Friday, August 5, 2011

perio ahead study material

1. The surface area of the periodontal ligament has been calculated to cover about
a. 25 square centimeters b. 50 square centimeters
c. 65 square centimeters d. 75 square centimeters

2. Pristine gingiva is the term used to describe which of the following conditions
a. Gingiva found in patients with impeccable oral hygiene and minimal plaque
b. Early gingivitis found in patients with some plaque formation.
c. A robust inflammatory response in gingiva results in clinical signs of inflammation
d. The inflammatory response results in marked collagen breakdown

3. Initial dental plaque bacteria signal the epithelium of the gingiva to produce a variety of biologically active mediators, most prominently called as
a. Organic acids b. Chemotactic peptides
c. Cytokines d. C-reactive protein

4. Host cells produce a myriad of soluble proteins that act directly on proteins, cells, or invading microorganisms and, ultimately, contribute to the defense of the periodontium. Interleukins released by periodontium are the example of
a. Cytokines b. Hormones
c. Mediators d. Growth factors

5. The process in which a cytokine alters the function of adjacent cells is:
a. Autocrine b. Paracrine
c. Found only in dorsal root ganglia
d. Found routinely in osteocytes

6. The diverse number of cellular products that are released by periodontium as defense mechanism can be simplified into four categories: cytokines, hormones, mediators, or growth factors. Proteins that are found in the plasma protein systems and perform important role in inflammation are
a. Cytokines b. Hormones
c. Mediators d. Growth factors

7. A complex family of signal molecules that regulate differentiation, proliferation, growth, and maturation of cells during inflammation are
a. Prostaglandins b. Interferon
c. Mediators d. Growth factors

8. What are biologically active molecules that are released into the bloodstream and stimulate functional activity of cells distant from the site of secretion?
a. Autosomal recessive neutrophils
b. Autosomal dominant basophils
c. Prokaryotic d. Hormones

9. What is the dividing line between acute and chronic inflammation?
a. 3 days b. 7 days
c. 3 months d. There is no clear dividing line.
10. The most common systemic effects of inflammation include fever and:
a. Leukocytosis b. Pinocytosis
c. Phagocytosis d. Bacterial endocarditis

11. Low-grade but persistent bacteremia may allow oral bacteria to aggregate platelets through:
a. Protein synthesis
b. Receptor-ligand interactions
c. Biofilm exudates
d. Histamine activation

12. Immediately after cellular injury, which cells release preformed biochemical mediators?
a. Stem b. Mast
c. Histamine d. B helper cells

13. Separating the “inner” and “outer” environments at the base of the gingival sulcus is the:
a. Junctional epithelium
b. Periodontal ligament
c. Remnants of Her twig’s root sheath
d. Epithelial rests of Mallassez

14. Diffusible protein that is a part of the outer membranes released after cell death is
a. Microtoxin b. Macrotoxin
c. Endotoxin d. Exotoxin

15. The term chronic inflammation in periodontitis has been replaced by:
a. Acute inflammation
b. Innate immune response
c. Acquired immune response
d. Cytokine activation phase

16. After bone resorption in periodontitis occurs, growth and remodeling are automatically triggered in a process called:
a. Osteogenesis b. Phagocytosis
c. Diapedesis d. Coupling

17. A prolonged high rate of osteoblast cell death in periodontitis in diabetic patients is called:
a. Phagocytosis b. Osteogenesis
c. Apoptosis d. Kinincytosis

18. The name given to a fragment of dead bone is
a. Sequestrum b. Perio Chip
c. Hemolytic bone d. Subtraction bone

19. The bacteria that are thought to be the most influential in causing periodontitis are all except
a. P. Gingivalis b. S. mutans
c. T. Denticola d. A. actinomycetemcomitans

20. The names of different types of periodontal probes are all except
a. Standard 10 mm Williams probe
b. 15 mm extended Williams probe
c. Nabers furcation probe
d. Nelsons firm grip probe
21. The two types of curettes most commonly used in periodontics are
a. Gracey and Langer
b. Gracey and Williams
c. Williams and Langer
d. Gracey and Nabers

22. When are systemic antibiotics NOT useful in the treatment of periodontal disease?
a. Aggressive acute periodontitis
b. Chronic periodontitis resistant to mechanical therapy
c. Multiple periodontal abscesses
d. Acute infections in medically compromised patients

