perio quiz 2

A single microscopic organism is termed a(n):

Bacterium

Bacteria that have double cell membranes and that do not stain purple with crystal violet are called:

gram negitive

A well-organized community of bacteria that adheres to surfaces and is embedded in an extracellular self-protective matrix is termed:

biofilm

Which structure of a biofilm protects the bacterial microcolonies from systemic antibiotics and the body’s immune system?

extracellular slime layer

Which structure of a biofilm facilitates the movement of nutrients to the bacteria

fluid channels

Which of the following would be most effective in controlling the bacteria in a dental plaque biofilm?

toothbrush and floss

Why is frequent periodontal instrumentation important in the control of dental plaque biofilms located in periodontal pockets?

a toothbrush and floss cannot clean root surfaces within a periodontal pocket

Current perspective on the etiology of periodontal disease states plaque biofilm is necessary for initial inflammation, and plaque biofilm alone is not sufficient for periodontal destruction.

both statements are true

Which hypothesis states that an abundance of biofilm bacteria causes the tissue destruction seen in periodontitis

non specific plaque hypothesis

Microbial blooms occur in which stage of plaque biofilm development in the oral cavity?

stage 4

The primary purpose of the immune system is to:

defend the life of the host (the individual)

All of the following are classic symptoms of acute inflammation, EXCEPT:

brusing

In which stage of inflammation is pain a common symptom?

acute inflammation

Which of these immune cells secrete antibodies?

B-lymphocytes

Which of the following is defined as a complex series of inactive, nonnucleated proteins circulating in the bloodstream that facilitates the destruction of bacteria by phagocytosis or puncturing bacterial cell membranes?

complement system

All of the following are components of the immune system, EXCEPT:

hemidesmosomes

Which of the following is a normal process that protects and heals the body following physical injury or infection?

acute inflammation

Chronic inflammation is a pathologic condition characterized by host tissue destruction. In chronic inflammation, the inflammatory process can become so intense that it inflicts permanent damage to body tissues.

both statements are true

What is the term for the process whereby leukocytes migrate toward the infection site in response to bioactive compounds released by leukocytes?

chemotaxis

Both NKT-lymphocytes and NK-lymphocytes are “natural killers.” NK-lymphocytes do not require pre-activation by other immune cells so they are true “natural killers.”

both statements are true

The primary purpose of the immune system when it responds to a bacterial infection of the periodontium is to:

defend the life of the host (the individual with the bacterial infection)

Which of the following is the cause of nearly all the tissue destruction seen in periodontitis?

host response

Cytokines that play an important role in periodontitis are:

IL-1, IL-6, IL-8, and TNF-α

When PMNs rush to the site of infection of the periodontium, they release substances that destroy healthy gingival connective tissue. What is the advantage of connective tissue destruction in this instance?

This creates a pathway for the PMNs to move quickly through the tissue

If the bacterial pathogens in early gingivitis continue to proliferate, what is the next phase of disease progression?

established gingivitis

In which of the following phases of periodontal disease progression does the plaque biofilm extend subgingivally into the gingival sulcus?

established gingivitis phase

Which phase of periodontal disease progression is characterized by tissue destruction?

periodontitis phase

The immune biochemical mediators secreted by the immune cells are responsible for which of the following tissue destruction seen in periodontitis?

all of the above

Which is associated with gingival health?

symbiotic biofilm

Which of the following is a known environmental risk factor for periodontal diseases?

tobacco smoking

Calculus is considered a local risk factor to developing gingivitis or periodontitis because:

The surface of calculus is irregular and provides a place for bacteria to grow undisturbed

Which of the following is NOT a mechanism for attachment of calculus to a tooth surface?

Attachment to the blood clots that can form on the tooth

The term overhanging restoration refers to restorations (or fillings) that:

Are not smoothly contoured with the tooth surface

Pathogenicity of plaque refers to:

Disease-causing potential of the plaque

Parafunctional occlusal forces are forces placed on the teeth that:

Result from tooth-to-tooth contact other than during chewing food

Which of the following can result in direct damage to the periodontium?

Both A and B

Which is NOT an adverse event associated with intraoral piercings?

frenal pull

Which patient habit is most likely to lead to dehiscence?

