Periodontics FINAL exam review
What are five types of things the immune system protects the body against?
Bacteria
Viruses
Fungi
Toxins
Parasites
Cholesterol
Which cells are the first to arrive at an infection site?
PMN neutrophils
Leukocytes
Lymphocytes
What are the four functions of the complement system?
Destruction of pathogens
Opsonization of pathogens
Recruitment of phagocytes
Immune clearance
To allow easier access to invasive microorganisms
Which best describes Chemotaxis?
Process whereby leukocytes: enter the connective tissue and are attracted to the site of the infection in response to biochemical compounds released by invading bacteria
Substance produced by the liver that increases the presence of inflammation in the body
Biologically active compounds secreted by cells that activate the body’s inflammatory response including the likes of: Cytokines, Prostaglandins, Matrix metalloproteinases
When leukocytes push their way between the endothelial cells and enter the connective tissue near the infection site.
Which best describes Trans-endothelial migration
When leukocytes push their way between the endothelial cells and enter the connective tissue near the infection site.
Substance produced by the liver that increases the presence of inflammation in the body
Process whereby leukocytes: enter the connective tissue and are attracted to the site of the infection in response to biochemical compounds released by invading bacteria
Biologically active compounds secreted by cells that activate the body’s inflammatory response including the likes of: Cytokines, Prostaglandins, Matrix metalloproteinases
Which best describes Phagocytosis
The process by which leukocytes engulf and digest microorganisms
Substance produced by the liver that increases the presence of inflammation in the body
Process whereby leukocytes: enter the connective tissue and are attracted to the site of the infection in response to biochemical compounds released by invading bacteria
Biologically active compounds secreted by cells that activate the body’s inflammatory response including the likes of: Cytokines, Prostaglandins, Matrix metalloproteinases
Which best describes Biochemical mediators
Biologically active compounds secreted by cells that activate the body’s inflammatory response including the likes of: Cytokines, Prostaglandins, Matrix metalloproteinases
Substance produced by the liver that increases the presence of inflammation in the body
Process whereby leukocytes: enter the connective tissue and are attracted to the site of the infection in response to biochemical compounds released by invading bacteria
When leukocytes push their way between the endothelial cells and enter the connective tissue near the infection site.
Which best describes C-reactive proteins?
Substance produced by the liver that increases the presence of inflammation in the body
Process whereby leukocytes: enter the connective tissue and are attracted to the site of the infection in response to biochemical compounds released by invading bacteria
Biologically active compounds secreted by cells that activate the body’s inflammatory response including the likes of: Cytokines, Prostaglandins, Matrix metalloproteinases
When leukocytes push their way between the endothelial cells and enter the connective tissue near the infection site.
Which best describes Acute inflammation?
Short term, normal process that protects and heals the body. It is achieved by the increased movement of plasma and leukocytes from the blood into injured tissues
Long-lived, out of control inflammatory response that continues for more than a few weeks. It is a pathologic condition that can destroy healthy tissue and cause more damage than the original problem.
Which best describes Chronic inflammation?
Long-lived, out of control inflammatory response that continues for more than a few weeks. It is a pathologic condition that can destroy healthy tissue and cause more damage than the original problem.
Short term, normal process that protects and heals the body. It is achieved by the increased movement of plasma and leukocytes from the blood into injured tissues
Why does increased blood flow comes to an area of inflamamtion?
Chemical mediators cause the blood vessels to dilate, increasing blood flow to the injured area
Because of the great influx of bacteria entering the area
What is the difference between monocytes and macrophages?
Monocytes are in the bloodstream, while macrophages are in the tissues
Macrophages are in the bloodstream, while monocytes are in the tissues
Which of the following seven are characteristics of shard decision making?
Develop a partnership with the patient
Establish patients preferences
Respond to patient’s ideas and expectations of therapy
Identify best choices for treatment after evaluating research
Allow the patient to reflect on alternative treatment
Develop the care plan in partnership
Document agreed-upon periodontal care plan
Discussing about price and what would fit the patient's budget
Which two sources of expertise brings equally important forms of experience to the decision-making process?
Patient
Clinician
Professional journal writer
Which of these five are related to informed consent?
A well informed patient is more compliant with treatment recommendations.
Patients have a higher trust in health care providers
Patients are more satisfied with their care
Leads to better treatment outcomes
Reduces malpractice risk
Doesn't have to be voluntary
What seven things happens when the patient and clinician arrive at a treatment decision?
