PERIODONTICS NBDES BOOK FINALS

1.Normal gingival color is described as coral pink

8. The normal color of gingiva (marginal, attached, and interproximal )may best be described by which one of the following statements?

1.Normal gingival color is described as coral pink

2. Normal gingival color is described as birght red

3. Normal gingival color is described as reddish blue

4. Normal gingival color is described as reddish pink

5.Normal gingival color may vary from coral pink to varying shade of red or reddish blue

3. Gingival contour is normally described as having a parabolic form with blinted margins

9.Which of the following statements about the clincial findings of normal gingiva is not true

1. Depending upon the number of areas of the mouth affected, color change may be characterized as localized or generalized

2. Often in dark-skinned individuals the gingiva contains patches of brown pigmentation and these patches are considered a normal finding

3. Gingival contour is normally described as having a parabolic form with blinted margins

4. When colro chagnes associated with ginigval inflammation have occured in the interdental papilla and have spread to the amrginal and attached gingiva, these changes are sreibed as diffuse

5. Changes in gignval contour may be the result of cleft formation or recession

4. Bleeding of the ignigva durign toothbrushing usually is not cosnidered an abnormal finding

10. Whcih of the following statements about hte gingiva is not true ?

1.Normal gingiva is firm nd resilient

2. NOrmal gingival surface is either keratinzied or parakeratinized

3. GIngival enlargement may cause a coronal postioning of the gingival margin

4. Bleeding of the ignigva durign toothbrushing usually is not cosnidered an abnormal finding

5. Fibroedematous gingival cosnistency indicates the rpesence of an icnrease in conenctive tissue fibers and cells alogn with the edema of inflammation

4. Pain

11. wHIch of the following signs and symptons is not usually associated with chronci gingival inflammation

1.Suppuration

2.Bleeding

3.COlro change

4. Pain

5. SPOngy, swollen gingiva

3. POcket probing

12. The onyl accurate way to determien the presence or abscence of a pocket is by

1. Radiographci examination

2. Occlusal examination

3. POcket probing

4. visial examiantion for gingival enlargment

5. VIsual exmaination for color change

4. A true periodontal pocket is one which is assocaited with apical migration of the epithelial attahcment and loss of bone

13. A true periodontal pocket is best defined by whcih one of the following statements?

1. A true periodontal pocket is one formed by a coronal shift of the gingival margin, without migration of the peithelial attachment

2. A true periodontal pcoket is oen whcih is over 5mm in depth

3. A true periodontal pocket is one which is over 7mm

4. A true periodontal pocket is one which is assocaited with apical migration of the epithelial attahcment and loss of bone

5. A true periodontal pocket is one whcih is associated with loss of bone without any migration of the epithlial attachment

1. The level of the epithelial attahcment (position of the base of the pocket) is for greater significance than th depth

14.Which one of the following statements best describes the significance of pcoket probing in the diagnossi of periodontitis ?

1. The level of the epithelial attahcment (position of the base of the pocket) is for greater significance than th depth

2. THe greater the pocket depth probing the more severe the peridontal disease

3. THe positon of the gingival margin determines whether a diagnosis of periodontitis can be made

4. Bleeding elicicted by gentle probing is indicate of periodontits

5. WHen suppuration of the pocket is evident during pocket probine, a diagnosis of peridontitis is automatic

4. THe lack of stippling may not be consdiered a sign of inflammation unless stippling is known to have been present previously

15. WHich of the following statements best describes the value of stippling as a diagnostic aid in gingival inflammation

1. the presence of stippling alwyas indicates total lack of gingival inflammation

2. The abscence of stippling is always indicate of gingival inflammation

3. THe abscence of stippling is never a diagnostic sign of gingival inflammation

4. THe lack of stippling may not be consdiered a sign of inflammation unless stippling is known to have been present previously

5. In order for gingiva to be truly healthy, stipplign mus always be present

4. THe inital contact in retruded centric position

16. Occlusal analysis would not usuasly included exmaintio nfor hwich of the followign parameters?

1. The presence of parafunctional movmeents

2. SOreness in the temporomandibular joint

3. THe presence of gingival inflammation

4. THe inital contact in retruded centric position

5. Overbite, overjet, and angle classficaiton

2. Excessive occlsual forces may alter the pathway of inflammation causing an lteration in the morphology of periodontal pockets

