DAPE 721 Midterm Exam
August 30, 2011
Dr. Elio Reyes, DDS, MSD Dr. Dwight E. McLeod, DDS, MS
NAME:
EXAM: SEAT
1. Which of the following is not present within the healthy junctional epithelium?
a. Endoplasmic reticulum b. Cytokeratin K19 c. Mitochondria d. Desmosomes e. None of the above
2. The number of cell layers of the junctional epithelium varies according to age; when studying the number of cell layers in histologic samples, the following can be observed:
a. early in life the layers of the junctional epithelium measure 0.25 mm and increase to 1.35 mm with age. b. early in life the junctional epithelium consists of 10-12 layers and decrease to 3-4 layers with age. c. early in life the junctional epithelium consists of 3-4 layers and increase to 10-12 layers with age. d. early in life the layers of the junctional epithelium measure 1.35 mm; and decrease to 0.25 mm with age.
3. The permeability of the sulcular epithelium cells is enhanced by which of the following:
a. CHO portions of glycoproteins and glycolipids in the cell membrane b. The production of laminin by the basal lamina c. Its proximity to the highly vascular crevicular plexus d. Cytokeratin K19 e. C and D only
4. The epithelial attachment consists of all of the following except:
a. hemi-desmosomes b. stratum granulosum c. reticular fibers d. laminin e. junctional cells arranged parallel to the root surface
5. The bonding mechanisms of the basal lamina of the junctional epithelium to the tooth surface include all of the following except:
a. hydrogen bonds. b. Sharpey’s fibers. c. molecular linkages. d. electrolytic attraction. e. enzyme separable bonds.
6. In the following diagram, the internal basal lamina is represented by:
a. A. b. B. c. none of the above.
Enamel (E), Junctional epithelium (JE), Connective tissue (CT).
7. Osteoblastic activity and bone aposition within the periodontal alveolar bone occurs during the mesial drift of a tooth at the:
a. mesial aspect. b. tension side. c. pressure side. d. fulcrum. e. A and C only
8. During orthodontic movement on a healthy periodontium, the following changes are evident on the pressure side:
a. apical osteoblastic ankylosis. b. capillary constriction and ischemia. c. osteoblastic activity and collagen mineralization. d. cementoblastic activity and collagen mineralization. e. A and B only.
9. The biologic width in humans measures an average of 2.0 mm. This distance is measured from the connective tissue attachment to the crestal alveolar bone.
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.
10. Histologically, the oral sulcular epithelium is considered to be:
a. keratinized stratified squamous epithelium. b. non-keratinized stratified squamous epithelium. c. non-keratinized simple squamous epithelium. d. pseudo-stratified epithelium. e. None of the above.
11. In health, the mitotic cell turnover rate of the junctional epithelium is:
a. faster than that of the sulcular epithelium. b. similar than that of the alveolar mucosa. c. slower than that of the oral epithelium. d. None of the above
12. Hypofunction of a tooth is associated with which of the following histological changes?
a. Narrowed PDL. b. Alveolar bone proper density increases. c. Decreased bone trabeculation density. d. Widened PDL. e. Both A and C.
13. Which of the following statements is accurate as related to the junctional epithelium?
a. The junctional epithelium is sporadically renewed. b. Junctional epithelium produces keratin approximately every 1-6 days. c. Mitotic activity of the junctional and oral sulcular epithelium shows a 24-hour periodicity. d. During the junctional epithelium life-cycle, the cells migrate from the gingival sulcus toward the stratum basale.
14. The radiographic image of the alveolar bone proper is termed ______.
a. Cribiform plate b. Lamina densa c. Bundle bone d. A and B e. None of the above
15. What is the type and approximate percentage of collagen in the alveolar bone?
a. 90% type I collagen b. 90% type IV collagen c. 10% type I collagen and 90% type IV collagen d. 10% type IV collagen and 90% type III collagen e. None of the above
16. The organic matrix of the alveolar bone is mainly composed of collagen, with small amounts of osteocalcin, osteonectin and other organic components like BMP’s. BMP’s stands for:
a. Bone metallo-proteinases b. Bonding matrix proteins c. Bone morphogenic proteins d. Binding mineral proteins
17. The structure (s), part of the periodontal apparatus, into which Sharpey’s fibers attach, is (are) known as:
a. bundle bone. b. cribiform plate. c. radicular cementum. d. All of the above e. A and B only 18. Composed of osteoprogenitor, and osteoclastic cells, the ______lines the internal marrow spaces of the cancellous bone, and is an active site for remodeling the supporting bone and alveolar bone proper.
a. endosteum b. periosteum c. interdental septum d. hydroxyapatite crystals
19. All of the following factors influence alveolar bone topography except:
a. Tooth position b. Root angulation c. Gingival biotype d. Periodontal disease e. Direction of occlusal forces.
20. The following is true when considering treatment for elderly patients:
a. From a physiologic perspective the bone healing processes are clinically similar to those of younger patients. b. Several cognitive and behavioral factors may be affected with age. c. Systemic medications may influence the health of the oral tissues. d. All of the above e. Only B and C
21. The Alveolar-Gingival fibers:
a. Maintain the integrity of the dental arch. b. Form a cuff-like band around each tooth. c. Are the most numerous gingival fiber bundle. d. Extend from the cementum to the outer periosteum. e. None of the above
22. In a healthy periodontium, the normal distance between the CEJ to the crest of the bone is about 2.0mm. This space is occupied by:
a. Sulcular epithelium b. Junctional epithelium c. Attached connective tissue d. A and B only e. B and C only 23. In which of the following investing tissues of the periodontium would you most likely find “incremental lines”? a. In which of the following investing tissues of the periodontium would you most likely find “incremental lines”? b. Dentin c. Cementum d. Bone e. Gingiva
24. Identify the correct statement regarding gingival bleeding.
a. Gingival bleeding is a reliable predictor of future attachment loss. b. Gingival bleeding is a primary cause of periodontal disease progression. c. The more severe the gingival bleeding is, the more chances of the presence of deeper pockets d. The absence of gingival bleeding is a reliable predictor of gingival health.