Ask the patient if they are ready to decide
Confirm their decision
Assist patient to follow through with decision
Assist in removing any barriers to implementing the decision
Make plans to review any postponed treatment
Monitor extent of treatment implementation
Revisit the decision with the patient fi anything changes or other options are needed
Stick with the first decision seeing how that's the best fit
What three legal issues would a provider come into when informed consent is involved?
Clinician did not perform treatment as decided upon
Clinicians did not inform patient properly or thoroughly about risks involved
Poor record keeping
Forgery from the patient
What best defines informed refusal?
An individual has a legal right to refuse all or part of the proposed treatment
An individual is NOT allowed to refuse depending on the severity of their condition
What are the four components of the periodontium?
Gingiva
Cementum
Periodontal ligament
Alveolar bone
Pulp cavity
Which part of the periodontium cushions the tooth from occlusal forces?
Periodontal ligament
Cementum
Which best describes free gingiva?
Unattached portion that surrounds a tooth in the region of CEJ, also known as ‘marginal’ or ‘unattached’ gingiva
The part of the gingiva that is tightly bound to the underlying cementum found on the cervical-third of the root and on the periosteum of alveolar bone
Which best describes attached gingiva?
The part of the gingiva that is tightly bound to the underlying cementum found on the cervical-third of the root and on the periosteum of alveolar bone
Unattached portion that surrounds a tooth in the region of CEJ, also known as ‘marginal’ or ‘unattached’ gingiva
What is the normal probing depths of healthy tissue?
1-3mm
2-4mm
What are the four functions of the periodontal ligament?
Supportive to maintain tooth in socket
Sensory provides feelings like pressure and pain
Nutritive by providing nutrients to cementum and bone
Formative by providing cementoblasts and osteoblasts
To make sure that the roots don't dig too deep into the alveolar bone
What anchors the PDL fibers to the tooth?
Cementum
Alveolar process
Which best describes Alveolar bone proper?
Cribiform plate consisting of the alveolus, foramina, and sharpey fibers
Layer of connective tissue that covers the outer surface of bone
Spongy bone that fills the interior portion of the alveolar process and is found in interproximal areas
Layer of compact bone that forms the outer wall on the facial and lingual and consists of the alveolar Crest
Which best describes Cortical bone?
Layer of compact bone that forms the outer wall on the facial and lingual and consists of the alveolar Crest
Layer of connective tissue that covers the outer surface of bone
Cribiform plate consisting of the alveolus, foramina, and sharpey fibers
Spongy bone that fills the interior portion of the alveolar process and is found in interproximal areas
Which best describes Cancellous bone?
Spongy bone that fills the interior portion of the alveolar process and is found in interproximal areas
Layer of connective tissue that covers the outer surface of bone
Cribiform plate consisting of the alveolus, foramina, and sharpey fibers
Layer of compact bone that forms the outer wall on the facial and lingual and consists of the alveolar Crest
Which best describes Periosteum?
Layer of connective tissue that covers the outer surface of bone
Cribiform plate consisting of the alveolus, foramina, and sharpey fibers
Spongy bone that fills the interior portion of the alveolar process and is found in interproximal areas
Layer of compact bone that forms the outer wall on the facial and lingual and consists of the alveolar Crest
What is the definition of pathogenesis?
The sequence of events that occur during the development of a disease or abnormal condition
The sequence of events during researching a new disease type
What is the main difference between gingivitis and periodontitis?
Gingivitis results in reversible destruction to the tissues of the periodontium and is confined to the gingiva, while periodontitis results in irreversible tissue damage and infects ALL parts of the periodontium
Periodontitis results in reversible destruction to the tissues of the gingivitis and is confined to the gingiva, while periodontitis results in irreversible tissue damage and infects ALL parts of the periodontium
True or false? Gingivitis doesn't always progress into periodontitis
True
False
when are signs of gingivitis clinically observed after cessation of oral self-care?
It is clinically observed from 4 to 14 days after plaque biofilm accumulates in the gingival sulcus
It is clinically observed from 15 to 30 days after plaque biofilm accumulates in the gingival sulcus
What are two characteristics of chronic gingivitis?
Last for months or years
New collagen fibers are formed resulting in more fibrotic tissue
Are there for a short amount of time before dispersing
What best describes Horizontal bone loss?
