Perio Final
Perio Final Exam Quiz
Test your knowledge on periodontal disease, bacteria, and immune responses with this comprehensive quiz designed for dental students and professionals. Whether you're preparing for exams or just want to refresh your knowledge, this quiz covers crucial aspects of periodontal health.
- 152 challenging questions
- Covering various topics in periodontology
- Ideal for students and practitioners alike
What are the tissues that surround implant called
Periodontium
Transgingival tissues
Peri-implant tissues
None of the above
Which of the following types of bacteria are associated with periodontitis?
Gram-positive bacteria
Nonpathogenic bacteria
Gram-negative bacteria
Innocuous bacteria
If a bacterium wants to join a biofilm, it should look for which of the following conditions:
A group of bacteria attached to a tooth surface
A freshly formed area of pellicle on a tooth surface
Clumps of bacteria floating in the saliva
An area of the mouth with a large number of free-floating bacteria
Which bacterial species are found in aggressive periodontitis?
A odontolyticus
A. Actinomycetemcomitans
P. gingivalis
Both B & C
This term is used when two bacterial cells adhere to each other
Bonding
Acquired pellicle
Joining
Coaggregation
The first bacteria to colonize on the tooth surface are
Pathogenic
Nonpathogenic
Motile
Anaerobic
Early bacteria in plaque biofilm are
Anaerobic bacteria
Gram-negative bacteria
Gram-positive bacteria
Motile bacteria
All of the following statements are true EXCEPT
Gram-positive bacteria are the first bacteria to attach to the pellicle
A disrupted biofilm must reform in a specific sequence
Motile bacteria are important first colonizer of the pellicle
Each bacteria strain has limited amount of bacteria to which it can adhere
Which type of bacterial subgingival attachment is the most harmful to the periodontal tissues
Pellicle-associatedplaque biofilm
Bacteria that float in the periodontal pocket space
Tooth-associatedplaque biofilm
Tissue-associatedplaque biofilm
A biofilm is
Calcified community of bacteria that is difficult to remove
Free-floating bacteria
A film that thrives on moist surfaces
A well-organized community of bacteria
Antimicrobial solutions work better when partnered with mechanical disruption of plaque-biofilm
True
False
All of the following statements are true EXCEPT
An example of biofilm is tobacco stain
Bacteria in biofilm can be resistant to antibiotics
Bacteria in biofilm are embedded in an extracellular slime layer
Biofilm is a well organized colony of bacteria
Biofilm only forms on dry surfaces
True
False
Each bacterial strain has a limited set of bacteria that is can adhere to
True
False
What is the best way of destroying plaque biofilm on teeth?
Antimicrobial rinse
Mechanical removal through good home care
Oxygen
Antibiotics
Within minutes after cleaning, the pellicle reattaches to the tooth surface
True
False
All of the following statements are true regarding disease progression EXCEPT
As disease progresses, the bacteria becomes more gram-negative
As disease progresses, the bacteria become more gram-positive
The number of bacteria in the site increases as the disease progresses
As disease progresses, bacteria become more motile
Bacteria can penetrate epithelium and invade connective tissue
True
False
Motile bacteria use flagella to swim
True
False
What causes swelling?
Exudate
Entry of fluid into the connective tissue
Increased heat in the area
Magic
Which of these are signs of chronic inflammation?
Heat
Redness
Pain
Non of these
These are the rapid responders and the 1st to arive at the infection site in a bacterial infection of the periodontium?
B-lymphocytes
Motile bacteria
Phagocytes
Polymorphonuclear leukocytes (PMNs)
This system protects the body from infections
Complement system
Endocrine system
Immune system
Lymphatic system
This is the process in which leukocytes are attracted to an infection cite
Migration
Coaggregation
Chemotaxis
Mitosis
This is the term used to describe the engulfing and digesting of cells
Phagocytosis
Coaggregation
Chemotaxis
Digestion
Cells activate the body's immune system by secreting biologically active compounds called
Peptide proteins
Homeostasis chemicals
B-reactive proteins
Biochemical medicators
This is the bodys reaction to inflammation:
Injury
Bruising
Invansion of pathogens
Both A & C
Which of these IS NOT a symptom of inflammation?
Swelling
Heat
Pain
Bruising
What is the main role of B-lymphocytes?
To promote phagocytosis
To intensify the immune response
Killing microorganisms on contact
To secrete antibodies
In what periodontal lesion stage to the first clinical signs appear?
