Deck 14: Periodontics

Question 1

On the basis of the assessment findings reported, what is the MOST accurate preliminary diagnosis for this client?

A)Dental plaque-induced gingivitis
B)Aggressive periodontitis
C)Chronic periodontitis
D)Periodontitis as a manifestation of systemic disease
E)Refractory periodontitis

Answer 1

Chronic periodontitis

Question 2

After bacterial virulence is established and the periodontal lesion is initiated, which is the first inflammatory cell to respond?

A)B lymphocytes
B)Plasma cells
C)Neutrophils
D)T lymphocytes
E)Macrophages

Answer 2

Neutrophils

Question 3

Which of the following are characteristic of aggressive periodontitis?

A)A long-standing inflammatory disease with periods of remission and exacerbation
B)A slowly progressive disease that usually manifests itself around puberty
C)A degenerative disease of the periodontium initially characterized by bone loss in anterior teeth and first molars
D)A rapidly progressive inflammatory disease that most often affects the entire dentition equally
E)A disease that most commonly affects children and adolescents with medically compromising conditions

Answer 3

A degenerative disease of the periodontium initially characterized by bone loss in anterior teeth and first molars

Question 4

Which of the following devices would be MOST effective for plaque biofilm removal in the mandibular anterior region?

A)Dental floss
B)Dental tape
C)Oral irrigation
D)Interproximal brush

Question 5

Which of the following periodontal therapies would be BEST recommended for this case?

A)Regenerative periodontal surgery
B)Gingival curettage
C)Nonsurgical periodontal therapy
D)Oral prophylaxis
E)Periodontal maintenance therapy

Question 6

In addition to professional dental hygiene care and proper oral hygiene measures, which of the following procedures or agents would address the client's chief concerns?

A)Selective stain removal
B)Chlorine dioxide mouthrinse
C)Tooth whitening
D)Daily fluoride mouthrinse

Question 7

An oxygenating mouthrinse would be beneficial for this client because he has inadequate oral hygiene and a weakened host response.

A)Both the statement and the reason are correct and related.
B)Both the statement and the reason are correct but NOT related.
C)The statement is correct, but the reason is NOT correct.
D)The statement is NOT correct, but the reason is correct.
E)NEITHER the statement NOR the reason is correct.

Question 8

What change in alveolar bone on a dental radiograph indicates early loss of bone?

A)Fuzziness in the crest of the bone
B)Faint cup-shaped areas interproximally
C)Vertical or angular defects
D)Furcation involvement

Question 9

Which of the following statements is MOST accurate regarding this client's health history assessment?

A)His general health requires no treatment modification, precautionary measure, or referral
B)Signs and symptoms of a possible uncontrolled condition exist, and physician referral is warranted
C)The client's poorly controlled diabetes is the cause of his periodontal disease
D)Prophylactic antibiotic premedication for prevention of infective endocarditis is indicated before any invasive procedures

Question 10

Which of the following diagnostic procedures is MOST accurate for determining severity of periodontal attachment loss?

A)Full-mouth digital radiographic survey
B)Microbial testing of plaque biofilm
C)Detection of pathologic tooth mobility or furcations
D)Periodontal probing of all sulcular areas
E)Determining presence or absence of bleeding on probing

Question 11

Controlled drug delivery (sustained-release drug delivery) of antibiotics should be considered in the care plan because the patient's systemic health warrants use of antibiotics for control of advancing periodontitis.

A)Both the statement and the reason are correct and related
B)Both the statement and the reason are correct but NOT related
C)The statement is correct, but the reason is NOT correct
D)The statement is NOT correct, but the reason is correct
E)NEITHER the statement NOR the reason is correct

Question 12

Smoking is the primary cause of this client's periodontal disease. Infrequent professional oral health care is an additional environmental risk factors contributing to his periodontitis also should be addressed in the dental hygiene care plan.

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

Question 13

What is the maximum continuing-care interval recommended for periodontal maintenance therapy for this client?

A)3 months
B)4 months
C)6 months
D)1 year

Question 14

Which of the following histologic changes in inflamed gingiva results in bleeding?