The most common pattern of bone loss, resulting in a fairly even reduction in height of bone
Less common pattern of bone loss, resulting in uneven reduction in bone height. It also results in more rapid progression of bone loss next to the root surface
What best describes Vertical bone loss?
Less common pattern of bone loss, resulting in uneven reduction in bone height. It also results in more rapid progression of bone loss next to the root surface
The most common pattern of bone loss, resulting in a fairly even reduction in height of bone
Why is it good to have a classification system for classifying periodontal diseases? Three choices
Helps diagnosing and treating periodontal and peri-implant diseases
Communicating clinical findings accurately to other health care providers
Submitting information to dental insurance providers
Because diseases rarely change over time
The staging concepts of the AAP periodontal disease classification is based on which two?
Severity
Complexity
Extent
Distribution
True or false? Gingivitis is always caused by bacteria plaque
False
True
Which of the following three are apart of the different grades of the AAP periodontal Disease classification system?
Grade A: Slow rate of disease progression
Grade B: Moderate rate of disease progression-
Grade C: Rapid rate of disease progression
Grade D: Extreme rate of disease progression
Which of the following six best match healthy gingiva?
Does not bleed when stimulated by clinical procedures like gentle probing
Free from inflammation and not altered by disease or trauma
Has a uniformed pink color
Lies snugly around tooth and firmly against alveolar bone
Is smooth and evenly scalloped
Resilient and is firmly bound to underlying cementum and bone
Bulbous, blunted or cratered contour
Which of the following six best match gingivitis?
Bulbous, blunted or cratered contour
Bleeding upon probing is evident
Reddish Inflamed appearance
Enlarged tissues due to increased fluids
Becomes soft, spongy, and nonelastic
Becomes flaccid when blown with air
Has a uniformed pink color
Which three best describes consistency of healthy tissue?
Firmly bound to underlying cementum and bone
Resilient and springs back quickly when pressed gently with a probe
Does not pull away from tooth when air is blown into the sulvus
Becomes soft, spongy, and nonelastic
How does increased fluid in inflamed gingival tissue causes the tissue to be characterized as?
It causes the tissue to be inflamed, soft, spongy and nonelastic. As well as flaccid with air
It causes them to appear more pink and uniform in texture and consistency
True or false? Regarding stippling, It can be detected by drying tissue gently with air syringe and is associated with healthy tissue. Diseased tissue will lack these.
True
False
What best describes Papillary inflammation?
Inflammation confined to the papilla
Inflammation is throughout the gingival margin, papilla, and attached gingiva; extending to the mucogingival junction
Inflammation confined to the gingival margin and papilla
What best describes Marginal inflammation?
Inflammation confined to the gingival margin and papilla
Inflammation is throughout the gingival margin, papilla, and attached gingiva; extending to the mucogingival junction
Inflammation confined to the papilla
What best describes Diffuse inflammation?
Inflammation is throughout the gingival margin, papilla, and attached gingiva; extending to the mucogingival junction
Inflammation confined to the papilla
Inflammation confined to the gingival margin and papilla
What is the most common type of periodontal disease?
Plaque induced gingivitis only
Non-plaque induced gingivitis only
Which choice best matches Cratered papilla
Papilla that appear to have been scooped out
Becomes more concave in shapes, interproximal
Appears overgrowth and puffy around the gingival margin
Which choice best matches Bulbous papilla
Appears overgrowth and puffy around the gingival margin
Becomes more concave in shapes, interproximal
Papilla that appear to have been scooped out
Which choice best matches Blunted papilla
Becomes more concave in shapes, interproximal
Appears overgrowth and puffy around the gingival margin
Papilla that appear to have been scooped out
True or false? Regarding pediatric and adult patients: Inflammation is not as intense in children as adults due to their immune responses being less developed and therefor not the same response to plaque biofilm.
True
False
What are the common sources of intraoral allergic reactions?
Ingredients in toothpastes, mouthwashes, or chewing gum. Cinnamon and carvone, two flavor additives are known to cause allergic reactions
The hints of latex and banana infused with the products
What best describes Recurrent periodontitis?
Return of destructive periodontitis that had been previously arrested. Happens especially with noncompliant self and professional care
Caused by an unknown etiology, occurs in patients despite practicing effective self-care and recommended schedule maintenance visits
What best describes Refractory periodontitis?