17. Which oone of the following statements best describes the ole of excessvie occlusal forces i nthe etiology of periodontal disease

1. Excessive occlsual forces cause the formation of periodontal pockets

2. Excessive occlsual forces may alter the pathway of inflammation causing an lteration in the morphology of periodontal pockets

3. Excessive occlsual forces cause a more rapid horizontal bone loss

4. excessive occlsual forces cause the formation of pseudopcokets

5. excessive occlusal forces increase the severity of gingval inflammation

5. ALL OF THE ABOVE

18. Parafunctional mvoements during bruxism or cleaning have been descriebed as potentially very desctructive. This destruction may manifest itself by

1. TOOTH MOBILITY

2. EXCESSIVE WEAR OF TEETH

3. MUSCLE SPASMS

4. TEMPOROMANDIBUALR JOINT DISCOMFORT

5. ALL OF THE ABOVE

3. BLeeding of the gums when chewing or brushing

19. When conducting an occlusal analysis, the therapist should elicity ifnromatio nfrom the patient about all the folowing clincial signs except

1/Clenching or bruxism

2. SOreness in the temporomandibualr joint

3. BLeeding of the gums when chewing or brushing

4. SPeech probkems

5. Looseness of any teeth

1. ANUG is characterized by a sudden onset and is often assocaited with periods of psychologic stress.

20. Acite necrotizing unlcerating gignivity (ANUG) is best descrbied by which of the following statements?

1. ANUG is characterized by a sudden onset and is often assocaited with periods of psychologic stress.

2.ANUG is rarely seen in the adult popualtion

3.ANUG is characterized by the presence of discrete ulcers on the lips, cheek,s or gingiva that persist for up to 2 weeks

4. ANUG is often precipitated by the manipualtion of the oral tisseus durign dentla treatment

5. ANUG is often assocaited with patches of desquamative tissue that have an extremely painfu exposed connective tissue surface

3. Temporomandibular joint disorders

21.Predisoposing facotrs that have been described as those conditions which modyf the host's response to plaque. Which of the folllowing facotrs may not be considered a predisposing factor?

1. Hormonal imbalance

2. Gingival enlargement

3. Temporomandibular joint disorders

4. Blood dyscrassias

5. Inadequate nutrition

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22. Which of the following signs or symptoms best differentiates periodontitis from gignivtis?

1. THe presence of pocket depth in excess of 3mm

2. THe severity of gingival inflammation

3. The presence of pocket depths where the epithelial attachment has migrated apically, past cementoenamel junction, with radiographic evidence of bone loss

4. Radiographic evidence of a widening of the periodontal ligament space

5. THe presence of gingival recession

1. Juvenile periodontitis is a rapidly advancing severe peridontits in individuals of adolescent age

23. JUvenile periodontitis is best described by which on of the following statements?

1. Juvenile periodontitis is a rapidly advancing severe peridontits in individuals of adolescent age

2. A diagnosis of juvenile peridontitis is a condition that always clearly manifests signs and symptoms of a degenerative process

3. Juvenile periodontitis is not associated with the presence of abscence of bacterial organisms

4. Juvenile periodontitis never reveals any signs of supperation or bleeding

5. Juvenile periodontitis is best described as a radpible advancing ulcerative condition affecitn ght periodontium of younger individuals

3. THere is some evidence that the plauqe formed in cases of juvenile periodontitis is associated with flora that is different from the asoscaited with adult periodontitis

24. wHich of the following statements most accurately describes the plaque flora of individuals afflicted with juveniles periodontitis?

1. The plque formed in cases of juvenile periodontitis

has been shown to calcify far mroe rapidly

2/ THe plque formed in case of juvenile periodontitis is believed to be indeitical to the plaque formed with cases of adult periodontitis

3. THere is some evidence that the plauqe formed in cases of juvenile periodontitis is associated with flora that is different from the asoscaited with adult periodontitis

4. THere is little or no plauiqe formed in cases of juvenile periodontitis

5. THe plaque formation assocaited with juvenile periodontitis is far mroe tenacious and more difficult to remove with sntadard home care procedures.

