Perio Midterm Review
Periodontal Midterm Review Quiz
Test your knowledge on periodontal health with our comprehensive midterm review quiz! This quiz consists of 203 carefully curated questions that cover various aspects of periodontal disease, diagnosis, treatment, and management.
Whether you are a student preparing for exams or a professional looking to refresh your knowledge, this quiz is tailored to help you:
- Enhance your understanding of periodontal concepts
- Identify key risk factors for periodontal disease
- Review important terminology and indices used in the field
Which of the following structures comprise the attachment apparatus?
Gingiva, cementum, alveolar and supporting bone, periodontal ligament
Gingiva, cementum, periodontal ligament
Cementum, alveolar and supporting bone, periodontal ligament
Cementum, alveolar and supporting bone
At which one of the following areas is the width of attached gingiva greatest?
Mandibular second premolars
Mandibular canines
Maxillary lateral incisors
Maxillary first premolars
Maxillary second molars
Which one of the following substances is the primary component of the connective tissue of the periodontium?
Gingival crevicular fluid
Calcium
Collagen
Proteoglycans
Which one of the following structures directly attaches the junctional epithelium to the enamel?
Desmosomes
Hemidesmosomes
Basal lamina
Gingival fibers
Which one of the following structures is involved in the attachment of the gingiva to the tooth surface?
Alveolar mucosa
Dentogingival unit
Mucogingival junction
Desmosomes
Which of the following structures comprise the biological width?
Gingival sulcus, junctional epithelium, gingival connective tissue attachment
Gingival sulcus, sulcular epithelium, gingival connective tissue attachement
Junctional epithelium, gingival connective tissue attachment
Sulcular epithelium, gingiva connective tissue attachment
Which one of the following types of bone lines the tooth socket?
Alveolar
Interradicular
Interdental
Trabecular
Which one of the following structures is referred to as a semipermeable structure?
Junctional epithelium
Oral epithelium
Sulcualar epithelium
Lamina propria
Cementum
All of the following structures are avascular except one. Which is the one exception?
Enamel
Junctional epithelium
Cementum
Lamina propia
Arteries that supply blood and lymphatics to the free gingiva originate from all the following parts of the periodontium except one. Which is the one exception?
Supraperiosteal
Periodontal ligament
Alveolar bone
Cementum
Which one of the following modalities would best determine disease prevalence?
Comprehensive periodontal charting
Epidemiologic population surveys
Patient questionnaires
National dental hygiene expenditures
Which one of the following terms describes the rate of new cases of periodontal disease occurring in a given time period?
Prevalence
Incidence
Severity
Extent
Index
An individual has been identified with advanced attachment loss at one point in time. Is it highly unlikely that this individual will again experience rapid attachment loss(>3mm) within the next three years?
First statement is true, second statement is false
First statement is false, second statement is true
Both statements are true
Both statements are false
Which one of the following indices is best used to monitor a patients plaque control in private practice?
Quigley-Hein Plaque index
Plaque Record (O'Leary)
Periodontal Srceening and Recording system
Sulcus Bleeding Index
Which one of the following best measure the severity of periodontal disease in a population?
Radiographs
Intraoral cameras
Indices
Surgical costs
All of the following potential risk facts are periodontal disease except one. Which is the one exception?
Age
Smoking
Diabetes
Oral cleanliness
A risk indicator differs from a risk factor in that there is no causal relationship of the associated characteristic with the disease. Low income and less education are risk indicators for periodontal disease.
First statement is true, second statement is false
First statement is false, second statement is true
Both statements are true
Both statements are false
According to recent surveys, which one of the following percentages of the US adult population has severe periodontal disease?
5-20
40-50
70-80
90-100
Which one of the following describes how the prevalence of gingivitis changed over the past thirty years?
Increased
Decreased
Remained the same
Increased in the first ten years then decreased
Which one of the following describes the prevalence of aggressive periodontitis in the general population?
Rare
Frequent
Universal
Nonexistent
All of the following are harmful products produced by bacteria that affected the periodontal tissues except one. Which is the exception?
Enzymes
Lipoligosaccharides
Waste products
Crevicular fluid
Which one of the following types of bacteria found in sub gingival plaque is considered pathogenic for periodontitis?
Prophyromonas gingivalis
Actinomyces viscosis
Streptococcus sanguis
Corynebacterium matruchotii
Which one of the following is the primary risk factor for periodontal disease?
Dental calculus
Dental biofilm
HIV/AIDS
Systemic drugs
Which one of the following features makes bacteria an important risk factor for periodontal disease?