Caused by an unknown etiology, occurs in patients despite practicing effective self-care and recommended schedule maintenance visits
Return of destructive periodontitis that had been previously arrested. Happens especially with noncompliant self and professional care
What is the difference between localized and generalized periodontitis?
Localized may involve one site on a single tooth or several sites on several teeth As well as 30% or less of the teeth. While, Generalized may involve most or entire dentition and more than 30% of teeth
Generalized may involve one site on a single tooth or several sites on several teeth As well as 30% or less of the teeth. While, Localized may involve most or entire dentition and more than 30% of teeth
What are the six typical warning signs of periodontitis?
Abundance of mature plaque and calculus
Gingival bleeding
Loss of attachment/mobility
Reddish to purplish tissues or palish
Tissue swelling
Suppuration
No loss of attachment/mobility
What are the five optimal treatment modalities in treating periodontal disease?
Focus on reinforcing daily self-care
Periodontal instrumentation to remove microbial etiology
Eliminate local intraoral factors
Periodontal surgery
Adherence to periodontal maintenance regimen
Neglect of checking on the status of operations
What are the three therapeutic endpoints of periodontal therapy?
Elimination of microbial etiology and contributing factors that perpetuate inflammation
Preservation of state of the teeth and periodontium in a state of health, function and stability
Prevention of disease recurrence
To increase the accumulation of bacteria
What is a characteristic of disease sites that have not responded to treatment?
Increasing clinical attachment loss- Increasing clinical attachment loss
Increased BOP
What is the most common mucogingival deformity?
Gingival recession
Benign tumors
What is the main differences between necrotizing gingivitis and necrotizing periodontitis?
Necrotizing periodontitis leads to attachment loss and bone loss.
Necrotizing gingivitis leads to attachment loss and bone loss.
True or false? A palatolingual groove cannot enhance plaque retention thereby contributing to initiation of periodontal disease.
False
True
Which best matches with Necrotizing Gingivitis?
Tissue necrosis to gingival tissues
Severe necrosis extends beyond gingiva to other parts of the oral cavity: tongue, cheeks, palate. Bone denudation occurs through alveolar mucosa tissue. Most severe and rarest NPD
Necrosis of gingival tissues, periodontal ligament, and alveolar bone. Extremely rapid and destructive form of periodontitis
Which best matches with Necrotizing Periodontitis?
Necrosis of gingival tissues, periodontal ligament, and alveolar bone. Extremely rapid and destructive form of periodontitis
Severe necrosis extends beyond gingiva to other parts of the oral cavity: tongue, cheeks, palate. Bone denudation occurs through alveolar mucosa tissue. Most severe and rarest NPD
Tissue necrosis to gingival tissues
Which best matches with Necrotizing Stomatitis?
Severe necrosis extends beyond gingiva to other parts of the oral cavity: tongue, cheeks, palate. Bone denudation occurs through alveolar mucosa tissue. Most severe and rarest NPD
Tissue necrosis to gingival tissues
Necrosis of gingival tissues, periodontal ligament, and alveolar bone. Extremely rapid and destructive form of periodontitis
Which best matches thin scalloped periodontal biotype
Slender triangular shaped tooth crowns with clear thin delicate gingiva and thin alveolar bone along with subtle cervical scalloping
Slender tooth crowns with pronounced gingival scalloping and thick fibrotic gingiva
Square-shaped tooth crowns with pronounced tissue scalloping, thick fibrotic gingiva and thick alveolar bone
Which best matches Thick flat periodontal biotype
Square-shaped tooth crowns with pronounced tissue scalloping, thick fibrotic gingiva and thick alveolar bone
Slender tooth crowns with pronounced gingival scalloping and thick fibrotic gingiva
Slender triangular shaped tooth crowns with clear thin delicate gingiva and thin alveolar bone along with subtle cervical scalloping
Which best matches Thick scalloped periodontal biotype
Slender tooth crowns with pronounced gingival scalloping and thick fibrotic gingiva
Slender triangular shaped tooth crowns with clear thin delicate gingiva and thin alveolar bone along with subtle cervical scalloping
Square-shaped tooth crowns with pronounced tissue scalloping, thick fibrotic gingiva and thick alveolar bone
What best describes Osseointegration?
The direct contact of bone with the implant surface
How bones correlate to one another in the body
What is the difference between peri-implantitis and peri-implant mucositis?