Advanced lesion
Initial lesion
Early lesion
Established lesion
In what periodontal lesion stage do PMNs first travel through the bloodstream into the gingival connective tissue?
Early lesion
Established lesion
Advanced lesion
Initial lesion
Collagen destruction in the periodontal tissues is caused by which biochemical mediator?
Monocytes
Matrix metalloproteinases(MMPs)
PMNs
Immunoglobulins
Periodontal pathogens are the only cause of periodontal disease
True
False
What are the functions of cytokines?
Possibly initiate destruction & bone loss
Attract immune cells to the site of infection
Send macrophages to an infection site
All of the above
What is the function of matrix metalloproteinases (MMPs)?
Signals the first rsponders of the immune response
Initiate the function of macrophages
Signals the leukocytes to cease function
Collagen destruction in periodontal tissue
Bacteria colonizes near the gingival margins in what phase of periodontal disease?
Early lesion
Advanced lesion
Established lesion
Initial lesion
Tissue destruction becomes the main outcome of the immune response in advance periodontitis
True
False
The immune system is a cause of tissue destruction
True
False
What kind of risk factor for periodontal disease does smoking fall under?
Genetic
Acquired
Accumulated
Environmental
What is the process called when bacteria is engulfed?
Mitosis
Phagocytosis
Meiosis
Coaggregation
What is the second layer of defense?
Complement system
Bacterial reproduction
Mytosis
Phagocytosis
Endotoxin is another name for lipopolysaccharides
True
False
What are endotoxins found on the outer layer of
T-cells
Macrophages
Gram positive bacteria
Gram negative bacteria
Collagenases and proteases are created by periodontal bacteria that can destroy host tissues
True
False
The biologic seal functions as a barrier between the implant and the oral cavity
True
False
Osseointegration is regarded as successful if there is
Discomfort only when in function
No more than a class II clinical mobility
Radiographic bone loss of 3mm per year
Absence of gingival inflammation of peri-implant tissues
Dental implants should be checked radiographically at least ___________.
Every other year
Once a year
Every 6 months
Every 2 months
Which of the following scalers is BEST for instrumenting around implants?
A titanium scaler
A gold-tipped curette
Universal ultrasonic tip
Plastic sickle scaler
All of the following are signs of a failing implant EXCEPT
Radiographic bone loss around the implant
Firm, pink tissue
Pain
BOP
All of the following statements are true about probing an implant EXCEPT
A metal probe may be used if there is very light pressure
Too much pressure will cause the probe to penetrate the biologic seal
Probing measurements are taken from a fixed reference point
No probing is recommended as a part of implant maintenance
Self-care around the implant can be accomplished using any of the following aids EXCEPT
End-tufted brush
Standard wire interproximal brush
Implant floss
Soft bristle brush
This term described periodontitis around an osseointegrated implant resulting in loss of alveolar bone
Perio-implantitis
Peri-implant gingivitis
Implant periodontitis
Both B and C
A sulcus lined by sulcular epithelium surrounds the implant abutment post
True
False
It is important to use clinical findings and radiographs to sequence the treatment plan and set a goal for treatment
True
False
This outline is carried out by the dentist, dental hygienist, & patient to eliminate disease & return patient to health
This outline is carried out by the dentist, dental hygienist, & patient to eliminate disease & return patient to health
Master periodontal treatment plan
Nonsurgical periodontal instrumentation
Periodontal maintenance
The clinical measurements that determine the difference between gingivitis and periodontitis is the _________.
Pocket depth readings
Clinical mobility and furcation involvement
Level of gingival margin
Clinical attachment level (CAL)
What phase of periodontal therapy does periodontal instrumentation fall?
Maintenance therapy phase
Surgical therapy phase
Nonsurgical periodontal therapy phase
Preliminary therapy phase
Which phase of periodontitis measured to keep it from recurring after it has been brought under control?
Maintenance therapy phase
Surgical therapy phase
Nonsurgical therapy phase
Preliminary therapy phase
All of the following are characteristics of shared decision making EXCEPT:
Document the signed care plan and make arrangements for follow-up
Consult with the dentist and other health care but not the patient
Elicit the patient's ideas, concerns, and expectations
Develop a care plan in partnership with the patient
The two most important sources in the treatment decision making process are the_____ and _____.
Standard of care and textbooks
Dental hygienist and dentist
Clinician and patient
Treatment options and values
A patient voluntary agreement to proposed treatment is called______
Patient approval
Informed consent
Informed refusal
Treatment phasing
Two local risk factors for periodontitis can be caused by poorly contoured restorations OR deep root grooves.