23. What is a PerioChip?
a. It is a hydrolysed gelatine chip containing 2.5 mg of chlorhexidine
b. The name given to a fragment of dead bone
c. Inter sulcular natural herbal products or bisguanide antiseptics
d. quaternary ammonium compounds used for periodontal drug delivery

24. What inhibits the action of chlorhexidine?
a. Toothpaste b. Bisguanide
c. Quaternary ammonium compounds d. Tannic acid

25. Approximately how long does it take for signs of inflammation to develop following the formation of a plaque biofilm?
a. 1–2 days. b. 2–3 days.
c. 3–4 days. d. 4–5 days.

26. An expression of the patient’s condition in numerical terms expressed as a percentage is called as
a. Index b. Incidence
c. Prevalance d. Fineness

27. How many sites on a tooth are probed in order to measure the bleeding index?
a. Two b. Three c. Four d. Six.

28. What is the major factor in determining the different bacteria in supragingival and subgingival plaque?
a. Bacteriocins b. Oxygen
c. Hemolysis d. Epithelial cell barrier

29. In HIV gingivitis the gingival margin has a distinct red band, and the tissue may bleed easily. This situation is typically called as
a. Linear gingival erythema (LGE)
b. Desquamative ulceration gingivitis (DUG)
c. Blunting of interdental papilla and clefting.
d. Lichenoid reaction

30. What is the first cellular line of defense of the body against the periopathogens?
a. Epithelial cell barrier
b. PMN
c. Bacteriocins
d. Hemolysis
31. Periodontal disease activity is measured by all of the following except
a. Periodontal probe b. Subtraction radiography
c. Bite wing radiography d. flow rates of GCF

32. Periodontal attachment loss is measured by using a periodontal probe and a fixed reference point, such as the
a. Cementoenamel junction (CEJ).
b. Dentinoenamel junction (DEJ).
c. Height of gingival margin
d. Sulcular depth

33. Bone sounding serves all of the following purposes except
a. Amount of bone loss
b. Flap design.
c. Number of walls in the bony defect
d. Osteoclastic activity in the bone

34. The main bacteria associated with active destructive periodontal disease - adult periodontitis is
a. P. gingivalis b. E. corrodens
c. F. nuc/eatum d. C. recta

35. The two inflammatory mediators which are indicators of periodontal disease activity are
a. Interleukin 1.-beta and tumor necrosis factor alpha
b. Interleukin 1 and Insulin like GF
c. Interferone and tumor necrosis factor alpha
d. tumor necrosis factor alpha and Insulin like GF

36. After a periodontal pocket has been scaled, root planed, and curetted, a soft tissue reattachment to the root surface may occur. Pocket reduction is due to
a. Gain in attachment
b. Decrease of inflammation.
c. Formation of Fibrous reattachment
d. Formation of long junctional epithelium

37. The term used for gingival cells of junctional epithelium that attach to the root cementum is by
a. The cells attach by hemidesmisomes.
b. Sulcular depth
c. Epithelial cell barrier
d. Bacteriocins

38. V-shaped defect in the supporting alveolar bone—buccal or lingual plates which is difficult to treat.
a. Dehiscence b. Fenestration
c. Negative bony architecture d. Periodontosis

39. The localized drug delivery system applied to periodontal therapy uses which antibiotic
a. Tetracycline b. Metronidazole
c. Doxycycline d. Clindamycin

40. An extract from the blood root plant that exhibits antimicrobial properties and has been formulated into various dentifrices and mouthwashes is
a. Triclosan b. Sanguinaria
c. Chlorhexidine d. Arachidonic acids
41. Occlusal trauma associated with centric occlusion and may indicate a slight occlusal discrepancy
a. Fremitus b. Bruxism
c. Masticatory muscle soreness d. Ablation

42. The distance between margin of the crown prosthesis preparation and the crest of bone in order to maintain a proper biologic width should be at least
a. 1. mm b. 2. mm c. 3. mm d. 4. mm

43. Bone recontouring procedure and ramping of interproximal bone are examples of
a. Osteoplasty
b. Ostectomy
c. Create positive architecture
d. Increase the clinical crown length