Colonize and multiply in subgingival area
Irritate the epithelial lining of the pocket
Breakdown in the epithelial cells in the gingiva
Cause tissue erosion
Which of the following bacteria is primarily found in pregnancy gingivitis?
Porphyromonas gingivalis
Streptococcus sanguis
Prevotella intermedia
Actinomyces viscosis
Loe and coworkers proved that there is a direct relationship between dental plaque and periodontal disease because the removal of dental plaque improves gingival health.
Both the statement and reason are correct and related
Both the statement and reason are correct but not related
The statement is correct but the reason is not
The statement is not correct but the reason is correct
From which of the following sources do sub gingival bacteria receive nutrition?
Saliva
Dental calculus
Crevicular fluid
By-product of bacterial metabolism
Endotoxins from supra gingival plaque
Which of the following types of subgingival plaque cannot be removed with a periodontal debridement?
Tooth-associated
Tissues- associated
Unattached
Invading
In which of the following phases of plaque formation does supragingival bacteria migrate subgingivally?
Phase I
Phase II
Phase III/4-7 days
Phase III/7-11 days
All of the following bacteria are strongly associated with invading epithelium and gingival connective tissue except one. Which is the one exception?
Spinochetes
Aggregatibacter actinomycetemomitans
Prevotella intermedia
Porphyromonas gingivalis
Which one of the following types of cells is primarily recruited in high numbers to the site of acute inflammation?
Mast
Macrophil
Neutrophil
Lymphocyte
Which one of the following cells is phagocytic?
Mast
Lyphocyte
Macrophage
Melanocyte
Which one of the following cells is mainly involved in the body's immune response to invading bacteria?
Lymphocytes
Mast
Macrophages
Neutrophils
Periodontal disease are considered a group of infections characterized by destruction of the periodontium. The direct effects of the bacteria and indirect effects by the body's own immune response are primarily responsible for the destruction.
Both statements are true
Both statements are false
First statement is true, second is false
First statement is false, second is true
The first attempt at self protection from bacterial invasion comes from which one of the following areas in the oral cavity?
Supra gingival environment
Sub gingival environment
Gingival connective tissue
Tonsillar area
Which one of the following cells can contribute to periodontal bone resorption?
Cytokines
Macrophages
Neutrophils
PMNs
Which one of the following cells is responsible for "patrolling" the body?
PMN's
Macrophages
Lymphocytes
Neutrophils
Which one of the following cells/substances is involved in regulating the activity of other cells?
Macrophages
Cytokines
Lymphocytes
Neutrophils
Which one of the following substances are released from all gram-negative bacteria and cause damage to the periodontium?
Hyaluronidase
Collagenase
Leukotoxins
Endotoxins
Which of the following are theories of periodontal disease activity?
Continuous model
Random burst
Asynchronous, multi burst
All of the above
Which one of the following sources accounts for the mineralization of sub gingival calculus?
Salivary proteins
Crevicular fluid
Dental plaque
Acquired pellicle
Which one of the following reasons explains the surfaces of the mandibular incisors?
Difficulty in cleaning the area with a toothbrush
Inability of efficient salivary flow to that area
Presence of the parotid duct
Presence of warton's duct
Which one of the following reasons makes calculus an important local etiologic factor for periodontal disease?
It directly irritates the epithelial lining of the pocket
Minerals cause a breakdown in the epithelial attachment
The presence of lipooligosacchairdes cause the tissue to erode.
It is porous and can provide a reservoir for bacteria
All of the following anatomic factors may predispose a site to periodontal disease except one. Which is the one exception?
Tooth position
Furcation area
Crown surface
Root surface
On which of the following surfaces do palatogingival grooves usually appear?
Lingual surfaces of mandibular lateral incisors
Lingual surfaces of mandibular central incisors
Palatal surfaces of maxillary lateral incisors
Palatal surfaces of maxillary central incisors
Palatal surfaces of maxillary canine
Which one of the following concerns should the dental hygienist be aware of in patients taking bisphosphonates?
Diabetes
Osteonecrosis of the jaw
Stroke
Hypertension
Respiratory disease
Which one of the following evidence exists to support the concept of a genetic predisposition to periodontal disease?
Presence of a specific type of bacteria
Increased levels of bacterial enzymes in the blood
Association of periodontitis with certain transmitted traits
Transmission of bacteria through saliva from mother to child
Which one of the following mechanisms explains how increased stress adversely affects the periodontium?