A)Vasodilation within the gingival connective tissue
B)Ulceration of the sulcular lining
C)Lymphoid cell accumulation
D)Collagenase destroying the lamina propria
E)Alteration of fibroblasts in the connective tissue

Question 15

Which of the following would be the BEST indicator of treatment success at the re-evaluation appointment 4 to 6 weeks following initial periodontal therapy?

A)Relatively free of plaque biofilm
B)Stable periodontal probing depths
C)Absence of gingival inflammation and bleeding
D)No re-formed dental calculus deposits

Question 16

The recession noted in the mandibular anterior region requires evaluation by a dentist or periodontist. If periodontal surgery is indicated, a gingivectomy would be performed to correct this condition.

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

Question 17

In cases of periodontitis, what is the first area to be involved in bone resorption?

A)Facial and lingual aspects of supporting bone
B)Cribriform plate or lamina dura
C)Cancellous portion of supporting bone
D)Cortical plate of the interdental septum
E)Bone surrounding the apical area of the tooth

Question 18

Tooth mobility and fremitus are hallmarks of occlusal trauma because trauma is the primary cause of clinical attachment loss when occlusal trauma is present.

A)Both the statement and the reason are correct and related
B)Both the statement and the reason are correct but NOT related
C)The statement is correct, but the reason is NOT correct
D)The statement is NOT correct, but the reason is correct
E)NEITHER the statement NOR the reason is correct

Question 19

All of the following are concerns related to potential outcomes of dental hygiene care in this case EXCEPT one. Which one is the EXCEPTION?

A)Lack of client motivation and adherence to recommendations
B)Delayed healing following treatment
C)Poorly controlled diabetes mellitus
D)Genetic predisposition

Question 20

All of the following tissue changes result in true periodontal pocket formation EXCEPT one. Which one is the EXCEPTION?

A)Apical migration of the junctional epithelium
B)Apical migration of the gingival margin
C)Destruction of the connective tissue attachment
D)Resorption of the alveolar bone

Question 21

Which area within the periodontium is LEAST susceptible to tissue breakdown in periodontal disease?

A)Gingival crevice
B)Dentogingival junction
C)Interdental col
D)Junctional epithelium
E)Attached gingival

Question 22

All of the following tissues comprise nonkeratinized epithelium EXCEPT one. Which one is the EXCEPTION?

A)Crevicular epithelium
B)Attached gingiva
C)Interdental papilla
D)Junctional epithelium
E)Marginal gingival

Question 23

Which radiographic findings will MOST likely be seen in dental plaque-induced gingivitis?

A)Widened periodontal ligament space and triangulation
B)Slight changes in the lamina dura
C)Condensing osteitis
D)Normal lamina dura and crestal bone

Question 24

A 35-year-old client with early chronic periodontitis who smokes and has challenges with self-care is new to your health care facility. All of the following initial or nonsurgical periodontal therapies are appropriate to recommend for this client EXCEPT one. Which one is the EXCEPTION?

A)Topical antimicrobial mouthrinse
B)Gingival curettage
C)Scaling and periodontal débridement
D)Selective stain removal
E)Periodontal maintenance and supportive periodontal therapy

Question 25

All of the following are environmental risk factors associated with periodontal disease EXCEPT one. Which one is the EXCEPTION?

A)Smoking
B)Rough restorative margins
C)Mouthbreathing
D)Age
E)Dental calculus

Question 26

Which type of periodontal disease is characterized by gray, sloughing tissue, pain, and spontaneous bleeding?

A)Pericoronitis
B)Pregnancy-related gingivitis
C)Necrotizing ulcerative gingivitis
D)Gingival abscess
E)Aggressive periodontitis

Question 27

All of the following conditions can be determined by radiographic examination EXCEPT one. Which one is the EXCEPTION?

A)Extent and severity of bone loss
B)Height of crestal bone
C)Widening of the periodontal ligament space
D)Presence of periodontal pockets
E)Presence of dental calculus

Question 28

All of the following conditions can cause periodontitis as a manifestation of systemic disease EXCEPT one. Which one is the EXCEPTION?