44. In distal wedge procedure a block of tissue is removed from the distal aspect of a tooth to reduce the pocket depth. Distal wedge procedures are frequently the sequel to the extraction of a
a. First molar. b. Second molar
c. Third molar d. Second premolar

45. A palatal/lingual curtain procedure with the purpose of maintaining the buccal gingival architecture is carried out in the region of
a. Maxillary posterior teeth b. Maxillary anterior teeth
c. Mandibular anterior teeth d. Mandibular posterior teeth

46. Root amputation is indicated in
a. Multirooted teeth with periodontal involvement
b. Single rooted tooth with periodontal involvement
c. Teeth with endodontic involvement
d. Teeth with perio-endo lesion

47. Main advantage of using a laser for periodontal procedures is
a. It is Safe and convenient
b. The laser cauterizes blood vessels
c. Minimizes instrumentation
d. Decreased operating time

48. Soft tissue graft is to be used as treatment of gingival recession when
a. Probing depth is at least 1.5 – 2.5 mm
b. Probing depth is upto the level of mucogingival junction
c. probing depth extends beyond the mucogingival junction
d. probing depth is short of the mucogingival junction

49. What is the primary reason for failure of a free gingival graft?
a. disruption of the vascular supply b. Infection
c. Dislodging of the blood clot
d. Opening away of the sutures

50. It is difficult to place a free gingival graft in the region of
a. Buccal area of the mandibular premolars
b. Lingual area of the mandibular premolars
c. Buccal area of the maxillary premolars
d. Lingual area of the maxillary premolars
51. An intraoral autograft from an extraction site can be harvested
a. 3—4 weeks after extraction
b. 4—6 weeks after extraction
c. 6—8 weeks after extraction
d. 8—10 weeks after extraction

52. Which bone-grafting material has the greatest osteogenic potential with the fewest sequelae in periodontal applications?
a. Freeze-dried allografts b. Autografts
c. Allografts d. Alloplasts

53. Bacteria that is most commonly found to be associated with periimplantitis
a. A. actnomycetemcomitans b. P.intermedia
c. P. gingivals d. Capnocytophaga species

54. Which of the following is not part of the periodontium?
a. The gingiva. b. The tooth.
c. Cementum. d. The periodontal ligament.

55. Wound healing is adversely affected by:
a. Diabetes. b. Pregnancy.
c. Down’s syndrome. d. Osteoporosis.

56. Which of the following are not a group of gingival periodontal fibres?
a. Dentogingival fibres. b. Dentoperiosteal fibres.
c. Semicircular fibres. d. Transseptal fibres.

57. Which of the following is not an abscess of the periodontium?
a. Periapical abscess. b. Gingival abscess.
c. Periodontal abscess. d. Pericoronal abscess

58. A disadvantage of chlorhexidine mouthwash is:
a. It contains alcohol.
b. It is expensive.
c. It is only available in liquid form.
d. It stains the teeth.

59. A BPE Code 3 means:
a. Probing depth 0–3 mm, bleeding on probing, no calculus or root roughness.
b. Probing depth 0–3 mm, bleeding on probing, calculus or root roughness.
c. Probing depth 2.5-5.5 mm, bleeding on probing, calculus or root roughness.
d. Probing depth 3.5–5.5 mm, bleeding on probing, calculus or root roughness.

60. Which of the following is not a periodontal probe?
a. Williams probe. b. Briault probe.
c. Nabers probe. d. BPE probe.

61. The active ingredient of the PerioChip is:
a. Amoxicillin.
b. Minocycline.
c. Metronidazole.
d. Chlorhexidine.

62. Systemic antibiotics are inappropriate for:
a. Aggressive periodontitis.
b. A periapical abscess.
c. Patients with systemic symptoms.
d. Multiple periodontal abscesses.

63. Approximately what percentage of bacterial endotoxin can be removed from the root surface by rinsing and brushing?
a. 99%. b. 80%. c. 75%. d. 50%.

64. Which of the following is not normally associated with periodontitis?
a. S. intermedius. a. P. gingivalis.
c. B. forsythus. d. T. denticola.

65. The process that results in fine droplets forming in the water coolant of an ultrasonic scaler is called:
a. Microstreaming. a. Capitation.
c. Macrostreaming. d. Cavitation.