Increases in subgingival pathogenic bacteria
Increases in estrogen levels results in gingivitis
Less compliance with home care of teeth and gums
Shifts the concentration of available endotoxins
The hormonal changes associated with pregnancy cause an increase incidence of gingival disease because these changes are associated with an increase in sex hormone levels.
Both the statement and reason are correct and related
Both the statement and reason are correct but not related
The statement is correct but the reason is not correct
The statement is not correct but the reason is correct
Smoking affects the periodontium by which one of the following mechanisms?
Decreasing the number of melanocytes
Suppressing of immune system
Altering the metabolism of fibroblasts
Increasing the amount of fibrotic tissue
Decreasing the number of periodontal pathogens
Periodontal disease maybe important risk factor for all of the following medical conditions except one. Which is the one exception?
Stroke
Hypertension
Diabetes mellitus
Low birth weight babies
Kidney failure
Which of the following statements about smoking and periodontal disease is true?
Smoking dramatically affects the oral microflora
Smoking cessation is beneficial to perio health
Past effects of smoking on the periodontium are usually reversible
Current smokers have a low level of tooth mobility
Smokeless tobacco does not increase the incidence of periodontal disease
Which of the following substances may be related to periodontal disease activity to low birth weight babies?
Blood
Suppuration
Gingival crevicular fluid
Prostaglandin E(2)
Saliva
Which of the following bacteria in the mouth has been found to possibly infect and obstruct blood vessels in the heart and the brain?
Prevotella intermeida
Fuscobacterium nucleatum
Porphyromonas gingivalis
Campylobacter retus
Tannerella forsythesis
Which of the following explains why patients with periodontal disease may be at risk for reparatory disease especially in hospital and nursing homes?
Neglected oral hygiene
Decayed teeth
Collapsed circulatory system
Increased risk for heat failure
Increased risk for other systemic disease
Which of the following features describes gingivitis?
Occurs primarily in children
Extensive attachment loss
Bone loss does not occur
Primary risk factors include pathogenic bacteria and calculus
All of the following medications are contributing risk factors in causing gingival enlargement except one. Which is the one exception.
Phenytoin
Cyclosporine
Ibuprofen
Nifedipine
Valproate
Which one of the following periodontal disease is described by having inflammation of the gingiva without loss of clinical tissue attachment?
Dental plaque-induced gingivitis
Chronic periodontitis
Aggressive periodontitis
Refractory periodontitis
Which periodontal lesion, according to Page and Schroeder, is characterized by chronic gingival inflammation and the presence of plasma membrane?
Initial
Early
Established
Advanced
Today, most oral contraceptives do not cause gingival inflammation because of the lower level of hormones used.
Statement and reason are correct
Statement and reason are false
Statement is correct, reason is false
Statement is false, reason is correct
Which periodontal lesion, according to Page and Schroeder, is characterized as chronic gingival inflammation and the initial presence of PMNs?
Initial
Early
Established
Advanced
During the disease process, junctional epithelium transforms into...
Alveolar bone
Periodontal ligament
Pocket epithelium
Sulcular epithelium
Oral epithelium
Which of the following lesions does clinical inflammation first appear?
Initial
Early
Established
Advanced
Which one of the following features described chronic periodontitis?
Occurs primarily in children
No connective tissue attachment loss occurs
Bone loss does not occur
Risk factors include pathogenic bacteria and smoking
The latest classification of periodontitis is based on all of the following facts except one. Which is the one exception?
Age of patient
Clinical presentation
Radiographic survey
Historical data
Microbial profile
Which one of the following forms of periodontitis is associated with chemotactic defect in the polymorphonuclear leukocytes or macrophages?
Dental plaque induced gingivitis
Chronic periodontitis
Puberty gingivitis
Localized aggressive periodontitis
Drug influenced gingivitis
Which one of the following bacteria is found in high numbers in localized aggressive periodontitis?
Prophyromonas gingivalis
Prevotella intermedia
Actinomyces viscosus
Aggregatibacteria actinomycetemcomitans
Which one of the following types of pocket has its base located apical to the alveolar crest as evidenced on a radiograph?
Gingival
Pseudo
Suprabony
Infrabony
Which one of the following features differentiates periodontitis from gingivitis?
Dilation of blood vessels in the lamina propria
Redness of the gingiva
Loss of connective tissue attachment
Number of bacteria present in the pocket
Which periodontal lesion according to Page and Schroeder, is characterized by attachment loss and bone resorption?
Initial
Early
Established
Advanced
A periodontal pocket forms when...
The junctional epithelium migrates apically and laterally from the tooth surface
Gingival fibers proliferate
Bacteria multiply in the pocket
Alveolar bone loss occurs
All of the following factors are responsible for bone loss except one. Which one is the exception?