A)Diabetes mellitus
B)Chédiak-Higashi syndrome
C)Papillion-Lefèvre syndrome
D)Ehler-Danlos syndrome
E)Leukemia

Question 29

Which of the following BEST describes the junctional epithelium?

A)Keratinized epithelium
B)Basal cell epithelium
C)Squamous cell epithelium
D)Orthokeratinized epithelium
E)Parakeratinized epithelium

Question 30

Which of the following structures demarcates the attached gingiva from the alveolar mucosa?

A)Gingival groove
B)Junctional epithelium
C)Gingival margin
D)Base of the sulcus
E)Mucogingival junction

Question 31

All of the following risk factors have been associated with the prevalence of gingivitis EXCEPT one. Which one is the EXCEPTION?

A)Socioeconomic status
B)Level of education
C)Dietary habits
D)Tooth alignment
E)Sites previously affected by periodontitis

Question 32

Which of the following bacteria are tissue invading and thus associated with destruction of collagen and resorption of bone in periodontitis?

A)Actinomyces viscosus
B)Porphyromonas gingivalis
C)Streptococcus sanguis
D)Treponema pallidum
E)Capnocytophaga ochracea

Question 33

Which of the following types of drugs have been associated with gingival overgrowth?

A)Oral contraceptives
B)Antidepressants
C)Calcium channel blockers
D)Antihistamines
E)Quinolones

Question 34

Which of the following antimicrobial and antigingivitis agent is the MOST effective because it is highly substantive?

A)Essential oils
B)Chlorhexidine gluconate
C)Povidone iodine
D)Cetylperidium chloride
E)Stannous fluoride

Question 35

At a re-evaluation appointment with a client 6 weeks after completion of nonsurgical periodontal therapy, the hygienist notes generalized gingival inflammation and bleeding. Periodontal probing depths remain unchanged. Plaque control is acceptable, although re-instruction is indicated on the lingual of the mandibular molars. What is the MOST probable explanation for these findings?

A)Residual dental calculus deposits are present
B)Plaque removal was absent for the past 24 hours
C)Systemic disease influencing host response is present
D)Plaque removal was enhanced immediately before appointment

Question 36

Which of the following indicates that gingivitis has progressed to periodontitis?

A)Widened periodontal ligament space on radiographs
B)Periodontal probing depth ≥4 mm
C)Clinical attachment loss
D)Gingival recession
E)Bleeding on probing

Question 37

Oral examination findings for a 16-year-old female with good general health status include localized 4-mm and 5-mm periodontal probing depths, with radiographic bone loss visible on teeth #3, #14, #24, and #25; slight gingival inflammation in the mandibular anterior region; fair oral hygiene with minimal deposits is present; and no active caries are visible. On the basis of these findings, which of the following would be the MOST accurate preliminary diagnosis?

A)Necrotizing ulcerative gingivitis
B)Chronic periodontitis
C)Dental plaque-induced gingivitis
D)Localized aggressive periodontitis
E)Hormone-associated gingivitis

Question 38

Which of the following situations would be an indication for regenerative periodontal surgery?

A)An edematous 5-mm pseudopocket
B)Severe drug-influenced gingival enlargement
C)An infrabony pocket of 6 mm on the distal aspect of tooth #30
D)Gingival recession that extends into the alveolar mucosa
E)A periodontal abscess

Question 39

All of the following are possible causes of gingival recession EXCEPT one. Which one is the EXCEPTION?

A)Faulty toothbrushing
B)Bacterial plaque biofilm
C)Dehiscence
D)Dental caries
E)Tooth position in the arch

Question 40

Which condition should be suspected when a radiolucent area occurs at the apex of the root of a tooth on a radiograph?

A)Periodontal abscess
B)Pyogenic granuloma
C)Occlusal traumatism
D)Periapical abscess
E)Mucogingival problem

Question 41

Which of the following is an objective of periodontal regenerative surgery?