66. The Bass tooth-brushing technique involves a:
a. Scrubbing action. b. Rotational movement.
c. Side-to-side vibration. d. Vertical movement.

67. Which of the following is an important clinical feature of necrotising gingivitis?
a. Tooth mobility. b. A pseudomembrane.
c. Infra-bony pocketing. d. Rounded papillae.

68. Which of the following radiographs are most useful for periodontal diagnosis?
a. Oral pantomograph. b. Occlusal.
c. Periapical. d. Lateral oblique.

69. Smoking tends to:
a. Increase tooth mobility.
b. Increase gingival inflammation.
c. Decrease plaque formation.
d. Decrease gingival bleeding.

70. Initially formed calculus contains mainly:
a. Octocalcium phosphate. b. Hydroxyapatite.
c. Calcium chloride. d. Sodium chloride.

71. The film of glycoproteins covering the teeth within minutes of being cleaned is called:
a. A biofilm. b. A pellicle. c. Plaque. d. Calculus.

72. Which of the following is not a normal clinical feature of aggressive periodontitis?
a. Relatively good oral hygiene.
b. Clear signs of bone loss.
c. Low levels of visible plaque.
d. A pseudomembrane.

73. The incidence of necrotising periodontal diseases has reduced over the last 30 years except for:
a. Diabetic patients.
b. HIV-positive patients.
c. Patients with endocarditis.
d. Patients with ectodermal dysplasia.
74. Which of the following indicies would one likely use in assessing severity or extent of periodontitis in epidemiologic studies in large population
a. PMA index b. Plaque index
c. Gingival index d. Periodontal index

75. What surgical procedure is indicated most frequently following endodontic therapy on a mandibular molar having both periodontal-bifurcation involvement and extensive bifurcation caries
a. Hemisection b. Fenestration
c. Root amputation d. Apical curettage

76. Which of the following has a greatest impact on the success of a periodontal flap procedure
a. Type of initial incision
b. Extend of flap reflection
c. Position of the flap at closure
d. level of the postoperative plaque control

77. Sulcular brushing is best accomplished using a
a. Natural-bristle brush
b. Soft 2-3 row brush with rounded bristle tips
c. Brush with angular-cut bristle tips and a soft texture
d. Brush with square-cut bristle tips and a medium texture

78. Without treatment, which of the following periodontal conditions has the poorest prognosis
a. Gingivitis b. Occlusal traumatism
c. Moderate periodontitis d. Juvenile periodontitis

79. Loss of periodontal attachment is determined by measuring the distance between the
a. Gingival margin and the cementoenamel junction
b. Gingival margin and the bottom of the periodontal pocket
c. Cementoenamel junction and the bottom of the periodontal pocket
d. Gingival margin and the most coronal portion of the connective tissue attachment

80. Of the following indicies, which takes into account the thickness of plaque on the tooth
a. PDI
b. Plaque index of OLeary
c. Plaque index of loe and Silness
d. Simplified oral hygine indexof Green and Vermillion

81. When patient fails to demonstrate adequate oral hygine during initial therapy,the best course of action is
a. Conservative osseous surgery
b. To perform curettage only
c. To limit therapy to gingivectomy
d. To continue providing oral hygiene instruction and root planning

82. Heavy fibrous gingival hyperplasia is best treated by
a. Subgingival curettage
b. Scaling and plaque control
c. Reverse bevel flap operation
d. Gingivectomy or gingivoplasty
83. Water irrigation devices have been shown to
a. Eliminate plaque
b. Dislodge food particles from between the teeth
c. Prevent calculus formation
d. Diminish plaque formation

84. A pocket formed by gingival enlargement with out apical migration of the junctional epithelium is which of the following
a. Absolute pocket b. Pseudopocket
c. Periodontal pocket d. True pocket

85. When measuring the depth of a periodontal pocket, the measurement is made from the base of the pocket or the attached periodontal tissues to
a. The cementoenamel junction
b. The height of the gingival margin
c. A fixed point
d. The unattached periodontal tissue

86. Which of the following ingredients serves to retain moisture in a commercial tooth paste
a. Detergent b. Humectant
c. Surfactant d. Binder

87. Which of the following types of mouth washes are prepared to relieve pain
a. Astringents b. Anodynes
c. Buffering agents d. Oxygenating agents

