and incisor teeth. 94. In Rapidly Progressing periodontitis A. the patient is in the age range from the early 20's to the mid 30's. B. the diagnosis is based on the rate of bone destruction over a period of time. C. the lesions are generalized throughout the mouth. D. All of the above

14. Plaque (POH -OHI)

95. Acquired pellicle is derived from A. saliva. B. gingival fluid. C. plaque bacteria. D. epithelial cells and white blood cells.


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96. Which of the following MOST efficiently removes dental plaque? A. Brushing and Flossing B. Rinsing with Chlorhexidine C. Chewing Detergent Foods D. Using Oral-Irrigation Devices 97. Frequent brushing helps to prevent calculus formation by A. neutralizing local acidity. B. breaking up the matrix of plaque. C. removing the ions that attach to tooth surfaces. D. removing food particles on teeth and interproximal areas. 98. Which is the least effective method of dental plaque removal? A. Dental Floss B. Soft Toothbrush C. Interproximal Brush D. Water Irrigation 99. The carbohydrate present in the greatest amounts in the matrix of supragingival plaque is A. Dextran. B. Levan. C. Glactose. D. Methylpentose.

100. Second generation antiplaque agents differ from first generation agents in A. spectrum of activity. B. substantivity. C. mechanism of action. D. use of penicillin analogues. 101. Which is the best brushing technique for most patients? A. Sulcular brushing B. The roll technique C. Horizontal scrub technique D. The Stillman method 102. Plaque accumulation has a direct effect on A. level of materia alba. B. severity of gingivitis. C. severity of periodontitis. D. accumulation of calculus. 103. Antitartar toothpastes A. are beneficial only for subgingival calculus. B. contain the active ingredient pyrophosphate to interfere with crystal formation in calculus. C. contain active ingredient chlorhexidine gluconate to decrease bacteria associated with calculus formation. D. also have been found to lighten tooth color 1-2 shades. 104. For a plaque control agent to be accepted by the American Dental Association Council on Dental Therapeutics

the following is mandatory: A. clinical trials lasting a minimum of six months. B. clinical trials are double-blind. C. significant reduction in plaque and gingivitis. D. microbial monitoring to ensure that neither resistant nor pathogenic opportunistic organisms emerged. E. all of the above.


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105. Which of the following products, utilized in a mouth rinse, have been approved by the ADA Council of Dental Therapeutics for plaque control?

A. Prebrushing rinses containing sodium benzoate (Plax) B. Cetylpyridinium chloride (Cepacol - Scope) C. Fluoride D. Oxygenating Agents E. None of the above

15. Prognosis

106. The prognosis of treated gingivitis usually is A. good. B. fair. C. poor. D. questionable. 107. A tooth with greater than 50% bone loss is usually considered to have a guarded prognosis. The prognosis for

this condition in a 20-year-old would be better than in a 50-year-old. A. Both statements are TRUE. B. Both statements are FALSE. C. The first statement is TRUE, the second is FALSE. D. The first statement is FALSE, the second is TRUE. 108. Long term studies have demonstrated that the tooth with the worst long term prognosis is: A. the mandibular first molar. B. the maxillary first molar. C. the maxillary cuspid. D. the mandibular cuspid. E. the mandibular second bicuspid. 109. The teeth which have the greatest chance for recurrence of periodontitis after completion of treatment are A. maxillary 2nd molars. B. maxillary 1st molars. C. mandibular 2nd molars. D. maxillary 1st. 110. Which tooth would have the best prognosis? A. A maxillary bicuspid with a complete vertical root fracture B. A mandibular cuspid with a complete root fracture C. A mandibular molar with 50% bone loss and a short root trunk D. A mandibular molar with 50% bone loss and a long root trunk

16. Restorative-Perio (biologic width)

111. Overhanging restorations are considered to be modifying factors in the etiology of periodontal disease. Their presence appears to promote a change in a non-pathogenic subgingival microflora to a pathogenic subgingival microflora.

A. Both statements are TRUE. B. Both statements are FALSE. C. The first statement is TRUE, the second is FALSE. D. The first statement is FALSE, the second is TRUE.