True
False
Which of the following factors is considered the MOST SIGNIFICANT risk factors for developing periodontal disease?
Stress
Smoking cigarrettes
Chronic poor home care
Medications that cause gingival overgrowth
Biological equilibrium in periodontal health means there is a balance between
Plaque and local risk factors
Bacterial plaque biofilms and the host response
Local contributing factors and systemic factors
Local risk factors and acquired risk factors
The portion of the implant that protrudes through the tissue into the mouth is the ________.
Implant body
Prosthesis
Abutment post
Implant fixture
Which of the following tissues is NOT part of the periodontium?
Peridontal Ligament
Gingiva
Cementum
Alveolar Mucosa
During mastication, the tooth is cushioned from occlusal forces by the:
Periodontal Ligament
Gingiva
Cementum
Alveolar Bone
Which part of the periodontium may become damaged after years of periodontal intrumentation?
Periodontal ligament
Cementum
Gingiva
Alveolar bone
Lattice-like bone that fills the interior portion of the alveolar process refers to
Cortical bone
Periosteum
Cribiform plate
Cancellous bone
In health, the alveolar crest covers the cementoenamel junctions of the teeth.
True
False
Which of the following is a mesh-like material that surrounds the cells and provides a framework?
Extracellular matrix
Mast cell
Nucleus
Collagen fiber bundle
What structure forms the base of a periodontal pocket?
Basal epithelium
Sulcular epitherlium
Junctional epithelium
Oral epithelium
This demarcation is a shallow linear depression that seperates the free and attached gingiva
Mucogingival junction
Free gingival groove
Gingival margin
Alveolar mucosa
All of the following are functions of gingival fibers EXCEPT:
They connect adjacent teeth to one another to control tooth position
They unite free gingiva with cementum of the root
They provide rigidity needed to withstand frictional forces during chewing
They prevent plaque biofilm from entering the gingival connective tissue
All of the following are functions of the periodontal ligament EXCEPT:
It unites free gingiva with cementum
It attaches the tooth to the bony socket
It provides sensory and nutritive function
It produces osteoclasts to resorb bone
The ends of periodontal ligament fibers (brush-like) that embed in bone and cementum are known as:
Interradicular fibers
Oblique fibers
Sharpey's fibers
Horizontal fibers
The characteristics of periodontitis may include which of the following:
Loss of alveolar bone
Destruction of the gingival and PDL fibers
Apical migration of the junctional epithelium
All of the above
What is the most common pattern of bone loss?
Horizontal
Vertical
Oblique
Interproximal
What is the difference between a gingival and a periodontal pocket?
Gingival pocket is a true pocket, perio is a false pocket
A periodontal pocket does not have exudate
A gingival pocket is from horizontal bone loss, perio from vertical
A gingival pocket is f/ inflammation, perio pocket f/ migration of the JE
The space between the free gingiva and tooth surface is called:
Interdental gingiva
Junctional epithelium
Gingival sulcus
Periodontal ligamen
A 12 yo female with an extremely clean dentition, 2-3mm pockets, and an severe inflammatory response, likely diagnosis?
Gingival disease with bacterial origin
Drug-influencedgingival enlargement
Gingival disease associated with fluctuations in sex hormones
Plaque-induced gingivitis
What is the first clinical sign of gingivitis?
Gingival recession
Furcation involvement
Bleeding on probing
Tooth mobility
How would you describe enlarged papillae that expand out of the interproximal spaces?
Soft, sppongy tissue
Cratered papilla
Bulbous papilla
Blunted papilla
Increased fluid in inflamed gingival tissue (edema) can be best described as:
Pointed, knife-like papilla
Firm and pink
Firm and fibrotic
Soft and spongy
When describing the distribution of gingivitis, all of the following may be applied EXCEPT:
Marginal
Diffuse
Lingual
Papillary
Diabetes associated gingivitis is an example of:
Gingival diseases modified by a systemic factor
Gingival disease of genetic origin
Gingival disease modified by malnutrition
Dental plaque-induced gingival disease
Two important elements of periodontitis are bacteria/biofilm and host inflammatory response
True
False
These two factors are included the periodontitis disease process:
Indirect tissue destruction by the host inflammatory response
Direct tissue destruction by bacteria
Both of these options
Neither of these options
Term when patient is successfully treated for periodontitis & symptoms return appear after several months or years
Refractory periodontitis
Recurrent periodontitis
Redundant periodontitis
Periodontitis
Which of the following is NOT a treatment goal for a patient with periodontitis?