88. Which one of the following best describes the objective of root planing
a. Removal of the factors that promote gingival inflammation
b. Removal of the diseased epithelial attachment
c. Removal of the diseased attached gingiva
d. Removal of the diseased sulcular epithelium

89. An early effect of primary traumatic occlusion is
a. Vertical pocket formation
b. Generalised alveolar bone loss
c. Undermining resorption of the alveolar bone
d. Hemorrhage and thrombosis of blood vessels in the periodontal ligament

90. The best immediate treatment for bruxism problem would be
a. To refer for a psychiatric counseling
b. Elimination of the balancing interference
c. Temporary splinting of the mobile teeth
d. To construct an occlusal night guard

91. Ultrastructural and biochemical studies have shown that plaque microorganisms produce substances which seperate them from one another and form a matrix for further plaque accumulation .This matrix is made up of dextrans(glucans) and
a. Levans
b. Mmucoproteins
c. Disaccharides
d. lipoproteins
92. A material composed of particles of sufficient hardness to cut or scratch a softer material when drawn across its surface is called
a. An abrasive b. A cleanser
c. A polish d. A dentrifrice

93. The process by which all forms of life ,including bacterial spores and viruses ,are destroyed describes the process of
a. Sterilization
b. Cleaning
c. Disinfecting
d. Decontamination

94. A patient who manifests a peculiar inflammation of the marginal and attached gingiva and demonstrates ulcerated and necrotic epithelium that sloughs with air blasts probably has
a. Chronic desquamative gingivitis
b. Periodontitis
c. Necrotizing ulcerative gingivitis
d. Redmouth syndrome

95. Subgingival calculus differs from supragingival calculus in
a. location b. Density
c. Color d. All of the above

96. Which of the following instruments is best suited for root planing
a. File b. Chisel
c. Curette d. Scaler

97. Repeated application of a topical fluoride will not cause enamel mottling because
a. Topical fluoride is too weak to produce mottling
b. The tooth is already calcified and cannot be altered
c. The glycerin base of the polishing agent will protect the tooth from mottling
d. Both A and C

98. Which of the following groups of the gingival fibers arises from the alveolar crest and inserts coronally into the lamina propria
a. Dentogingival fibers
b. Alveologingival fibers
c. Transseptal fibers
d. Circular fibers

99. Which of the following is not a function of the periodontal ligament
a. Supportive
b. Nutritional
c. Sensory
d. Regenerative

100. Which of the following is the most effective chemotherapeutic agent against bacterial plaque
a. Zinc chloride
b. Chlorhexidine
c. Hydrogen peroxide
d. Sodium perborate


1. Ans. D. The surface area of the periodontal ligament has been calculated to cover about 75 square centimeters. Thus, a person having 50% horizontal bone loss and inflamed pocket epithelium would have a wound surface of approximately 30 to 40 square centimeters.

2. Ans. A. Gingiva found in patients with impeccable oral hygiene and minimal plaque. Gingival tissues are free of clinical signs of inflammation, and tissues are essentially free of inflammatory infiltrate. Right panel: Early gingivitis is found in subjects with some plaque formation. While the gingival tissues are free of clinical signs of inflammation, a mild inflammatory infiltrate is evident, consisting of vasculitis and the presence of neutrophils.

3. Ans. C. Initial dental plaque bacteria typically gram-positive cocci and filaments release a variety of chemical compounds during their normal metabolism such as organic acids, chemotactic peptides, etc. These products are soluble and penetrate the superficial layers of the sulcular epithelium. These substances signal the epithelium of the gingiva to produce a variety of biologically active mediators called as cytokines

4. Ans. A Cytokines have a broad variety of actions combined with functional redundancy within the inflammatory system. Examples of cytokines are the interleukins.

5. Ans. B. A cytokine is a low-molecular-weight, biologically active protein that alters the function of the cell that released it (autocrine) or the function of adjacent cells (paracrine).

6. Ans. C. Mediators are proteins that are found in the plasma protein systems as well as agents released from mast cells. An example of a mediator is histamine.

7. Ans. D. Growth factors are a complex family of signal molecules that regulate differentiation, proliferation, growth, and maturation of cells. An example of a growth factor is transforming growth factor.

8. Ans. D. Hormones are biologically active molecules that are released into the bloodstream and stimulate functional activity of cells distant from the site of secretion.