Traumatic toothbrushing

In comparing smokers and nonsmokers with periodontitis, smokers have all of the following, EXCEPT:

More signs of inflammation

The effect of smoking and periodontal destruction is dose dependent with number of cigarettes daily. Nonsmokers and smokers heal well in response to periodontal treatment.

the first statement is true, second is false

What percentage of the periodontitis cases among adults in the United States is associated with current and former smoking?

greater than 50%

Smokers are at higher risk for tooth loss. In smokers, the periodontal tissues are continuously exposed to more than 7,000 toxins in smoke.

both statements are true

In smokers, the clinical signs of inflammation, such as redness and bleeding upon probing, are:

Diminished and less evident than in nonsmokers

In smokers, the lack of bleeding on probing does NOT indicate healthy tissue as it does in nonsmokers

true

Smoking cessation is beneficial to periodontal health. The American Academy of Periodontology does NOT recommend including tobacco cessation counseling in periodontal therapy

The first statement is true, the second false

Which is an example of a noncombustible nicotine product?

E cigs

Smoking cannabis has a lower risk of periodontitis than using combustible and noncombustible products. Chronic use of cannabis may have an increased risk of developing oral leukoplakia and oral cancer.

The first statement is false, the second true

A healthy immune system decreases the incidence of periodontal disease.

True

Research shows that diets high in refined carbohydrates reduce the risk for periodontal disease.

False

Emerging scientific evidence indicates obesity appears to play a role in the etiology of periodontal disease.

True

Diets deficient in vitamin D, calcium, and antioxidants increase the risk for periodontal disease.

True

Research suggests antioxidants can influence periodontal disease onset, progression, and wound healing.

True

Vitamin A has effective antioxidant properties and helps protect against the ROS generated during inflammatory responses.

True

The key to answering the second basic diagnostic question is

attachment loss

Migration of the junctional epithelium to a position apical to the level of the CEJ is termed:

attachment loss

Signs of periodontal disease are features of the disease that are observed by:

the clinician

The natural level of the junctional epithelium is located:

at the same level as the CEJ

Staging of periodontitis defines the:

severity of disease

ADA Case Type II patients are defined as patients having

slight (mild) periodontitits

Self-care education for a patient is normally provided during which phase of treatment?

nonsurgical periodontal therapy phase

Disease grading indicates:

rate of progression of disease

A systematic approach to clinical problem solving that allows the integration of best available research evidence with clinical expertise and patient values is called:

evidence based health care

Examples of shared decision-making characteristics include all of the following, EXCEPT:

develop a treatment plan for the patient

Sharing expertise includes:

clinician and patient collaborations

Understandable language to explain treatment options to patient should include:

simple sentences

Periodontal maintenance goals include minimizing recurrence of periodontal disease and reducing the incidence of tooth loss.

True

Which of the following is NOT an objective of periodontal maintenance?

decrease attachment levels

Procedures performed during a periodontal maintenance appointment include patient interview, clinical assessment, and periodontal instrumentation.

true

Which of the following has NOT been demonstrated to reduce root caries?

silver diamine fluoride

Research evidence suggests that a proper interval for periodontal maintenance is:

every 3 months

Compliance is defined as the:

Extent to which a patient’s behavior coincides with medical or health advice

Giving the patient multiple self-care aids to use each day is a proven technique for improving patient compliance

false

Factors that increase an individual’s susceptibility to periodontal infection modifying or amplifying the host response to microbial infection are called:

systemic risk factors

Persons with well-controlled diabetes have no more periodontal disease than persons without diabetes.

true

Which of the following individuals is MOST likely to have periodontitis?

An individual with poorly controlled diabetes

Levels of sex hormones may have an effect on the periodontium.

true

ALL pregnant women develop gingivitis

false

Certain individuals have a genetically determined immune response that predisposes them to periodontal disease.

true

Abnormalities in PMN function such as in individuals with neutropenia can lead to overwhelming systemic bacterial infection and increased susceptibility to severe periodontal destruction.

true

Individuals with Down syndrome rarely develop periodontitis.

false

Which of the following medications commonly causes gingival hyperplasia?

phenytoin (dilantin)

High financial stress increases the incidence of periodontal disease

True

All of the following are metabolic syndrome disturbances that increase risk for periodontal disease, EXCEPT:

gout

Which newer class of osteoporotic medications may prevent MRONJ in patients who are menopausal?

SERMS

According to current research, the presence of systemic disease may increase the severity of periodontitis. The presence of periodontitis may have an adverse effect on an individual’s systemic health.

both statements are true

One hypothesis proposed to explain a possible link between periodontitis and cardiovascular disease is that periodontitis triggers the production of C-reactive proteins in the body.

true

The American Academy of Periodontology statement indicates that most pregnant woman do NOT require a periodontal examination.

false

Pregnant women with severe periodontitis may develop bacteremia more frequently, exposing the fetus to aggressive periodontal pathogens.

true

Periodontal disease may exacerbate diabetes mellitus by worsening glycemic control over time.

true

Bacterial respiratory infections are thought to be acquired through aspiration of fine droplets from the oral cavity and throat into the lungs.

true