Periodontology Midterm Exam

A realistic representation of the anatomy of the periodontal area, highlighting the gums, teeth, and supporting structures in a clinical setting.

Periodontology Midterm Exam

Test your knowledge and understanding of periodontology with our comprehensive midterm exam. This quiz covers a wide range of topics essential for dental hygienists and students, offering a deep dive into periodontal anatomy, diseases, and treatments.

  • 118 challenging questions
  • Multiple choice format for easy navigation
  • Ideal for students and professionals alike
118 Questions30 MinutesCreated by LearningTree531
A dental hygienist inserts a calibrated periodontal probe into a healthy sulcus until the tip reaches the base of the sulcus. What anatomical structure forms the base of the sulcus?
Periodontal ligament
Gingiva
Cementum
Junctional epithelium
During mastication, the tooth is cushioned from occlusal forces by the:
Periodontal ligament
Gingiva
Cementum
Alveolar bone
After many years of hard periodontal scaling, 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
Which of the following tissues is NOT part of the periodontium?
Periodontal ligament
Gingiva
Cementum
Alveolar mucosa
What shallow linear depression separates the free and attached gingiva?
Gingival sulcus
Mucogingival junction
Free gingival groove
Gingival margin
Which of the following statements is FALSE about the junctional epithelium?
Junctional epithelium is a specialized type of epithelium that attaches to the tooth surface
Junctional epithelium forms the base of the sulcus
Junctional epithelium is the point at which the alveolar mucosa meets the attached gingiva
) It functions as a barrier between biofilm and the supporting connective tissues
Which of the following is NOT a function of the periodontal ligament?
Supportive - suspends the tooth in its socket
Sensory - provides feeling of pressure and pain to the tooth
Formative - builds and maintains cementum
Defensive - prevent food from becoming packed in the sulcus
The alveolar crest follows the contours of the cementoenamel junctions of teeth. In health, the alveolar crest covers (is above) the cementoenamel junctions of the teeth.
Both statements are true
Both statements are false
The first statement is true; the second is false
The first statement is false; the second is true
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 patient has a healthy periodontium. If the hygienist could see the microscopic structures of this patient's periodontium, how would the interface of the junctional epithelium with the gingival connective tissue appear?
It would have a smooth interface
It would have a parallel interface
It would have a sloping interface
It would have a wavy interface
Which of the following gives connective tissue the strength to withstand mechanical forces?
Extracellular matrix
Macrophages
Lymphocytes
Basal lamina
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
The mat of extracellular matrix that separates epithelial sheets from underlying connective tissue is called:
Basal lamina
) Stratified squamous epithelium
Collagen
Periosteum
If the alveolar crest of bone is located 2 mm apical to CEJ of teeth, this would indicate:
Health
Mild disease
Progressing disease
Advanced disease
Which of the following is the most common pattern of bone loss?
Vertical bone loss
Horizontal bone loss
Interproximal bone loss
Circumferential bone loss
Lattice-like bone that fills the interior portion of the alveolar process refers to:
Cortical bone
Cancellous bone
Periosteum
Cribiform plate
The ends of periodontal ligament fibers that embed in bone and cementum are known as:
Interradicular fibers
Sharpey fibers
Rete pegs
Endpoint fibers
The depth of a clinically normal gingival sulcus is no greater than:
1mm
3mm
5mm
7mm
The space between the free gingiva and tooth surface is called:
Interdental gingiva
Gingival sulcus
Junctional epithelium
Periodontal ligament
Instrumentation can lead to exposure of dentin, causing hypersensitivity.
True
False
What is a valley like depression in the portion of the interdental gingiva that lies directly apical to the contact area?
PDL
Cementum
Col
Junctional epithelium
Gingivitis is a bacterial infection that is confined to the gingiva; it results in irreversible destruction to the tissues of the periodontium.
Both true
Both false
First true, second false
First false, second true
___________ is a bacterial infection of all parts of the periodontium, including the gingiva, periodontal ligament, bone and cementum
Gingivitis
Periodontitis
Chronic gingivitis
Acute gingivitis
Which of the following is/are TRUE about chronic gingivitis?
Lasts for months or years
May never progress into periodontitis
Painless
More common than acute gingivitis
All of the above
What are/is the characteristic(s) of periodontitis?
Apical migration of the JE
Loss of connective tissue attachment
Loss of alveolar bone
A and B only
All of the above
Periodontitis is a reversible condition.
True
False
The base of a suprabony pocket is located coronal to the alveolar crest. The base of an infrabony pocket is located below the alveolar crest.
Both statements are true
Both statements are false
The first statement is true; the second is false
The first statement is false; the second is true
The difference between a gingival pocket and a periodontal pocket is that:
A gingival pocket is a result of gingival enlargement, 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
Gingival pockets are also called pseudopockets meaning false pocket, because there is no destruction of PDL fibers or alveolar bone.
True
False
What is an inactive disease site?
A healthy site that has not been infected my bacteria
A disease site that shows continued apical migration of the JE overtime
One that has the attachment of the JE unchanged overtime
None of the above
Healthy gingival tissue in the human population:
May be pigmented
May be various shades of pink
Will have papilla that comes to a point and fill the space between teeth
All of these
Hygienists should be alert for signs of gingival inflammation. Which sign of inflammation usually is the FIRST sign seen clinically?
Changes in tissue color
Changes in tissue contours
Changes in tissue texture
Bleeding on gentle probing
All of the following tissue descriptions describe gingivitis EXCEPT:
Light pink with scalloped margins
Dark pink with irregular scalloped margins
Generalized light pink with localized area of redness in posterior interproximals
Shiny pink with localized areas of cratered papillae
Chronic gingival inflammation includes all of the following EXCEPT:
Increased numbers of leukocytes attracted to the gingival tissues
Increased blood flow to the gingival tissues
Increased bone loss
Bleeding on gentle probing
By far the most common type of periodontal disease is:
Gingivitis associated with dental plaque only
Gingival disease modified by systemic factor
Allergy-induced gingivitis
Nonplaque-induced gingivitis
Acute Gingivitis has a brief duration that is improved with good self-care. Chronic gingivitis lasts a long time and always develops into periodontitis.
Both statements are true
Both statements are false
The first statement is true; the second is false
The first statement is false; the second is true
Which of the following statements best describes diffuse inflammation?
Inflammation that includes the interdental papilla
Inflammation that includes both the gingival margin and papilla
Inflammation that includes the gingival margin, papilla, and attached gingiva
Inflammation that includes the gingival margin, papilla, attached gingiva, and alveolar mucosa
Gingival papillae that are enlarged and expand out of the interproximal spaces are described as
Blunted papilla
Bulbous papilla
Cratered papilla
Soft, spongy tissue
Your patient has had infrequent visits to the dentist. A periodontal assessment shows the following:
 