Prostaglandins
Endotoxins
B-cells
Hyaluronidase
Which one of the following periodontal diseases classification is characterized by localized vertical bone loss in the first molars in a 13 year old patient with little plaque accumulation?
Chronic periodontitis
Generalized gingivitis
Localized aggressive periodontitis
Ulcerative periodontitis
Which one of the following statements describes a patient with necrotizing periodontal disease?
Higher prevalence in females then males
Higher incidence of skin lesions
Pain is prominent feature
Geographic distribution shows a higher prevalence in the eastern US
Which of the following bacterium present in NUG patients may penetrate periodontal tissues?
Treponema denticola
Prevotella intermedia
Fusobacterium species
Streptococcus sanguis
Both necrotizing ulcerative gingivitis and necrotizing ulcerative periodontitis are currently categorized under the classification of
Acute necrotizing disease
Necrotizing ulcerative disease
Chronic periodontitis
Aggressive periodontitis
Necrotizing ulcerative gingivitis may be the first clinical sign of underlying systemic disease such as
Human immunodeficiency virus infection
Diabetes mellitus
Osteoporosis
Kidney failure
Which of the following diseases must be differentiated from NUG?
Herpes simplex type 2
Primary herpetic gingivostomatitis
Canker soars
Acquired immunodeficiency syndrom
All of the following criteria that define NUG except one. Which is the one exception?
Pain
Bleeding
Papillary necrosis
Fever
The distinguishing feature between NUP and NUG is
Amount of gingival bleeding
Alveolar bone loss
Number of bacteria present in pocket
Intensity of pain
Which of the following conditions is a concern in immunosuppressed necrotizing ulcerative disease patients?
Fungal infection
Heart problems
Stunting of growth
Protozoa infection
A prominent sign of NUG is
High fever
Punched out interdental papillae
Gingival abscess formation
Alveolar bone loss
The "older" term for NUG is
Oral gingivitis
Atypical gingivitis
Trench mouth
Aphtous ulcer
All of the following parts of the periodontium are affected by occlusal trauma except one. Which is the one exception?
Periodontal ligament
Alveolar bone
Gingiva
Cementum
All of the following signs and symptoms are found in occlusal trauma except one. Which is the one exception?
Tooth mobility
Tooth migration
Pain upon chewing
Occlusal erosion
Which one of the following radiographic signs is evident in occlusal trauma?
Widening of periodontal ligament space
Deposits of acellular cementum
Deposits of alveolar bone
Receding pulp tissue
Occlusal trauma in combination with chronic inflammatory periodontitis may result in greater tooth mobility and alveolar bone loss because occlusal trauma causes periodontal pocket formation
Both statement and reason are correct and related
Both statement and reason are correct but not related
The statement is correct, but the reason is not
The statement is not correct, but the reason is correct
Two days after a patient receives an amalgam restoration, he reports back to the office complaining of pain and looseness of the tooth. Which one of the following would be most appropriate?
Replace amalgam with composite
Reduce the heigh of the restoration
Polish the restoration
Maintain the restoration as is
Which one of the following factors is the primary cause of secondary occlusal trauma?
Tooth with severe bone loss
Night and daytime bruxism
Tongue thrusting
Pipe chewing
A patient complains of soreness in the jaw upon waking up in the morning. She is having stressful problems at work. She complains that some of her lower teeth are "wearing down." Which one of the following conditions does this patient most likely have?
Fractured Jaw
Parafun
Severe periodontitis
Necrotizing ulcerative gingivitis
Which one of the following conditions is best treated with a night guard?
Tooth with severe bone loss
Tongue-thrusting habit
Teeth with severe abrasion
Clenching and grinding
Which of the following is most common bacterium found in the purulent exudate of a tooth with a periodontal abscess?
Porphyromas gingivalis
Candida albicans
Staphococcus sp.
Actinobacillus actinomycetemcomitants
A gingival abscess is localized to the
Periapical area
Interdental papilla
Periodontal pocket
Pericoronal area
Which of the following clinical features of a periodontal abscess?
Fibrotic gingiva
Edematous gingiva
Gingival recession
Firm gingiva
Which of the following is a complication from a pericoronal abscess?
Gingival recession
Trismus
Attrition
Furcation defect
Fibrotic gingiva
Which of the following is occurring when a pocket entrance is "opened" with a probe or curet on the tooth with an acute periodontal abscess?