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1.Desquamative gingivitis is a diffuse involvement of the gingiva where the epithelium tends ot desquamate in patches, leaving an exposed underlying connective tissue base

25. WHich of the folloiwng statements best describes the clinical appearance of desquamative gingivitis?

1.Desquamative gingivitis is a diffuse involvement of the gingiva where the epithelium tends ot desquamate in patches, leaving an exposed underlying connective tissue base

2. desquamative gingibitis is characterized by the formation of discrete ulcers that tend to last up to 2 weeks

3. Desquamative gingivitis reveals the formation of vesicel which tend to rupture and leave a painful ulcerated surface

4. Desquamative gingivitis is characterized by ulcerated soft tissue craters in the tips of the papillae

5. Desquamative gingivitis revelas no clinically evident changes; however, patients generally report a painful burnign sensation in the gums

2. WHen there is a temperature elevation with ANUG, another diseae entity (HERPES) or a superimposed systemic infeciton should be suspected

26. WHen there is an elevated temperatuve assocaited with a suspected ANUG which one of the following statements best describes the possible clinical significance of this finding?

1. WIth na elevation in temperature, the disease entity is in a very advanced state and antibiotic therapy should be instituted immediately

2. WHen there is a temperature elevation with ANUG, another diseae entity (HERPES) or a superimposed systemic infeciton should be suspected

3. A temperature elevation is pathognomonic of ANUG

4. WHen there is an elevation in temperature, teatment of ANUG should be postponed

5. When there is an elevation in temperature in ANUG, local debridgement should begin immediately

2. THere is an abnormal reposne to electric and thermal pulp testing

27. Which one of the following statements is not a correct sign or symptom of a periodontal abscess?

1. There is a localized swelling of the gingiva

2. THere is an abnormal reposne to electric and thermal pulp testing

3. Pain in the area of the abscess

4. Tooth or teet hvery sensitie to pressure

5. Heavy deposits of subgignival calculus in the affected area

3.pellicle

28. Appearing almsot immediately after the cleansing of a tooth, the film of salivary orgin which coats the surface is called

1. plaque

2.materialaba

3.pellicle

4.levans

5.lipoproteins

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4. rods and cocci

29.THe predominant microorganisms in the first 24 hours of plaque formation are

1.vibrios

2.filaments

3.spirochetes and vibrios

4. rods and cocci

5. cocci and filaments

4. a and d

30. plaque microrganisms are organized into a matrix which is composed of :

a. dextrans

b.lipoproteins

c.monosaccharides

d.levans

1. a

2. b

3. a and c

4. a and d

5. b and d

5. a and b

31. Plaque is differentiated from amterai alba by which of the following characteristics?

a. plaque consists of an organized matrix while materia alba is not orgnaized

b. plaque adheres firmly ot the tooth surface while materai alba is easily dislodged

c. plaque can be remove with a water spray while material alba must be mechanically removed

d. plaque cannot be differentiated from materia alba because they are the same entity

1. a

2. c

3. d

4. a and c

5. a and b

1. It serves to retain plaque

32. The importance of an overhanging margin on a crown as an etiologic agent in periodontal disease is primarily related to which of the following factors?