• Plaque biofilm that is consistent with the amount of inflammation
• Swelling and redness of the gingiva
• Bleeding on probing
• Generalized loss of attachment.
 
Which of the following is the most likely disease classification for this patient?
Plaque-induced gingivitis
Nonplaque-induced gingival disease
Periodontitis
Refractory periodontitis
All of the following are characteristics of periodontitis EXCEPT:
Radiographic evidence of horizontal bone loss
Can be modified by cigarette smoking
Most common in adults who are younger than age 35 years
Disease progresses at a slow to moderate rate
The dental clinician notes the following clinical signs during the periodontal assessment of an young male teenager:
 
• Moderate plaque biofilm present at the gingival margin
• Gingival redness and tenderness
• Bleeding on gentle probing
• Gingival margin slightly coronal to the CEJ
• Probing depths of 2 to 3 mm
• An inflammatory response that seems appropriate given the amount of plaque biofilm.
 
Which of the following types of periodontal disease should the hygienist suspect for this patient?
Plaque-induced gingivitis by bacteria only
Puberty-associated gingivitis
Chronic gingivitis
Drug-influenced gingivitis
Levels of sex hormones cause exagerated response to presence of plaque
True
False
During which human phase is the gingiva bright red, soft, tingly stretched, smooth and bleed easily?
Puberty
Menstrual cycle
Oral contraceptives
Pregnancy
All of the above
Diabetes-associated gingivitis is an example of:
Dental plaque--induced gingival diseas
Gingival disease modified by malnutrition
Gingival disease of genetic origin
Gingival disease modified by a systemic factor
All of the following are typical warning signs of periodontitis EXCEPT:
Bad taste in the mouth
Loose teeth
Red, swollen gingiva
Pain
When describing distribution of gingivitis, all of the following may be applied EXCEPT:
Papillary
Lingual
Diffuse
Marginal
Which of the following is/are a contributing factor to periodontitis?
Smoking
Diabetes and HIV
Family history
Crowding, dental caries, tooth morphology
Occlusal trauma
All of the above
With periodontits pain usually is NOT a symptom
True
False
When the distribution of the diease is LOCALIZED, 
 
1) It covers more than 50% of the dentition 
 
2) May involve one site on a single tooth or several teeth. 
 