Transformation of the epithelium into connective tissue
Conversation of the acute abscess into a gingival abscess
Incision and drainage
Laceration of the fistula tract
The radiographic evaluation of alveolar bone loss associated with periodontitis is based on the status of which of the following structures?
Interdental septum
Cementoenamel junction
Periodical bone
Periodontal ligament fibers
Which one of the following radiographic structures is described as a thin radiopaque line surrounding the entire tooth and is continuous with the alveolar crest?
Dentin
Cementum
Lamina dura
Periodontal ligament fibers
Gingival fibers
Which one of the following types of images uses less radiation and is used before implant placement?
Panoramic
periapical
Cone beam CT
Vertical bitewing
Which one of the following types of radiographs is best to evaluate the alveolar bone crest for moderate to severe bone loss?
Periapical
Horizontal bitewing
Vertical bitewing
Panoramic
Computed tomography
Which of the following predisposing facts of periodontal diseases can be seen on radiographs?
Gingival recession
Periodontal pockets
Furcation involvement
Tooth mobility
All of the following types of radiographs are currently used in the treatment/planning of implants except one. Which is the one exception?
Periapicals
Bitewings
Panoramic
CT scan
Which one of the following features does the computed tomographic process provide?
A three-dimensional view of the area if interest
Two-dimensional view of the area if interest
A global view of all oral structures
A closeup view of the periodical structures
All of the following are reasons for using radiographs in periodontics except one. Which is the one exception?
Identify predisposing factors
Detect early to moderate bone changes
Determine the shape and depth of periodontal pockets
Determine baseline data and use a mean of evaluating pretreatment results
The normal crest of interproximal bone is located____________
2.0 mm apical to the cementoenamel junction
3.0 mm apical to the cementoenamel junction
2.0-3.0 mm coronal to the cusp tip of the crown
3.5 mm apical to the cusp tip of the crown
Which one of the following types of radiographs is used primarily in clinical research rather than lineal practice?
Panoramic film
Direct digital
Digital subtraction
Computed tomography
Which of the following tissues is NOT part of the periodontium?
Periodontal ligament
Gingiva
Cementum
Alveolar mucosa
During mastication, the tooth is cushioned from occlusal forces by the:
Periodontal ligament
Gingiva
Cementum
Alveolar bone
After many years, the periodontal instrumentation might remove a part of the periodontium. Which anatomical area of the periodontium could be removed from the root after years of instrumentation?
Periodontal ligament
Gingiva
Cementum
Alveolar bone
Lattice-like bone that fills the interior portion of the alveolar process refers to:
Cortical bone
Cancellous bone
Periosteum
Cribriform plate
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?
Mast cell
Extracellular matrix
Nucleus
Collagen fiber bundle
A dental hygienist inserts a periodontal probe into a deep 6 mm periodontal pocket until it reaches the base of the pocket. Which anatomical structure forms the base of the periodontal pocket?
Junctional epithelium
Sulcular epithelium
Basal epithelium
Oral epithelium
Which demarcation is a shallow linear depression that separates 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 prevent plaque biofilm from entering the gingival connective tissue
They provide free gingiva with rigidity needed to withstand frictional forces during chewing
They unite free gingiva with cementum of the root
All of the following are functions of the periodontal ligament EXCEPT:
It attaches the tooth to the bony socket
It provides sensory and nutritive function
It unites free gingiva with cementum
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
Sharpey's fibers
Rete pegs
Endpoint fibers
The characteristics of periodontitis may include which of the following:
Apical migration of the junctional epithelium
Destruction of the gingival and PDL fibers
Loss of alveolar bone
All of the above
Which of the following is the most common pattern of bone loss?
Vertical bone loss
Horizontal bone loss
Interproximal bone loss
Circumferential bone loss
The difference between a gingival pocket and a periodontal pocket is that:
A gingival pocket is a result of increased size of the gingiva due to inflammation, and a periodontal pocket is a result of apical migration of junctional epithelium and alveolar bone loss
A gingival pocket does not have exudate, and periodontal pocket exhibit exudate
A gingival pocket occurs when there is horizontal bone loss, and a periodontal pocket occurs when there is vertical bone loss
A periodontal pocket is a "false" pocket while a gingival pocket is a "true" pocket
Continued apical migration of the junctional epithelium indicates a:
Pseudopocket
Site of active disease
Gingivitis
Inflammation
In gingivitis, all of the following are histologic changes that can occur EXCEPT:
The junctional epithelium is still coronal to the CEJ
The junctional epithelium may start to detach at the coronal end
There is loss of alveolar bone
There are no changes to the PDL fibers or alveolar bone
Gingival papillae that are enlarged and expand out of the interproximal spaces are described as:
Blunted papilla
Bulbous papilla
Cratered papilla
Soft, spongy tissue
Increased fluid in inflamed gingival tissue (edema) can be best described as:
Soft and spongy tissue
Firm and fibrotic tissue
Tissue that is pink and firm
Gingival tissue with pointed, knife-like papilla
When describing distribution of gingivitis, all of the following may be applied EXCEPT:
Papillary
Lingual
Diffuse
Marginal
The dental clinician notes the following clinical signs during the periodontal assessment of an young female teenager: • A small amount plaque biofilm present at the gingival margin • Gingival tissues appear bright red and soft • Bleeding upon gentle probing • Gingival margin slightly coronal to the CEJ • Probing depths of 2 to 3 mm • An inflammatory response that seems exaggerated given the small amount of plaque biofilm. Which of the following types of periodontal disease should the hygienist suspect for this patient?