Instrumentation to remove microbial etiology
Elimination of local intraoral factors
Improve the aesthetics/appearanceof the patient's teeth
Reinforce daily home care
All of the following are typical warning signs of periodontitis EXCEPT
Pain
Red, swollen gingiva
Loose teeth
Bad taste in mouth
Localized disease is greater than or equal to 10% of the mouth, generalized disease is less than of equal to 75%.
True
False
All of the following are characteristics of periodontitis EXCEPT:
Disease progresses at a slow or moderate rate
Most common in adults who are younger than 35 years
Can be modified by cigarette smoking
Radiographic evidence of horizontal bone loss
All of the following are true of periodontitis EXCEPT
Host response plays an important role in pathogenesis
The disease ALWAYS progresses at a rapid rate
Signs may include periodontal pockets and tooth mobility
Gingival bleeding is a common clinical finding
Disease sites that have not responded successfully to treatment are characterized by:
Plaque levels compatible with healthy gingiva
Increasing clinical attachment loss
White fibrotic gingival tissue
Pain in the localized area
All of the following are examples of local contributing factors for periodontal disease, EXCEPT:
Dental caries
Occlusal trauma
Crevicular fluid
Tooth morphology
In combination with plaque biofilm, which of the following situations lead to progression of periodontal disease?
Dental caries on the facial of #3
A mesial root concavity on #12
Overhang on restoration on distal #7
All of the above
In a smoker, does absence of BOP always indicate a healthy periodontium?
Yes, an absence of BOP is a sign of health
Yes, absence of BOP means that no gingivitis is present
No, the clinical signs of inflammation are suppressed in smokers
No, periodontium is unhealthy if it is red and swollen
Diabetics have a better response to treatment than non-diabetics.
True
False
Earliest radiographic signs of periodontitis include:
Breaks in alveolar crestal bone
Widening of the PDL space by resorption on the mesial or distal
Fuzziness of the alveolar crestal bone
All of the above
In periodontitis, inflammation can become so serious that it causes permanent damage to the tissues
True
False
What is bone taken from another human or cadaver?
Alloplast
Xenograft
Allograft
Autograft
Regeneration is a result of periodontal surgery that results in regeneration of cementum, PDL, and alveolar bone.
True
False
Apical migration of JE, destruction of PDL fibers, & alveolar bone loss are all results of gingivitis.
True
False
What is the main goal of guided tissue regeneration?
Cover areas of recession
Decrease pocket depth
Obtain tissue health
Regenerate lost alveolar bone and cementum
Acute periodontal conditions are usually related to pre-existing periodontitis.
True
False
An endodontic lesion where bacteria enters a pulp chamber can be a cause of a periodontal abcess.
True
False
An operculum is the bubble lesion that makes up a periodontal abcess.
True
False
What is an operculum?
Tissue that covers a partially erupted tooth
Tissue that covers the retropad
Bone around the tooth
Tissue that cover bone
Alveolar bone loss is one of the signs and symptoms of necrotizing ulcerative gingivitis (NUG).
True
False
Signs and symptoms of necrotizing gingivitis include all of the following EXCEPT
Formation of a pseudomembrane
Punched-out papillae
Swollen lymph nodes
Loss of alveolar bone
Which of the following are routine components of a periodontal maintenance appointment?
Evaluation and resinstruction of home-care techniques
Placement of new restorations
Comprehensive periodontal assessment
Both A and C
Data obtained at the perio maintenanve appt should be measured against data collected at the last perio maintenance appt
True
False
Clinical data collected at the periodontal maintenance appointment should be measured against what?
Initial baseline data
Average patient data
Standard guidelines
Expected readings
Periodontal maintenance can be performed on patients who have previously been treated for gingivitis.
True
False
Periodontal instrumentation is performed during the periodontal examination.
True
False
Which of the following is NOT an objective of the periodontal assessment?
Detect clinical signs of inflammation
Identify damage to the periodontium already caused by disease
Docu features of the periodontium to serve as baseline data
Determine whether a patient needs to see a periodontist
How often is fluoride varnish recommended for reduction in root caries?
6 months
3 months
1 year
2 years
What is recommended therapy for a patient at low-risk for root caries?
Nothing, they are at low risk.
1.23% prescription fluoride toothpaste
5% NaF Varnish
Over-the-counterfluoride toothpaste
The area that the JE and connective tissue attach to the root surface is called the biologic width. This is aprox. 4mm.