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112. The biologic width extends from A. the most apical extension of the crown margin to the alveolar bone crest. B. the gingival margin to the bottom of the sulcus. C. the apical extent of a crown margin to the junctional epithelium. D. the cementoenamel junction to the apical extent of the crown margin. 113. A patient with 1-2 mm probing depths needs 4 mm of crown lengthening. Which is the best surgical procedure to

accomplish the crown lengthening procedure? A. Gingivectomy B. Modified Widman C. Apically positioned flap with osseous reduction D. Subgingival curettage 114. In the crown lengthening procedure which surgical technique is best performed? A. Osseous recontouring B. Gingivectomy C. Modified Widman D. Gingival Curettage

17. Scaling and Root Planing (technique, scalers and curets, ultrasonics)

115. The primary purpose of scaling and root planing is to A. smooth root surfaces. B. remove pathologic granulation tissue. C. remove the epithelial lining of pockets. D. remove plaque, calculus and altered cementum. E. expose collagen fibers to facilitate reattachment. 116. Root planing should be performed between the A. junctional epithelium and cementoenamel junction. B. osseous crest and junctional epithelium. C. gingival line and cementoenamel junction. D. gingival line and contact point. 117. A large reduction in tissue size and pocket depth is expected when the patient presents for root planing with A. gingival recession. B. highly inflamed, edematous tissue. C. fibrotic, hyperplastic tissues. D. Dilanton hyperplasia. 118. Which of the following procedures has, as its primary objective, the reduction of existing inflammation? A. Splinting of mobile teeth B. Occlusal correction C. Mucogingival surgery D. Scaling and root planing 119. The chisel differs from a curette in that A. it requires an edge that is less sharp. B. it utilizes a cutting edge that is less wide. C. it is made from stainless steel. D. it is used with a push rather than a pull motion.


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120. During scaling and root planing, all can take place except A. enamel removal. B. calculus removal. C. cementum removal. D. dentin removal. E. plaque removal. 121. The Gracey curette A. only has one edge that needs to be sharpened. B. has an offset face, forming a 70 degree angle with the shank. C has a rounded end to minimize tissue trauma. D. is used with the terminal shank parallel to the tooth surface. E. all of the above 122. When sharpening a curette, the angle between the sharpening stone and the face of the blade is: A. 60 to 70 degrees. B. 70 to 80 degrees. C. 80 and 90 degrees. D. 100 to 110 degrees. 123. The morphology of a tooth root is an important consideration in therapy because A. the furcation entrance is narrower than a standard curette in 58% of first molars. B. almost 100% of mandibular molars have root concavities. C. in maxillary molars root cavities are often found on 94% of the MB roots, 31% of the DB roots and

17% of palatal roots. D. enamel projections are found in 28% of mandibular molars and 17% of maxillary molars. E. all of the above. 124. Following scaling and root planing there is a decrease in probing depths due to A. new bone formation. B. connective tissue attachment tooth root surface. C. tissue shrinkage. D. increase in the zone of attached gingiva. 125. Which one of the following adjuncts to subgingival scaling and root planing is placed directly in the periodontal pocket? A. Periochip (Chlorhexidine) B. Atridox (Doxycycline) C. Actisite (Tetracycline) D. A and C E. All of the above

18. Supportive Periodontal Treatment (Maintenance)

126. A dentist has just completed definitive periodontal treatment for a patient. Initially, this dentist should see this patient for supportive maintenance every

A. month. B. 3 months. C. 6 months. D. 12 months. 127. Periodontal recall of a 50 year old patient with a history of periodontitis and a 16 year old patient with a history of gingivitis is one and the same. The treatment of choice for both patients is a prophylaxis. A. Both sentences are true. B. Both sentences are false. C. The first sentence is true and the second sentence is false. D. The first sentence is false and the second sentence is true.


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128. A gingivectomy will re-establish proper contours when which of the following pathologic conditions are present? 1. Pseudopocket 2. Suprabony pocket 3. Gingival enlargement (hyperplasia) 4. infrabony pocket 5. Cleft involving alveolar mucosa A. 1, 2, and 3 B. 1, 2, and 5 C. 2, 3, and 4 E. 2, 4, and 5 F. 3, 4, and 5 G. All of the above 129. In which area of the mouth would you want to avoid a vertical releasing incision? A. Maxillary anterior facial B. Mandibular anterior facial C. Mandibular posterior lingual D. Maxillary posterior facial 130. Gingivectomy is indicated in the treatment of each of the following EXCEPT one. Which one is this