Peri-implantitis is periodontitis in tissues surrounding Osseo integrated implant, resulting in bone loss, while Peri-implant mucositis, Also know as peri-implant gingivitis, plaque induced gingivitis in tissues surrounding the implant
Peri-implant mucositis is periodontitis in tissues surrounding Osseo integrated implant, resulting in bone loss, while Peri-implantitis Also know as peri-implantitis plaque induced gingivitis in tissues surrounding the implant
What are the two materials that implants are made from?
Titanium
Zirconia
Steel
Silver
What three factors influences by implant biomechanical overload?
Position of the implant fixture
Number of implants supporting prosthesis
Occlusal force distribution among implants and remaining teeth
The length of time the implant was set
What is a master periodontal treatment plan?
A sequential outline of measures to be carried out by the dentist, dental hygienist, and patient
The last resort when it comes to an extremely severe treatment
What three questions do we use to guide in a diagnosis?
Does the clinical assessment indicate periodontal health or inflammatory disease in the periodontium?
If the clinical assessment indicates inflammatory disease, is the disease gingivitis or is it periodontitis?
If the patient has gingivitis/periodontitis, what type?
Have the assessments from the patient been completed yet?
What is a hidden signs of inflammation?
Bone loss
BOP
Erythema in gingiva
What clinical measurements determine the difference between gingivitis and periodontitis?
Gingivitis: no attachment loss, Periodontitis: attachment loss, bone loss seen on radiographs
Periodontitis: no attachment loss, Gingivitis: attachment loss, bone loss seen on radiographs
What is best used to get a precise periodontal disease classification of a patient's periodontal status?
Assigning a diagnosis based on the AAP
Information that was obtained from the internet
What are the five phases of therapy?
Assessment phase
Nonsurgical phase
Surgical phase
Restorative phase
Periodontal maintenance
Influx phase
What is the definition of oral health as defined by the world dental federation
Oral health is a changeable state of well-being, considering physical, mental, and social aspects while addressing demands of life and daily function.
Oral health is NOT changeable state of well-being, considering physical, mental, and social aspects while addressing demands of life and daily function.
What are four Acquired risk factors for perio?
Plaque and calculus
Partial dentures
Open contacts
Overhanging and poorly contoured restorations
Malpositioned teeth
What are four Anatomical risk factors for perio?
Malpositioned teeth
Furcations
Root grooves and concavities
Enamel pearls
Plaque and calculus
What is the most significant risk factor for developing Perio?
Cigarette smoking
Alcohol consumption
True or false? Regarding Host response, If an individual’s immune system can effectively deal with a mouthful of periodontal pathogens, no destructive periodontal disease will occur.
True
False
What are six examples of Non-modifiable risk factors?
Socioeconomic status
Genetics
Adolescence
Pregnancy
Age
Leukemia
Smoking
What are five examples of Modifiable risk factors?
Smoking
Diabetes
Poor diet
Stress
Certain medications
Age
True or false? Perio risk factors can be acquired and anatomical
True
False
Which of the following three are components of an implant?
Implant body: The ‘root’ of the implant that is surgically placed into the living alveolar bone
Abutment: Titanium post that attaches to the implant body and supports the crown or denture
Crown: Screwed onto the abutment
Cement: Used to cling all the components together after setting
The Complement system carries out all of the following functions EXCEPT one. Which is it?
Engulfing bacteria
Puncturing the cell membrane of certain bacteria
Recruiting additional phagocytic cells to the infection site
Removal of immune complexes from circulation
A leukocyte secretes a biologically active compound that attracts more immune cells to an iinfection site. Biologically active compounds secreted by cells that activate the body's immune system are termed what?
Biochemical mediators
C-reactive proteins
Degranulation proteins
Chemotaxic chemicals
Inflammation is the body's reaction to ________
Injury
Invasion of pathogens
Edmea
Injury and Invasion of pathogens
The complement system is part of ______
The immune response
Breakdown in collagen matrix
Treatment of chronic disease
Activity that breaks down bone
All of the following are symptoms of inflammation EXCEPT one. Which is it?
Bruising
Heat
Swelling
Pain
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 luekocytes are attracted to an infection site?
Chemotaxis
Osponization
Trans-endothelial migration
Phagocytosis
A leukocyte travels through the bloodstream to an infection site and pushes its way between the cells lining the blood vessel. This process of exiting the blood vessel is termed ______
Trans-endothelial migration
Chemotaxis
Osponization
Phagocytosis
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