True
False
How many mm is the biologic width?
2mm
3mm
4mm
5mm
Fluid movement within the tubules stimulates nerve endings causing sensitivity according to the hydrodynamic theory.
True
False
How long does it take to block open dental tubules?
48 hours
3 months
2-3 weeks
24 hours
What is the most commonly used type of implant?
Subperiosteal
Blank
Endosseous or endosteal
None of the above
Calcium and phosphate forms what substance?
Calculus
Plaque
Fluoride
Biofilm
Stress can contribute to periodontal disease because stress can cause a patient to neglect home care.
True
False
How does calculus negatively impact the periodontium?
Calculus is rough and can scratch the tissue
Calculus is cosmetically unattractive
Calculus deposits always have a thin layer of living plaque biofilm
Calculus releases enzymes that irritate the tissue
Occlusal trauma, and tooth morphology are all local contributing factors for periodontal disease.
True
False
Absence of bleeding always indicates a healthy periodontium, even in smokers.
True
False
What is determined by measuring the distance between the CEJ and the base of the pocket?
Recession
Pocket depth
Width of attached gingiva
Clinical attachment level
Tooth #12 has 3mm of recession and a pocket depth reading of 3mm. What is the clinical attachment loss on this tooth?
2mm
6mm
3mm
0mm
Tooth mobility is measured by measuring how far a tooth moves back and forth as well as depresses into the pocket
True
False
What is the importance of addressing calculus deposits present during a comprehensive periodontal assessment?
Calculus is a necessary factor for the initiation of periodontal disease
Calculus deposits must be removed during nonsurgical therapy
Calculus is a local contributing factor in disease
B and C
Radiographs can accurately display the shape and depth of bone deformaties.
True
False
Radiographs can show periodontal disease activity.
True
False
Radiographs can reveal ALL of the following periodontal conditions EXCEPT
Open crown margins and overhang restorations
Advanced furcations
Widening of the PDL
Early bone loss
All of the following are goals of nonsurgical therapy EXCEPT
Stabilize attachment levels
Eliminate and control local risk factors
Assess the extent of damage caused by periodontal disease
Minimize systemic factors
The scientific basis for performing periodontal instrumentation includes all of the following EXCEPT
Promote patient home care
Promote keratination of the periodontal tissues
Eliminate inflammation
Reduce harmful subgingival bacteria
Three common triggers for dentinal hypersensitivity are brushing, eating cold foods, and eating acidic foods.
True
False
Re-evaluating a pt who was treated for mild periodontitis, the pt has heavy biofilm. What would you recommend?
Refer the patient to perio
Recommend surgical intervention
Schedule a 6 month recall
Retrain the patient in home care and stress the importance
What is the goal of periodontal instrumentation?
Remove the outer layer of diseased cementum
Instrument the roots until "glassy smooth"
Clean the root surface & pocket space enough for tissue to reattach
Remove calculus and deplaque all sulcii
When is the minimum amount of time you should wait before reassessing a patient after periodontal therapy?
2 weeks
1 week
1 month
3 months
An antibacterial chemical agent that is placed directly into a pocket and dissolves over time is called what?
Antimicrobial delivery device
Controlled-releasedelivery device
Anti-bacterial delivery device
Bacterial delivery device
All of the following are indications for periodontal surgery EXCEPT
To remove diseased tissue
To remove the healthy epithelial lining from the inner wall of a pocket
To graft bone into an osseous defect
To reduce pocket depths
The healing pattern after instrumentation in non-surgical therapy is the formation of a long junctional epithelium.
True
False
In gingivitis, the JE migrates apically, PDL fibers are destroyed, & alveolar bone loss can be seen in radiographs.
True
False
Periodontitis is a mixed infection
True
False
All of the following are periodontal pathogens EXCEPT
A. actinomycetemcomitans
P. gingivalis
Tannerella forsythia
Odontolyticus
This component of the cell prevents bacteria from being killed by antibiotics, antimicrobials, or the immune system
Macrophages
Extracellular matrix (slime layer)
Monocytes
Cytokines
This bacteria is commonly found in patients with periodontal disease and not in periodontally healthy patients
Tannerella forsythia
A. actinomycetemcomitans
A. odontolyticus
P. Gingivalis
What is the purpose of increased blood flow to the site of inflammation in the mouth?
Wash the offenders from the site
Deliver immune defenders to the site
Create heat for healing
None of these
True
False
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