3) Involves 30% or less of the teeth 
 
 
1
2,3
1,2,3
2 only
Associated symptoms of NPD include all of the following EXCEPT
Pigmented gingiva
Fetid odor
Excessive salivation
Swollen lymph nodes
Biologic equilibrium in periodontal health means there is a balance between:
Local risk factors and acquired risk factors
Local contributing factors and systemic factors
Bacterial plaque biofilms and the host response
Bacterial plaque biofilms and local risk factors
A patient was successfully treated for periodontitis 2 years ago, but today presents with a reappearance of the signs of symptoms of periodontitis. The hygienist notices that the patient's self-care is NOT adequate. Which of the following is the most likely disease classification for this patient?
Periodontitis
Redundant periodontitis
Recurrent periodontitis
Refractory periodontitis
Oral signs and symptoms of necrotizing periodontal diseases include:
Numbness in the gingival tissues without pain
Papilla are knife-like and fill the interproximal spaces
Papilla appear cratered or "punched out"
The gingiva is pink and firm
Which of the following is a predisposing factor for Necrotizing Periodontal Diseases?
Poor oral hygiene/plaque control
Emotional stress
Alcohol use
Smoking
All of the above
Necrotizing periodontal diseases include all of the following EXCEPT:
Necrotizing stomatitis
Necrotizing mucogingiva
Necrotizing periodontitis
Necrotizing gingivitis
Necrotizing periodontal diseases is characterized by papillae that appear cratered. Although tissues in NPD appear fiery red, they are not painful.
Both statements are true
Both statements are false
The first statement is true; the second statement is false
The first statement is false; the second statement is true
Gingival papillae with a concave appearance are described as:
Blunted papilla
Bulbous papilla
Cratered papilla
Soft, spongy tissue
Gingival papillae that are enlarged and expand out of the interproximal spaces are described as:
Blunted papilla
Bulbous papilla
Cratered papilla
Soft, spongy tissue
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
Only 4-5mm of radiographic evidence of bone loss around the implant
No more than a class II clinical mobility
Discomfort only when in function
The term for periodontitis in the tissues surrounding an osseointegrated dental implant, resulting in loss of alveolar bone is called
Peri-implant gingivitis
Peri-implantitis
Implant periodontitis
A or C
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
Self-care around the implant can be accomplished using any of the following cleaning aids EXCEPT a(n):
Soft bristle brush
Implant floss
Standard wire interproximal brush
End-tufted brush
Which is/are clinical signs of a failing implant?
Peri-implant pocket
Bleeding
Suppuration
Swelling
All of the above
Disease sites that have not responded successfully to treatment are characterized by:
Increasing clinical attachment loss
Plaque levels compatible with healthy gingiva
White fibrotic gingival tissue
Pain in the localized area
Which of the following is a therapeutic endpoint for periodontal therapy?
Elimination of microbial etiology
Elimination of contributing factors to periodontitis
Preservation of health, function, and stability of the teeth and periodontium
Prevention of disease recurrence
All of the above are therapeutic endpoints of periodontal therapy
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
It is important to use both clinical findings and radiographs during the clinical assessment process.
True
False
The clinical measurement(s) that determine(s) the difference between gingivitis and periodontitis is the __________________.
Clinical loss of attachment
Level of the free gingival margin
Pocket depth readings
Clinical mobility and furcation involvement
Reevaluation of phase I therapy is part of which phase of a periodontal master treatment plan?
preliminary therapy phase
Nonsurgical periodontal therapy phase
Surgical therapy phase
Maintenance phase
Periodontal instrumentation is part of which periodontal therapy phase?
Preliminary therapy phase
Nonsurgical periodontal therapy phase
Surgical therapy phase
Maintenance therapy phase
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 dentis
Standard of care and textbooks
Informed consent is a patient's voluntary agreement to proposed treatment.
True
False
What is/are the main goal of periodontal maintenance?
 
1) on-going care at specific intervals 
 
2) all measures used to keep periodontitis under control 
 
3) this phase used to maintain teeth functioning throughout life 
 
4) goals is to prevent recurrence of disease 
 
 
1,2,3
2,3,4
2, 3
1,2,3,4
Is the rate of destruction around an implant the same as natural teeth?
Yes
No
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 process of communication between a patient and healthcare providers: 
 
1) must be voluntary 
 
2) demonstrate they are legally able to provide consent 
 
3) according to "reasonable patient standard"
 