EXCEPTION? A. Suprabony Pockets B. Infrabony Pockets C. Phenytoin-Induced Hyperplasia D. Hereditary Gingival Fibromatosis 131. Which of the following has the greatest impact on the success of a periodontal-flap procedure? A. The type of initial incision B. The extent of flap reflection C. The position of the flap at closure D. The level of post-operative plaque control E. The post-operative width of attached gingiva 132. Guided tissue regeneration works on the principal of selected cell repopulation by A. inhibiting the maturation of connective tissue cells. B. blocking the downgrowth of epithelium. C. destroying migrating epithelial cells. D. inhibiting the maturation of epithelial and connective tissue cells. 133. Which suturing technique permits different tension on facial and lingual flaps? A. The horizontal mattress suture B. The vertical mattress suture C. The interrupted figure eight suture D. The continuous sling suture 134. Which kind of suture is best used when only the buccal surface of an area has been flapped for a surgical

procedure? A. The horizontal mattress suture B. The vertical mattress suture C. A simple loop suture D. The sling suture


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135. What is the main difference in the Apically Positioned Flap procedure and the Modified Widman procedure? A. The initial incision B. The utilization of a post-operative periodontal dressing C. The degree of root instrumentation D. The final position of the flap margin 136. Following a gingivectomy, where do the epithelial cells come from? A. The periodontal ligament B. The surrounding attached gingiva C. The surrounding alveolar mucosa D. The underlying osseous structures 137. Under what circumstances would you not want to use a partial thickness flap? A. The presence of parakeratosis B. The presence of thin tissue C. A patient with diabetes D. In the maxillary anterior where aesthetics is a concern 138. Guided tissue regeneration is best used for which classification of furcation defect? A. Class one B. Class two C. Class three D. Class four (no tissue in furcation) 139. How would you treat a class two furcation with probing depths of 5-8 mm on the facial surface of tooth #31? A. Guided tissue regeneration B. Osseous surgery C. Gingivectomy D Extraction 140. You are performing a guided tissue regeneration on tooth #19 with a buccal class two furcation involvement.

Which of the following circumstances would enhance regeneration in this area? A. Short root trunk B. A large vertical component to the furcation C. A large horizontal component to the furcation D. Low or minimal interproximal bone 141. Which of the following clinical findings has the greatest influence on the type of incision to use in periodontal flap

surgery? A. Probing depth B. Frenum attachment C. Depth o f the vestibule D. Amount of attached gingiva E. Presence of intrabony defects. 142. Root Planing should be avoided during the modified Widman flap procedure BECAUSE the modified Widman

flap margin will be placed apically to the level of altered root surfaces. 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 an accurate statement. E. NEITHER the statement nor the reason is correct.


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143. Gingivectomy is NOT likely to be the treatment -of-choice for the elimination of pockets when the base of the pocket is located at the mucogingival junction or

A. apical to the alveolar crest. B. below the free gingival groove. C. coronal to the cementoenamel junction. D. apical to the cervical convexity of the tooth crown. 144. The initial incision for a Gingivectomy is made apical to which structure? A. The crest of bone B. The junctional epithelium C. The periodontal ligament D. The mucogingival junction E. Gingival attaching fibers 145. Why is a periodontal dressing used after a surgical procedure? A. To hold the tissues in their final position. B. To keep dental plaque from forming at the surgical site C. To protect the tissues from trauma from mastication D. All of the above 146. In the gingivectomy technique, the depth of pockets is indicated by bleeding points made with a periodontal

probe or with a pocket marking forceps. Incisions are then made coronal to the bleeding points. A. Both statements are TRUE. B. Both statements are FALSE. C. The first statement is TRUE, the second is FALSE. D. The first statement is FALSE, the second is TRUE. 147. Your patient has a class two furcation on the facial surface of tooth #31 with a probing depth of 7mm. What is

the best method of treating this area? A. Pack the area with tetracycline impregnated cord B. Guided Tissue Regeneration C. Extraction D. Osseous recontouring E. Hemisection F. Gingivectomy 148. In the Modified Widman Surgical Procedure what form of attachment occurs in most cases? A. Regeneration of bone, PDL and cementum B. Long Junctional Epithelium C. Bone attached to the root surface D. Connective tissue attachment to the previously diseased root surface 149. In Guided Tissue Regeneration, the only cells which have the potential for regeneration of the attachment

apparatus of the tooth are best described as A. the epithelial cells with lateral cell growth. B. the periodontal ligament cells which proliferate coronally. C. the bone cells which proliferate coronally. D. the epithelial cells which migrate apically. 150. A modified Widman flap would be indicated when the goal of therapy is to provide A. complete pocket elimination. B. regeneration of the periodontium. C. access to root surfaces for thorough debridement. D. increased keratinized tissue.


