Exam 1-A NAME: _ _____ KEY A & B________________ Seat #: __________________________________ Exam # _________ DAPE 731, Periodontology Year III Dr. Elio Reyes, D.D.S., M.S.D. Dr. Dwight E. McLeod, D.D.S., M.S. October 13, 2009 USE Pencil on Separate Answer Sheet 50 questions multiple choice & true/false – 2 pts each 100 points 3 bonus questions fill in the blank – 1 point each. Total possible points 103 Which periodontal procedure has the specific goal of removing the epithelial lining of the periodontal pocket? A. Periodontal prophylaxis B. Gingival curettage C. Subgingival scaling and root planing D. Gingivoplasty E. None of the above Which one of the following procedures is considered a gingival curettage procedure? A. Gingivectomy B. Subgingival scaling and root planing C. Electrocautery procedure D. Excisional new attachment procedure E. The inverse bevel technique A positive Nikolsky’s sign determines the difference between these conditions: A. Cicatrical pemphigoid / Mucous membrane pemphigoid. B. Mucous membrane pemphigoid/ Pemphigus vulgaris. C. Pemphigus vulgaris/ Stomatitis medicamentosa. D. Stomatitis medicamentosa/ Cicatrical pemphigoid. E. None of the above. Which one of the following conditions is not classified into the “Periodontitis as a manifestation of systemic diseases” category? A. Hematological disorders B. Genetic disorders C. Diabetes mellitus D. A and B E. None of the above In distinguishing “Necrotizing Ulcerative Periodontitis” from “Periodontitis associated with Systemic Diseases”, which of the following factors would best assist you to differentiate? A. The amount of subgingival calculus present. B. Level of the mucogingival junction. C. Presence of pseudomembranous sloughed layer. D. Bleeding upon probing. Identify the tissues that comprise the pocket wall: 1. Sulcular epithelium 2. Connective tissue matrix 3. Keratinized epithelium 4. Periodontal ligament fibers A. 1, 2, 3, 4 B. 1, 2, 3 C. 2, 4 D. 4 The type of healing that occurs after a gingivectomy surgery with a scalpel can be categorized as: A Tertiary healing. B. Secondary healing. C. Primary healing. D. A combination of primary and secondary healing. E. None of the above. Patients with Desquamative Gingivitis are frequently treated with? A. Mouth rinses containing Coenzyme Q and Vitamin C. B. Topical corticosteroids. C. Immunofluorescence . D Gingival massage. E. Antibiotics. A contraindication for the gingivectomy procedure includes: A. Suprabony pockets. B. Infrabony pockets. C. Pseudopockets. D. Supercrestal pockets. E. Gingival pockets. The type of healing that occurs after gingival curettage is classified as: A. Regenerative. B. Repair by long junctional epithelium. C. Reattachment. D. New attachment. E. Guided tissue regeneration. Which of the following mouth rinses are ADA approved for the treatment of periodontitis? A. Peridex. B. Listerine. C. Cepacol. D. A and B. E. None of the above. During a gingivectomy procedure, which one of the following procedures is not performed? A. Scaling and root planing B. Osseous recontouring C. Bone grafting of infrabony pockets D. Soft tissue scalloping E. B and C Which one of the following gingivectomy procedures is more precise and predictable? A. Laser gingivectomy B. Electrode gingivectomy C. Scalpel gingivectomy D. Chemical gingivectomy E. None of the above Treatment of necrotizing ulcerative gingivitis in patients free of systemic involvement includes: 1. occlusal adjustment. 2. penicillin therapy. 3. oral hygiene instruction. 4. debridement. 5. gingivoplasty. A. 1, 3, and 5. B. 2, 3, and 4. C. 1, 2, and 5. D. 2 and 3 only. E. 3 and 4 only. Which one of the following procedures has the sole purpose of reshaping the gingival tissues? A. Gingivectomy B. Gingivoplasty C. Gingival curettage D. Excisional new attachment procedure E. None of the above Which periodontal procedure does not eliminate the cause of inflammation? A. Gingival curettage B. Gingivectomy C. Excisional new attachment procedure D. Osseous surgery In reference to the roots of mandibular premolars, the mental foramen usually faces: A. upward and distally. B. upward and mesially. C. downward and distally. D. downward and mesially. This procedure utilizes an internal bevel incision to achieve its surgical goal: A. Gingival curettage B. Excisional new attachment procedure C. Gingivectomy D. Laser guided gingivoplasty E. None of the above Gingivectomy is a commonly performed surgical procedure because it: A. involves minimal postsurgical discomfort and bleeding due to primary closure. B. allows adequate access to osseous defects. C. conserves keratinized gingiva. D. allows for reduction and reshaping of the gingiva. In edentulous patients the location of the mental foramen may vary significantly from that of dentate patients. What radiograph would you prescribe to facilitate its location? A. Lateral cephalograph