4) signed treatment plan 
1, 2
3,4
1,2,3
1,2,3,4
A local risk factor for periodontitis can be acquired OR anatomical. Concavities and furcations are local risk factors acquired over time.
Both statements are true
Both statements are false
The first statement is true; the second false
The first statement is false; the second true
Biologic equilibrium in periodontal health means there is a balance between:
A) Local risk factors and acquired risk factors
Local contributing factors and systemic factors
Bacterial plaque biofilms and the host response
Bacterial plaque biofilms and local risk factors
All of the following are classified as periodontal pathogens capable of colonizing the mouth, EXCEPT:
A. odontolyticus
A. actinomycetemcomitans
Tannerella forsythia
Porphyromonas gingivalis
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
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
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
Early colonizers of the plaque biofilm are:
Gram-negative bacteria
Gram-positive bacteria
Motile bacteria
Anaerobic bacteria
Periodontitis is associated with high proportions of
Aerobic bacteria
Nonmotile bacteria
Gram-negative bacteria
Innocuous bacteria
The protective factor that can prevent biofilm from being killed with antibiotics, antimicrobials, or the body's immune system is called:
Extracellular slime layer
Fluid channels
Microcolonies
Leukocytes
Antimicrobials work best when used with mechanical cleaning/disruption.
True
False
Which of the following species is considered to be the most important bacterial risk factor that distinguishes individuals with periodontitis from those who are periodontally healthy?
A. odontolyticus
A. actinomycetemcomitans
Tannerella forsythia
Porphyromonas gingivalis
Within minutes of a professional prophylaxis, the pellicle attaches to tooth surfaces. Within hours of the pellicle formation, bacteria begin to attach to the outer surface.
Both statements are true
Both statements are false
The first statement is false; the second is true
The first statement is true; the second is false
The fist bacteria to colonize on the tooth surface are nonpathogenic.
True
False
The complement system is part of:
The immune response
Breakdown in collagen matrix
Treatment of chronic disease
Activity that breaks down bone
Inflammation is the body's reaction to:
A) injury
B) invasion of pathogens
C) edema
D) a and b only
B-lymphocytes affect microorganisms by:
Engulfing and phagocytizing invading organisms
Secreting antibodies that neutralize microorganisms
Intensifying the immune system
Killing microorganisms on contact
A leukocyte secretes a biologically active compound that attracts more immune cells to an infection site. Biologically active compounds secreted by cells that activate the body's immune system are termed:
Degranulation proteins
Chemotaxic chemicals
Biochemical mediators
C-reactive proteins
In which phase of periodontal disease progression does the coronal-most portion of the junctional epithelium first detach from the tooth surface?
Early lesion
Established lesion
Initial lesion
Advanced lesion
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
Nitiate alveoDecrease a periodontal pocket to a gingival pocket
Cytokines function to:
Send microphages to the site of infection
Potentially initiates destruction and bone loss in chronic periodontitis
Attracts immune cells to an infection site by increasing vascular permeability
All of these
Classic signs of acute inflammation is/are,
Heat and redness
Swelling
Pain
Loss of function
All of the above
A polymorphonuclear leukocyte 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
Thns-endothelial migration
Phagocytosis
In which phase of periodontal disease progression are PMNs the most numerous cells at the site of the periodontal infection?
Initial lesion
Established lesion
Early lesion
Advanced lesion
Which phase of periodontal disease progression includes bacterial colonization near gingival margins?
Bacterial accumulation phase
Early gingivitis
Periodontitis
Established gingivitis
In which phase of periodontal disease progression does PGE2 mediate bone destruction by stimulating large numbers of osteoclasts to resorb alveolar bone?
Initial lesion
Established lesion
Early lesion
Advanced lesion
The host's response:
Is a minor component in the pathogenesis of periodontal disease
Induces the action of opsonization of bacteria
Secretes powerful regulatory lipids to affect immune response of other cells
Is the way in which the body to respond to periodontal pathogens
In which phase of periodontal disease progression are macrophages first recruited to the gingival connective tissue?
Initial lesion
Established lesion
Early lesion
Advanced lesion
If plaque biofilms were allowed to stay near the gingival tissues, the first clinical sign of inflammation would be:
Redness and swelling
Pus in the affected area
Bone loss evident on radiographs
Gingival recesion
The immune system protects the body against all of the following, EXCEPT:
Basophils
Bacteria
Toxins
Viruses
When inflammation becomes chronic, the inflammatory response can become so intense that it does permanent damage to the body tissues.
True
False
Factors affecting the immune response are,
Genetic
Environmental----tobacco smoking
Acquired -----diabetes
All of the above
The classic warnings seen in acute inflammation usually are absent in chronic inflammation
True
False
LPS(endotoxins) are found on the outer layer of gram-positive bacteria
True
False
Polymorphonuclear Leucocytes (PMNs), 
 
1) Provide the first line of defense (1rst responders) 
 
2) Attracted to bacteria (or infection sites) by a process called chemotaxis
 
3) Periodontal pathogens are most effectively destroyed by PMNs 
 
4) Also called neutrophils 
1, 2
2,3,4
1 only
1, 2, 3, 4
Tissue-associated plaque biofilm is the most harmful to the periodontal tissues
True
False
The _______ is the portion of the implant that protrudes through the tissue into the mouth.
Crown
Abutment post
Implant body
None of the above
Cigarette smoking is the most significant risk factor for periodontitis.
True
False
The most successful way to destroy plaque biofilm is,
Brushing
Flossing
Periodontal instrumentation
All of the above
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