25. In the development of gingivitis, which area around a tooth would you most likely expect to first see gingival bleeding upon probing?
a. Facial b. Lingual c. Distal d. Mesial e. C and D
26. Identify the incorrect statement regarding gingivitis
a. Gingivitis may be localized or generalized. b. Gingivitis may be marginal or diffused c. Gingivitis may lead to color change d. Gingivitis may lead to tissue enlargement e. All the statements are correct
27. In which stage(s) of gingivitis would you expect to see clinical signs of gingival bleeding upon probing?
a. Stage I b. Stage II c. Stages I and II d. Stages II and III e. Stages III and IV 28. In which stage(s) of gingivitis would you expect to see the first signs of vascular proliferation?
a. Stage I b. Stage II c. Stages I and II d. Stages II and III e. Stages III and IV
29. In which stage(s) of gingivitis would you expect to see the changes in gingival color?
a. Stage I b. Stage II c. Stages I and II d. Stages II and III e. Stages III and IV
30. In which stage(s) of gingivitis would you expect to see perivascular loss of collagen?
a. Stage I b. Stage II c. Stages I and II d. Stages II and III e. Stages III and IV
31. In which stage of gingivitis would you be most likely to make a clinical diagnosis of gingivitis?
a. Stage I b. Stage II c. Stage III d. Stage IV
32. The attached gingiva may be keratinized or parakeratinized. The attached gingiva is loosely bound to the periosteum of the alveolar bone.
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.
33. The mucogingival junction on the palate is clearly demarcated. The narrowest band of gingiva in the maxillary arch is associated with the maxillary premolars.
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.
34. The migration of neutrophils (PMNs), to the site of microbial invasion is known as:
a. clotting. b. phagocytosis. c. chemotaxis. d. immunologic self-recognizing.
35. Which of the following relationship at the cemento-enamel-junction occurs most frequently?
a. Enamel overlaps cementum b. Cementum overlaps the enamel c. Cementum and enamel fail to meet d. Cementum meets the enamel in an edge to edge butt joint
36. Which one of the following is not a function of the periodontal ligament?
a. Resorptive b. Nutritional c. Formative d. Sensory
37. Identify the incorrect statement.
a. Alveolar bone serves as attachment for Sharpey’s fibers b. Acellular cementum is found in the coronal 1/3 of the root c. Fusion of bone, cementum, and PDL is termed ankylosis d. Cementoblasts and lacunae are characteristic of cellular cementum e. Cementum is removed during scaling and root planing
38. Which of the following characteristics of the gingiva may undergo changes due to microbial induced gingival inflammation?
1. Contour 2. Texture 3. Size 4. Pigmentation
a. 1,2,3,4 b. 1,2,3 c. 3,4 d. 1,2
39. The predominant immunoglobulin that is secreted in the gingival crevicular fluid is:
a. Ig G. b. Ig A. c. Ig D. d. Ig M.
40. Which form of epithelium retains a pyknotic nucleus in the outer epithelial layer?
a. Orthokeratinization b. Parakeratinization c. Nonkeratinization d. A,B,C e. A,B
41. What is the name of the periodontal ligament fiber that is only associated with multirooted teeth?
__Interradicular______
42. __Epithelial Rest of Malasez______occurs as nests of cells that run linear and parallel to the root surface near the cementum in the apical and cervical areas of the tooth root.
43. A 28 year old pure Caucasian male and a 28 year old pure Black female presented to your office for treatment. Upon examination, you noticed that both patients presented with excellent oral health. How would you describe the color of their gingiva? a. The gingiva of the Caucasian male is Pink with light pigmentation b. The gingiva of the black female is Brown pigmentation, darker.
44. The width of keratinized tissue can be easily measured using anatomical landmarks. Name the apical and coronal landmarks which are utilized to measure the width of keratinized tissue. Apical landmark Mucogingival Junction Coronal landmark Free gingival crest (margin)
45. Name the four functions of the periodontal ligament and give an example for each function. a. _Physical______function b. Example ______c. _Formative______function d. Example ______e. _Nutritive______function f. Example ______g. _Sensory______function h. Example ______
46. Arrange the list below from the highest inorganic (for example, 1, 2, 3 and 4) content to the lowest inorganic content.
a. Dentin ___2______b. Bone ___3______c. Enamel ___1______d. Cementum ______
47. Gingival and periodontal ligament fibers are composed of collagen. Identify the two types of collagen that make up the gingival and periodontal ligament fibers.
a. Type I______Collagen
b. Type III______Collagen
48. Identify the form of gingivitis that may vary in clinical course between acute and chronic, depending upon the microbial virulence and host response.
Recurrent
49. Name the two layers of the lamina propria.
a.Papillary Layer______
b. Reticular Layer______
50. Name the three types of mucosa that are present in the oral cavity. a. Lining b. Specialized c Masticatory
BONUS QUESTIONS:
51. Which of the following has a nonkeratinized epithelium?
a. Junctional epithelium b. Sulcular epithelium c. The col d. A and C e. A, B, C
52. A dysfunction on __Neutrophils______, may predispose an individual to develop periodontal disease. This immune cell has been shown to have different functional defects and has been linked to several forms of periodontal disease. What is the name of this immune cell?
53. On the diagram representing the Stratified Squamous Epithelium below, name the corresponding strata. (4 points)
A:Stratum Corneum B:Stratum Granulosum C:Stratum Spinosum D:Stratum Basale E: Basal membrane