1. It serves to retain plaque

2. It serves as a mechanical irritant

3. It causes poor food deflection

4. It tears the gignival fibers

5. It leaves an unesthetic result

4. It is dental plaque which has becom mineralzied

33. WHich of the following statements is true of dental calculus?

1. It is composed entirely of inorganic materials

2. It is the primary etiologic agent in periodontal disease

3. It is classfied according to the degree of the inflammtory response it creates

4. It is dental plaque which has becom mineralzied

5. It is precipitated saliva

2. BActerial plaque creats a greater than usual inflammatory response

34. In regard to pregnanacy gingivitis, which of the following statements is correct

1. THe hormonla imbalance creates the inflammatory change in the tissues

2. BActerial plaque creats a greater than usual inflammatory response

3. It can be modified by hromonal therapy to being the body back to a state of equilibrium

4. It occurs in women with a hereditary predisposition to hormonal imbalance

5. Bacterial plaque accumulation is accelerated by the hormonal changes in pregnancy

5. a, b, and c

35. TRuama from occlusion leads to alteration in the

a.Peridoontal ligament

b. cementum

c. Alveolar bone

d. epihtelial attachment

1. a

2. c

3. a and b

4. a, c, and d

5. a, b, and c

4. a, b, and d

36. THe stages of trauma from occlusion include

a. injury to the periodontium

b. change in the morphology of the periodontium

c. stimulation of the periodontium

d. repair of the periodontium

1. a and b

2. a and c

3. a, b and c

4. a, b, and d

5. a, c and d

2. b

37. HIstologic changes found in trauam from occlusion include

a. inflammation in the periodontla ligament

b. hemorrhage and thrombosis of blood vessels to the periodontal ligament

c. apical migration of the epithelial attachement

d. replacement of collagenous fibers in the periodontal ligament with elastic tissue fibers

1. a

2. b

3. a and c

4. b and d

5. a, b, and d

5. Misdirected or excessive occlusal forces on a ttoht with normal bone support may lead to primary traumatism, and normal occlusal forces o a tooth which cannot withstand them because of decreased support may lead to secondayr traumatism

38. Primary occlusal traumatism can be differentiated from secodnayr trauamtism by whcih of the following?

1. Excessive occlusal forces in primary trauamtism lead to mobility, but in secondayr trauamtism they lead to tooth wear

2. Primar ytraumatism is more likely to occur in a patient with advanced periodontal disease than secondary traumatism

3. Primary traumatism can lead to insufficient stimulation of the periodontal ligament, whereas in secodnary trauamtism there is excessive stimulation of the periodontal ligament

4. Primary trauamtism occurs in teeth with decreased bone support, whereas secondarty trauamtism occurs in teeth with normal bone support

5. Misdirected or excessive occlusal forces on a ttoht with normal bone support may lead to primary traumatism, and normal occlusal forces o a tooth which cannot withstand them because of decreased support may lead to secondayr traumatism

5. all of the above

39. Which of the following statement best describes the treatment plan?

1. The treatment plan is the result of the analysis of all the data gathered during the examination

2. THe treatment plan is the orderly plan of aciton based on diagnosis and prognosis of the particular disease

3. The treatment plan is the orderly plan of acitn of resolving the patients' problems

4. THe periodontal treatment plan is usually divided into the broad categories of 1) initial therapy, 2 surgical therapy 3 maintenance

5. all of the above

2. Elimination or control of all etiologic factors

40. The major role of inital therapy is the

1. Alleviation of all emergency problems

2. Elimination or control of all etiologic factors

3. Establishment of a functional physiologic occlusion by means of sleective grinding and orthodontic therapy where indicated

4. Removal of calculus

5. None of the above

4. Peridoontally treated patients shoudl be kept in the maintenance phase for up to 6 months after treatement

41. WHich of the following statements concerning treatment plannin is not accurate?

1. Initial therapy is that phase of treatment where etiologic factors are removed or controlled

2. THe surgcial phase of the treatment plan is aimed at correction of the damage to the periodontal strcutures resulting from periodontal disease

3. THe maintenance phase of the treatment plan is as important or more important than the active pashe of the treatment paln

4. Peridoontally treated patients shoudl be kept in the maintenance phase for up to 6 months after treatement

5.One of the most important aspects of the treatment plan is the removal of plaque and plaque control program

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3. BOne grafting

42. Initial therapy does not include

1. Alleviation of all emergencies, rampant caries, chief complaint, iatrogenic resotraitons

2. scaling and root planing

3. BOne grafting

4. oclusal adjustment

5. Temporary stabilization

3. The ability to correct the resultant damage of peridontal diseae does not relate to prognosis

43. wHich of the following statements concerning prognossi of periodontal therapy is nor accurate?

1. PRognosis depends heavily upon proper diagnosis and the therapists clincia exposure

2. Prognosis is concerned with the ability of the practioner to recognize and elminate or control the factors causing periodontal disease

3. The ability to correct the resultant damage of peridontal diseae does not relate to prognosis

4. THe ability to achieve goals of a specific treatment plan determines whether a prognosis is good guarded or hopeless

5. THE individual patient's ability to maintain an adequate level of plaque control has great bearing upon the prognosis