Plaque-induced gingivitis
Gingival disease associated with endocrine system and fluctuations in sex hormones
Drug-influenced gingival enlargement
Gingival diseases of a specific bacterial origin
What is the first clinical sign of gingivitis?
Tooth mobility
Bleeding on probing
Furcation involvement
Gingival recession
Diabetes-associated gingivitis is an example of:
Dental plaque--induced gingival disease
Gingival disease modified by malnutrition
Gingival disease of genetic origin
Gingival disease modified by a systemic factor
Two important elements of periodontitis are bacteria/biofilm and host inflammatory response.
True
False
The disease process in periodontitis includes:
Direct tissue destruction by bacteria
Indirect tissue destruction by the host inflammatory response
Both a and b
Neither a nor b (there is no destruction of tissues in periodontitis)
A patient was successfully treated for periodontitis 2 years ago, but today presents with a reappearance of the signs of symptoms of periodontitis. Which of the following is the most likely disease classification for this patient?
Periodontitis
Redundant periodontitis
Recurrent periodontitis
Refractory periodontitis
Which of the following is NOT a treatment goal for a patient with periodontitis?
Reinforce daily home care
Improve the aesthetics/appearance of the patient's teeth
Elimination of local intraoral factors
Instrumentation to remove microbial etiology
All of the following are typical warning signs of periodontitis EXCEPT:
Bad taste in the mouth
Loose teeth
Red, swollen gingiva
Pain
Periodontitis may be localized (10% >) or generalized (> 75%) and may be modified by systemic (diseases) or local risk factors (poor restorations).
True
False
The yellow-white or grayish tissue slough covering affected gingival tissues in Necrotizing Periodontal Disease is called:
Gingival halo
Fibrin
Pseudomembrane
Gingival derma
Associated symptoms of Necrotizing Periodontal Disease include all of the following EXCEPT:
Pigmented gingiva
Fetid odor
Excessive salivation
Swollen lymph nodes
Predisposing factors (risk factors) for developing necrotizing periodontal diseases include:
Poor oral hygiene
Stress
Alcohol
Smoking
All of the above can be risk factors
Although tissues in necrotizing periodontal diseases appear fiery red and inflamed, they are NOT painful.
True
False
The tissues that surround the implant are termed the:
Peri-implant tissues
Transgingival tissues
Periodontium
None of these
The biologic seal functions as a barrier between the implant and the oral cavity.
True
False
Osseointegration is regarded as successful if there is:
Absence of gingival inflammation of peri-implant tissues
Radiographic bone loss of 3mm per year
No more than a class II clinical mobility
Discomfort only when in function
Dental implants should be checked radiographically at least __________.
Every 2 months
Every 6 months
Once a year
Every other year
Which of the following scalers is BEST for instrumenting around implants?:
Sickle scaler constructed of plastic
Universal ultrasonic tip
A gold-tipped curette
Scaler made of titanium
All of the following are clinical signs of a failing implant EXCEPT:
Bleeding on probing
Pain
Pink, firm tissue
Radiographic bone loss adjacent to the implant
A sulcus lined by sulcular epithelium surrounds the implant abutment post.
True
False
It is important to use clinical findings (data) and radiographs to sequence the treatment plan and set a goal for treatment.
True
False
A sequential outline of the measures to be carried out by the dentist, the dental hygienist, and the patient to eliminate disease and restore a healthy periodontal environment is termed:
Periodontal maintenance
Nonsurgical periodontal instrumentation
Master periodontal treatment plan
Collective outline of treatment
The clinical measurement(s) that determine(s) the difference between gingivitis and periodontitis is the __________________.