B. Panoramic C. Periapical D. Vertical bitewing E. None, the foramen is better assessed clinically How soon does epithelial migration from the wound margin occur after a gingivectomy surgery? A. 12-24 hours B. After 72 hours C. 7-10 days after the clot is dissolved D. By the beginning of the 3rd week E. None of the above Which bacteria has the pathogenicity to invade host tissue? A. A.actinomycetemcomitans B. P. gingivalis C. Spirochetes D. A and B E. A, B, C Infections involving the _____________ are very likely to present with severe trismus. A. Canine fossa space. B. Buccal space. C. Sublingual space. D. Masticator space. E. Submental space. Which bacteria is not classified as a “red complex” bacteria? A. P. gingivalis B. T. forsythia C. T. denticola D. B and C E. None of the above Which one of the following is not considered a risk factor for periodontal disease? A. Obesity B. Medication C. Systemic diseases D. Age E. None of the above Which of the following is true about the clinical course of necrotizing ulcerative gingivitis? A. Will not subside without professional treatment. B. Will lead to pocket formation. C. Is not responsive to Chlorhexidine rinses. D. Frequently recurs. There is a dose-effect relationship between cigarette smoking and the severity of periodontal disease. Cigarette smoking is associated with a twofold to seven fold increased risk of having an attachment loss compared to nonsmokers. 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. Local effects of cigarette smoking include: A. peripheral vaso constriction. B. local ischemia. C. growth of pathogenic bacteria. D. A and B E. A, B, C An Adult Prophylaxis (0110) differs from a Periodontal Maintenance (4910) procedure, in that: A. Charting is not recorded during a prophylaxis. B. The initial gingival or periodontal diagnosis dictates the treatment. B. Scaling is not performed during an Adult Prophylaxis. C. Root planning is not performed during a Periodontal Maintenance. D. None of the above. Systemic effects of cigarette smoking do not include: A. decreased IgG and IgA production B. increased PMN proliferation C. altered chemotaxis D. altered phagocytosis What percent of the American population has gingivitis? A. 95% B. 88% C. 65% D. 75% E. 100% Recurrent intra-oral herpes virus infection A. Is usually observed on the buccal mucosa and floor of the mouth. B. May be initiated by trauma to the oral tissues. C. Is rarely painful. D. Is never seen in a patient with herpes labialis. E. None of the above is true. Which one of the following is a not classical complication of diabetes? A. Periodontal disease B. Neuropathy C. Nephropathy D. Macrovascular disease E. None of the above The recommended target HbA1c by the American Diabetes Association is: A. >8% B. <7% C. 10% D. 110 mg/dL D. None of the above Primary herpetic gingivostomatitis is best treated by: A. Topical and systemic analgesics. B. Large single dosage of steroids. C. Bed rest and forced liquids. D. A and C. E. All of the above. Which one of the following is an indication of systemic inflammation? A. IL-1 B. TNF C. CRP D. MMP E. PGE Which one of the following is administered systemically? A. Perio Protect B. Periostat C. Arestin D. Atridox E. None of the above A diagnosis of “necrotizing ulcerative gingivitis” is best made by which of the following? A. Bacteriologic examination. B. Clinical signs and symptoms. C. Exfoliative cytology. D. Biopsy of the tissue. E. Psychological profile. Which one of the following mouth rinses is alcohol free? A. Crest-Prohealth B. Listerine Cool Mint C. Cepacol D. Scope The active agent in Arestin is: A. Amoxicillin. B. Minocycline. C. Doxycycline. D. Chlorhexidine. E. Cephalexin. The most compelling evidence now indicates that periodontitis is not a conventional infectious disease, but rather an inflammatory condition. This condition is triggered by a host-immune response to a constellation of periodontal biofilm-associated microorganisms. 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. Local drug delivery of antimicrobials (LDA) is contraindicated in: A. multiple pockets of > 5 mm B. intrabony defects C. when the use of previous LDA has failed to work D. A, B E. A, B, C Which periodontal surgical procedure does not have as its main goal to cover exposed root surfaces? A. Tunnelling procedure B. Subepithelial connective tissue graft C. Free gingival graft D. Lateral pedicle graft E. None of the above The submandibular space is found above the mylohyoid muscle. Infections of this space arise most likely from molar teeth. A. Both statements are true B. Both statements are false C. The first statement is true and the second one is false D. The first statement is false and the second one is true Which one of the following is not a periodontal resective surgical procedure? A. Gingivectomy surgery B. Crown lengthening surgery C.