9. Ans. D Chronic inflammation is generally considered an inflammatory process that lasts for a prolonged period of time (i.e., weeks, months, or even years). Although there is no clear dividing line between acute and chronic inflammation, the extended time frame for chronic inflammation is a result of persistent stimuli from causative agents.

10. Ans. A. The most common systemic effects of inflammation include fever and leukocytosis (abnormally high white blood cell count).

11. Ans. B. Oral bacteria and gingival inflammation may theoretically influence systemic health through four potential pathways: bacteremia, systemic dissemination of locally produced inflammatory mediators, provocation of an autoimmune response, and aspiration or ingestion of oral contents into the gut or airway. Low-grade but persistent bacteremia may allow oral bacteria to aggregate platelets through receptor-ligand interactions.

12. Ans. C. Mast cells are located in the connective tissues close to blood vessels and contain a variety of biochemical agents located in intracellular granules. Immediately after cellular injury, mast cells release preformed biochemical mediators that include histamine, neutrophil chemotactic factor, and the eosinophil chemotactic factor of anaphylaxis.

13. Ans. A. The tooth / periodontium transgingival connection constitutes a unique relationship; the root is an avascular mineralized surface, which emerges from the bone socket into the mouth, a contaminated cavity. Separating the “inner” and “outer” environments is the junctional epithelium at the base of the gingival sulcus.

14. Ans. C. Some gram-positive and -negative bacteria have the ability to produce diffusible proteins, or exotoxins. Exotoxins have specific pharmacologic actions and are considered powerful and lethal poisons. Conversely, endotoxin is part of the outer membranes released after cell death.

15. Ans. C. Previously, the host response to a bacterial challenge was characterized as either acute or chronic inflammation. However, chronic inflammatory diseases, such as periodontitis, have simultaneous acute and chronic components. As a result, the terms acute or chronic inflammation have been replaced by innate or acquired immune response, respectively.

16. Ans. D. Bone is a dynamic tissue well adapted for repair. After bone resorption occurs, growth and remodeling are automatically triggered in a process called coupling. In periodontal diseases, there is a net loss of bone so that coupling is incomplete.

17. Ans. C. There is a much more prolonged high rate of osteoblast cell death, also called apoptosis, in the diabetic group of patients suffering from periodontitis Thus, the increased death of osteoblasts may contribute to the diminished capacity of diabetic patients to form new bone after infection.


18. Ans. A

19. Ans. B

20. Ans. D

21. Ans. A

22. Ans. A

23. Ans. A


24. Ans. A

25. Ans. B

26. Ans. A

27. Ans. D

28. Ans. B The major factor is oxygen. The redox potential of the gingival sulcus greatly influences the bacterial composition.

29. Ans. A. Linear gingival erythema (LGE) is frequently used to describe HIV gingivitis. As the name implies, the gingival margin has a distinct red band, and the tissue may bleed easily.

30. Ans. B. Other than the epithelial cell barrier, the first line of defense is the PMN.

31. Ans. C. Classically disease activity (attachment loss) is measured by using a periodontal probe and a fixed reference point, such as the cementoenamel junction (CEJ). A number of different types of probes are used to measure disease activity (e.g., Florida probe). Other methods may include subtraction radiography.

32. Ans. A. The change in the probing depth, excluding any changes in the gingival height due to inflammation, determines disease activity. Statistically, disease activity is frequently defined as an attachment loss of 1.5 mm or greater.

33. Ans. C. Bone sounding is used to provide the clinician with additional information about the amount of bone loss. The area in question is anesthetized, and a probe is forced through the epithelium until it strikes bone. Sounding may facilitate flap design.

34. Ans. A. The bacteria associated with destructive periodontal disease include P. gingivalis, E. corrodens, F. Nuc/eatum, C. Recta, B. forsythus, and A. actnnomycetemcomjtans. The major player may be P. gingivalis.

35. Ans. A

36. Ans. A. After a periodontal pocket has been scaled, root planed, and curetted, a soft tissue reattachment to the root surface may occur. This reattachment is called a long junctional epithelium. Pocket reduction is due to a gain in attachment, not to a decrease of inflammation. Fibrous reattachment is also possible.