A)Improve the aesthetics of the client's face
B)Create gingival contour and appearance acceptable to the client
C)Remove alveolar bone to improve contour and correct defects
D)Remove enlarged tissue to assist the client in daily plaque control
E)Promote regeneration of connective tissue, periodontal ligament, cementum and alveolar bone

Question 42

Periodontal dressings improves the rate of wound healing following periodontal surgery. These materials also minimize client discomfort.

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

Question 43

What is the most common material used for dental implants?

A)Stainless steel
B)Porcelain
C)Gold
D)Titanium

Question 44

What is the advantage of synthetic absorbable sutures?

A)Do not require the client to return for removal
B)Have antibacterial properties
C)Cause less tissue reaction than silk or gut sutures
D)Are not treated by the surrounding tissue as a foreign body

Question 45

Which type of periodontal surgery is used to reduce probing depths and arrest periodontal disease by promoting new attachment of periodontal tissues?

A)Gingivoplasty
B)Guided tissue regeneration
C)Osseous resection
D)Bone grafting
E)Mucogingival surgery

Question 46

Joe Smith, age 50, returns for periodontal maintenance therapy every 3 months for 1 year after nonsurgical periodontal treatment for chronic periodontitis. The inflammation has been resolved, and periodontal probing depths have decreased from 5 mm or 6 mm to 4 mm or less in most treated areas, with the exception of the distal surface of #2, where the probing depth has increased from 4 mm to 6 mm. Radiographs reveal no change on #2 distal. Which of the following explains this finding?

A)Continuing clinical attachment loss
B)Error in periodontal probing technique
C)Calculus deposits affecting accuracy of initial reading
D)Inaccessibility and poor visibility in pocket areas
E)Healing of periodontal tissues

Question 47

Which of the following factors could limit a recommendation for dental implants?

A)Complete edentulism
B)Age over 65 years
C)Minimal bone density
D)Single missing tooth

Question 48

A client with dental implants returns for continuing care 6 months after dental implant placement. Which of the following factors assessed during oral examination and re-evaluation would be MOST effective for assessing success of previous dental hygiene care delivered?

A)Amount and distribution of bacterial plaque deposits
B)Condition of gingival tissue
C)Radiographic examination of alveolar bone
D)Presence or absence of dental calculus deposits
E)Efficacy of oral hygiene techniques demonstrated

Question 49

All of the following are advantages of controlled drug delivery (sustained-release drug delivery) over systemic drug administration in periodontal therapy EXCEPT one. Which one is the EXCEPTION?

A)Less concern about client adherence throughout indicated time frame
B)Site-specific antimicrobial action in periodontal pocket
C)High concentration delivered to the site of infection
D)Can be used when periodontal infection is generalized or severe

Question 50

What has the discipline of periodontal medicine shown about the relationship between periodontal diseases and systemic diseases?

A)Periodontitis causes systemic diseases such as heart disease and cerebrovascular disease
B)Persons with weakened host response have increased susceptibility to periodontitis
C)Periodontal disease is treated with systemic antibiotics
D)Periodontitis has been associated with systemic diseases as a possible risk factor
E)Genetic mutations affecting susceptibility and progression of systemic diseases also affect periodontitis

Question 51

Which of the following findings would indicate a failed dental implant?

A)Peri-implant inflammation
B)Bleeding on provocation
C)Alveolar bone loss
D)Loosening of the prosthetic crown
E)Mobility

Question 52

All of the following are substances produced by the host response to bacterial plaque biofilm EXCEPT one. Which one is the EXCEPTION?

A)Lipo-polysaccharide
B)Matrix metalloproteinase (MMP)
C)Cytokines
D)Interleukin 1 (IL-1)
E)Prostaglandin E2 (PGE2)

Question 53

All of the following are necessary for new attachment after periodontal surgery EXCEPT one. Which one is the EXCEPTION?

A)Thorough removal of bacterial irritants
B)Immobilization of mobile teeth
C)Regeneration or generation of new tissues or parts
D)Adequate number of fibroblasts and osteoblasts
E)Rapid apical growth of epithelium