Clinical loss of attachment (CAL)
Level of the free gingival margin
Pocket depth readings
Clinical mobility and furcation involvement
Periodontal instrumentation is part of which periodontal therapy phase?
Preliminary therapy phase
Nonsurgical periodontal therapy phase
Surgical therapy phase
Maintenance therapy phase
Which phase in the treatment plan includes all measures used to keep periodontitis from recurring once the inflammatory disease is brought under control?
Preliminary therapy phase
Nonsurgical periodontal therapy phase
Surgical therapy phase
Maintenance therapy phase
All of the following are characteristics of shared decision making EXCEPT:
Care plan is developed in partnership with the patient
Elicit the patient's ideas, concerns and expectations
Consult with the dentist and other health care professionals but not the patient
Document the agreed upon periodontal care plan and make arrangements for follow-up
The two sources of expertise that bring equally important forms of experience to decision-making process are:
Treatment options and values
Clinician and patient
Dental hygienist and dentist
Standard of care and textbooks
A patient's voluntary agreement to proposed treatment.
Treatment phasing
Informed refusal
Informed consent
Patient approval
A local risk factor for periodontitis can be acquired (poorly contoured restorations) OR anatomical (deep root grooves).
True
False
Which of the following factors is considered the MOST significant risk factor for developing periodontal disease?
Long-term use of medicines that cause gingival overgrowth
Chronic poor home-care
Smoking cigarettes
Stress
Which of the following are believed to play an important role in periodontitis?
Innocuous bacteria
Gram-negative bacteria
Gram-positive bacteria
Nonpathogenic bacteria
If a bacterium wants to join a biofilm, it should look for which of the following conditions:
An area of the mouth with a large number of free-floating bacteria
Clumps of bacteria floating in the saliva
A freshly formed area of pellicle on a tooth surface
A group of bacteria attached to a tooth surface
Periodontitis is associated with high proportions of:
Aerobic bacteria
Nonmotile bacteria
Gram-negative bacteria
Innocuous bacteria
Which of the following species is frequently detected in aggressive forms of periodontitis?
A) A. odontolyticus
B) A. actinomycetemcomitans
C) Porphyromonas gingivalis
D) Both B and C
The cell-to-cell adherence of one oral bacterium to another is termed:
A bacterial bloom
Coaggregation
Acquired pellicle
A microcolony
The first bacteria to colonize the tooth surface are:
Nonpathogenic
Pathogenic
Motile
Anaerobic
Early colonizers of the plaque biofilm are:
Gram-negative bacteria
Gram-positive bacteria
Motile bacteria
Anaerobic bacteria
All of the following are true regarding the benefits of daily disruption of plaque biofilms, EXCEPT:
Periodontal pathogens cannot colonize the tooth surface until the nonpathogenic bacteria attach to the pellicle
A disrupted biofilm must reform in a specific sequence
Motile bacteria are important first colonizers of the pellicle
Each bacterial strain only has a limited set of bacteria to which it can adhere
The type of bacterial subgingival attachment that is the most detrimental (harmful) to the periodontal tissues is:
Tissue-associated plaque biofilm
Tooth-associated plaque biofilm
Bacteria that float in the periodontal pocket space
Pellicle-associated plaque biofilm
A biofilm is:
Free-floating bacteria loosely connected
A well-organized community of bacteria
A calcified community of bacteria difficult to remove
An acellular translucent film thriving on moist surfaces
Antimicrobial agents work best when used with mechanical cleaning/disruption.
True
False
All of the following statements are true about biofilm, EXCEPT:
Biofilm is a well-organized community of bacteria that adheres to surfaces
Bacteria in biofilm are embedded in an extracellular slime layer
Bacteria in biofilm can be resistant to antibiotics
An example of biofilm is tobacco stain on teeth
The most successful means of destroying plaque biofilm on teeth is:
Double dose of antibiotics
Oxygen
Mechanical removal through good home care
Antimicrobial rinse
Within minutes after cleaning, the pellicle attaches to tooth surfaces.
True
False
Which of the following statements about disease progression is FALSE?
As disease progresses, the number of bacteria in a site increases
As disease progresses, bacteria become more motile
As disease progresses, the bacteria population becomes more gram-negative
As disease progresses, the bacteria become more gram positive
Bacteria can penetrate through epithelium and invade the gingival connective tissue.
True
False
Motile bacteria use ______________ to swim.
Wings
Flagella
Fingers
A cell wall
Your friend cut her finger while chopping vegetables yesterday. Today her finger is twice its normal size. What is the cause of the SWELLING?