37. Ans. A

38. Ans. A

39. Ans. A. Localized drug delivery is being developed to deliver the drug directly to the site of intended use—the periodontal sulcus. The great advantage of such systems is that because they are local, systemic side effects are almost nil. The best studied system involves a tetracycline fiber, but other systems exist. This method is the wave of the future with antibiotics, antiinflammatory drugs, and growth factors.

40. Ans. B. Sanguinaria, an extract from the blood root plant that exhibits antimicrobial properties, has been formulated into various dentifrices and mouthwashes. A major problem with sanguinaria is that it is easily washed from the oral cavity so that the antimicrobial effects are short-lived.
41. Ans. A. Fremitus is occlusal trauma associated with centric occlusion and may indicate a slight occlusal discrepancy. On examination the patient is asked to open slightly and tap gently. The examiner checks for minor tooth movement on tapping. This technique is used mostly for the maxilla.

42. Ans. D. The crown-lengthening procedure is indicated whenever clinical crown length is inadequate for the restoration. A general rule of thumb for a crown preparation is that you should have 4 mm between the margin of the preparation and the crest of bone to ensure adequate crown length. This measurement maintains a proper biologic width.

43. Ans. A. Osteoplasty is the reshaping or recontouring of nonsupportive bone. An example is the recontouring and ramping of interproximal bone. Ostectomy is the removal of supporting bone. This procedure is usually performed to create positive architecture or to increase the clinical crown length.

44. Ans. C. As the name implies, in the distal wedge procedure a block of tissue is removed from the distal aspect of a tooth to reduce the pocket depth. Distal wedge procedures are frequently the sequel to the extraction of a third molar. After the third molar is extracted, the bone fill is poor, leaving a periodontal defect.

45. Ans. B The palatal/lingual curtain procedure is a surgical procedure commonly carried out in treating the maxillary anterior teeth. Deep, interproximal buccal incisions are made to free the palatal tissue; the buccal flap is not elevated. After the palatal/lingual flap is elevated, debridement, scaling, and root planning are carried out from the palatal. The rationale behind this procedure is to maintain the buccal gingival architecture to minimize esthetic changes.

46. Ans. A. The procedure applies only to multirooted teeth. In general, a root amputation may be performed when periodontal involvement of a single root is severe. Endodontic and prosthetic considerations also must be taken into account.

47. Ans. B. There are two major advantages of using a laser for periodontal surgery: (1) the incision is sterile, and (2) the laser cauterizes blood vessels during the procedure. It also has been reported that the postoperative period is less painful because of the desensitization of nerve endings.

48. Ans. C. A soft tissue graft should be considered as soon as the mucogingival junction has been breached (i.e., probing extends beyond the mucogingival junction). Other factors also need consideration, such as location, frenum attachment, root sensitivity, root caries, and required restoration.

49. Ans. A. The chief reason that a free gingival graft fails is disruption of the vascular supply before engraftment. The second most common reason is infection.

50. Ans. A. free gingival graft procedure can be especially problematic when extensive recession has caused a mucogingival defect. The problem lies in the fact that you may encroach on the mental nerve/vascular bundle with the graft and cause problems with these structures.

51. Ans. C. As a general guideline, the intraoral autograft should be harvested 6—8 weeks after extraction. This gives the extraction site enough time to become organized with osteogenic components.

52. Ans. A. Osteogenic potential and sequelae are optimal with freeze-dried allografts

53. Ans. A. Many of the same species associated with periimplantitis are also associated with adult periodontitis, including A. actnomycetemcomitans, P. gingivals, and P.intermedia. Other species frequently detected by cultural methods are Capnocytophaga species, C. recta, and E. corrodens.