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151. Indications for Guided Tissue Regeneration include A. three wall bony defects. B. Class II mandibular defects. C. Class III maxillary defects. D. one wall bony defects. E. C and D. F. A and B. 152. In which of the following surgical procedures is an external beveled incision made? A. Gingivectomy B. Apicallly positioned flap C. Modified Widman D. Excisional New Attachment Procedure 153. You want access to the distal of a mandibular second molar to treat an 8 mm suprabony periodontal pocket.

Extending distally from the second molar there is 2 mm of attached keratinized gingiva. Which approach would produce the best result?

A. Subgingival curettage B. Gingivectomy C. Distal wedge D. Chemical curettage of the pocket 154. Which is a common cause of tearing during a flap procedure? A. Excess tension with the periosteal elevator during tissue reflection B. Inadequate finger rest or hand support. C. Inadequate flap extension mesially and distally D. All of the above 155. In the crown lengthening procedure, which surgical technique is best performed? A. Osseous Recontouring B. Gingivectomy C. Modified Widman D. Gingival Curettage

20 Systemic

156. Increased tooth mobility can be initiated by each of the following EXCEPT one. Which one is this EXCEPTION? A. Diabetes B. Hyperparathyroidism C. Traumatic Occlusion D. Resorption of Alveolar Bone 157. Which of the following systemic diseases is usually associated with an increase in susceptibility to periodontitis? A. Epilepsy B. Diabetes Mellitus C. Parkinson's Disease D. Addison's Disease 158. In addition to exhibiting palmar and plantar hyperkeratosis, a patient has a rapidly destructive process of the

periodontium of the primary and secondary dentitions. Most likely this patient has A. Downs Syndrome. B. Acatalasia. C. Chediak-Higashi Syndrome. D. Papillon-Lefevre Syndrome.


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159. A 12-year-old girl presents with "swollen gums" of three weeks durations. Upon performing an oral examination, the dentist sees that this patient's gingival tissues are markedly edematous and erythematous. Her parents state that although she has been generally well, she has had occasional malaise, anorexia, and fever in recent months. To manage this condition appropriately, the dentist should do which of the following?

A. Scale and curette the affected areas; prescribe mild rinses and a course of oral antibiotic therapy B. Refer the child to a physician for hematologic consultation C. Enroll the child in an active prevention program that emphasized adequate home care 160. An HIV positive patient without AIDS may be considered A. a candidate for conservative, non-surgical periodontal therapy. B. for an evaluation of health status, including consultation with physician and CD 4 count. C. for elective periodontal surgical and implant procedures. D. all of the above. 161. Linear gingival erythema can best be described by which of the following statements? A. Is found in adolescent and most commonly around maxillary anterior teeth B. Is usually cured after instituting proper home care and over all debridement C. Is more predominant in females D. Is a persistent easily bleeding, erythematous gingivitis seen in HIV positive patients 162. In treating an otherwise healthy asymptomatic HIV-infected individual A. hospitalization is needed for any procedure producing bleeding. B. supportive Periodontal Therapy should be conducted at short intervals (2-3 months). C. systemic antibiotics are needed before any periodontal procedures. D. periodontal surgical procedures are never indicated. 163. Periodontal disease has been identified as be a contributing factor in which of the following: A. Cardiovascular Disease B. Premature low weight babies C. Diabetes D. Pulmonary Disease E. All of the above

21. Miscellaneous

164. In adults who live in the United States and who are over 30 years of age, chronic periodontal disease is MOST prevalent in

A. black males. B. black females. C. white males. D. white females. 165. The long-term results of periodontal therapy suggest which of the following? A. Treatment prolongs the dentition of patients who have periodontal disease. B. Once a furcation is involved, a tooth is usually lost. C. Teeth with pockets greater than 8 mm. should be extracted. D. Some types of periodontal therapy are clearly better for the treatment of periodontal diseases than others.

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