Entry of fluid and cells into the connective tissues of the finger
A severe bacterial infection in the open cut in her finger
Decreased blood flow from the area of the cut in her finger
Destruction of epithelial tissue cells in the area of the cut
Your neighbor has a chronic inflammation in her foot due to diabetes. What signs and symptoms would you expect your neighbor to experience with this chronic inflammation?
Redness
Heat
Pain
None of these
In a bacterial infection of the periodontium, the cells that arrive to the infection site first (the rapid responders) are the:
Polymorphonuclear leukocytes (PMNs)
Macrophages
Monocytes
T-lymphocytes
A collection of responses that protects the body against infections by bacteria, viruses, fungi, toxins, and parasites:
Immune System
Complement System
Phagocytosis
Recruitment of cells
A leukocyte exits the blood vessel and enters the connective tissue to travel to the site of an infection. What is the process called whereby leukocytes are attracted to an infection site?
Opsonization
Chemotaxis
Trans-endothelial migration
Phagocytosis
A polymorphonuclear leukocyte (PMN) travels to an infection site, attaches to a bacterium, ingests, and digests the unfortunate bacterium. The process of engulfing and digesting microorganisms is termed:
Opsonization
Chemotaxis
Trans-endothelial migration
Phagocytosis
Biologically active compounds secreted by cells that activate the body's immune system are termed:
Degranulation proteins
Chemotaxic chemicals
Biochemical mediators
C-reactive proteins
Inflammation is the body's reaction to:
A. Injury
B. Invasion of pathogens
C. Bruising
A and B
All of the following are symptoms of inflammation EXCEPT:
Bruising
Heat
Swelling
Pain
Which immune cells are known as the "First Responders" ?
Leukocytes
Macrophages
PMN's
T- and B-lymphocytes
B-lymphocytes affect microorganisms by:
Engulfing and phagocytizing invading organisms
Secreting antibodies
Intensifying the immune system
Killing microorganisms on contac
In which phase of periodontal disease progression do clinical features first appear (redness of the gingival marginal tissues, edema)?
Early lesion
Established lesion
Initial lesion
Advanced lesion
In which phase of periodontal disease progression do the PMNs first begin to travel through the bloodstream to the gingival connective tissue?
Initial lesion
Established lesion
Early lesion
Advanced lesion
Which of the following is a biochemical mediator that causes extensive collagen destruction of the periodontal tissues?
Matrix metalloproteinases (MMPs)
Recombinant monokines
Prostaglandins of the E series (PGE)
Plasma cells
Periodontal pathogens alone cause periodontal disease.
True
False
Cytokines function to:
Send macrophages to the site of infection
Potentially initiates destruction and bone loss
Attracts immune cells to an infection site
All of these
Matrix metalloproteinases' (MMPs) functions:
Responsible for collagen destruction in periodontal tissue
Decrease rate of repairs to the periodontal connective tissue
Initiate alveolar bone destruction in periodontitis
Decrease a periodontal pocket to a gingival pocket
Which phase of periodontal disease progression includes bacterial colonization near gingival margins?
Initial lesion - bacterial accumulation phase
Early lesion - early gingivitis
Established lesion - established gingivitis
Advanced lesion - periodontitis
In advanced periodontitis, tissue destruction becomes the main outcome of the immune response.
True
False
Activity by the body's immune system can cause tissue destruction.
True
False
Tobacco smoking is a known risk factor for periodontal disease. Which of the following risk factor categories does it fall under?
Genetic
Accumulated
Environmental
Healthy
The "engulfing process" of bacteria is called:
Phagocytosis
Cytokine activity
Cellular release
Replication
The second layer of defense is the:
Phagocytosis
Complement system
Mytosis
Bacterial reproduction
Another name for Lipopolysaccharides is:
Endotoxins
Bacteria
Immunity
Immune System
Lipopolysaccharides (endotoxins) are found on the outer layer of:
Gram positive bacteria
Gram negative bacteria
Cytokines
B lymphocytes
Some periodontal bacteria (ex: p. gingivalis) can invade host tissues, and produce enzymes such as collagenases and proteases that can directly destroy host tissues.
True
False
In cases where inflammation becomes chronic, the inflammation can become so intense that it inflicts permanent damage to the body tissues...this is the case in periodontitis.
True
False
Periodontitis is:
An infection caused by 5 to 10 species of bacteria
A mixed infection
An infection caused by 700 species of bacteria
A single species infection
The rate of periodontal destruction is the same on an implant and a natural tooth.
True
False
Periodontitis is a reversible disease.
True
False
Gingivitis is reversible!
True
False
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