54. Ans. B. The tooth.

55. Ans. A. Diabetes.

56. Ans. C. Semi-circular fibres.

57. Ans. A. Periapical abscess.

58. Ans. D. It stains the teeth.

59. Ans. D. Probing depth 3.5–5.5 mm, bleeding on probing, calculus or root roughness.

60. Ans. B. Briault probe.

61. Ans. D. Chlorhexidine.

62. Ans. B. A periapical abscess.

63. Ans. A. 99%.

64. Ans. A. S. intermedius.

65. Ans. B. Cavitation.

66. Ans. C. Side-to-side vibration.

67. Ans. B. A pseudomembrane.

68. Ans. C. Periapical.

69. Ans. D. Decrease gingival bleeding.

70. Ans. A. Octocalcium phosphate.

71. Ans. B. A pellicle.

72. Ans. D. A pseudomembrane.

73. Ans. B. HIV-positive patients.

74. Ans. D. Russell developed an index for measuring periodontal disease that could be used in population surveys. It can be based solely upon the clinical examination, or it can make use of dental X-rays if they are available. It places greater emphasis on advanced disease.
Scoring:
(1) Each tooth is scored separately according to the following criteria.
(2) Rule: When in doubt, assign the lower score.
Criteria for Field Studies Additional X-Ray Criteria Score
negative (neither overt inflammation in the investing tissues, nor loss of function due to destruction of supporting tissues) radiographic appearance normal 0
mild gingivitis (overt area of inflammation in the free gingivae, but this area does not circumscribe the tooth) 1
gingivitis (inflammation completely circumscribes the tooth, but there is no apparent break in the epithelial attachment) 2
(not used in field study) early, notchlike resorption of the alveolar crest 4
gingivitis with pocket formation (the epithelial attachment is broken, and there is a pocket. There is no interference with normal masticatory function, the tooth is firm in its socket, and has not drifted. horizontal bone loss involving the entire alveolar crest, up to half of the length of the tooth root (distance from apex to cemento-enamel junction) 6
advanced destruction with loss of masticatory function (tooth may be loose; tooth may have drifted; tooth may sound dull on percussion with a metallic instrument; the tooth may be depressible in its socket) advanced bone loss, involving more than half of the length of the tooth root, or a definite intrabony pocket with definite widening of the periodontal membranes. There may be root resorption, or rarefaction at the apex 8

75. Ans. A.

76. Ans. D. Periodontal Flap Surgery, which is also called pocket depth reduction, your periodontist folds the gum back away from the tooth. Periodontal Flap surgery is recommended in many cases where pocketing depths have reached a level that makes maintenance or cleansing difficult. It is often associated with areas of bone loss and inflammation of the gum tissue around the teeth. when scaling and root planing have been unsuccessful in eliminating the entire pocket of decay, or when there has been bone loss that needs to be surgically corrected, then a dentist may perform periodontal flap surgery

77. Ans. B. The Bass method is the most well known sulcular brushing technique and is the most widely used technique. Adjacent plaque found slightly below the gingival margin is significantly reduced using a Bass technique. For this technique, the toothbrush head rests at a 45-degree (sulcular) angle, bristles directed toward the sulcus with small circular motions performing the plaque removal. For this method, the brush of choice is one with soft 2-3 row nylon trim bristles and end-rounded filaments, as gingival trauma may become a problem.

78. Ans. D. Juvenile periodontitis is a degenerative periodontal disease of adolescents in which the periodontal destruction is out of proportion to the local irritating factors present on the adjacent teeth; inflammatory changes become superimposed, and bone loss, migration, and extrusion are observed. Two forms are recognized: localized, in which the destruction is limited to the incisors and first molars; and generalized, involving all the teeth.without proper treartment the prognosisis very poor.

79. Ans. C. For diagnosis of loss of periodontal attachment: Two clinical measurements are necessary, recession and pocket depth. Recession is the measurement from the CEJ to the gingival margin. Pocket depth is the measurement from the gingival margin to the bottom of the sulcus/pocket. The total number of millimeters from the CEJ to the epithelial attachment or bottom of the sulcus/pocket (the sum of pocket depth and recession) represents the severity of attachment loss.

80. Ans. C. The Gingival Index (GI) was developed by Loe and Silness to describe the clinical severity of gingival inflammation as well as its location.
Appearance Bleeding Inflammation Points
normal no bleeding none 0
slight change in color no bleeding mild 1
and mild edema with
slight change in texture
redness, hypertrophy, bleeding on probing moderate 2
edema and glazing /pressure
marked redness, hypertrophy, spontaneous bleeding severe 3
edema, ulceration

81. Ans. D.

82. Ans. D. Gingival fibromatosis or Heavy fibrous gingival hyperplasia is removed by gingivectomy, with recurrences being treated in the same fashion or by more conservative removal of local areas of hyperplasia. Improved oral hygiene will greatly diminish the risk of recurrence. Drug-induced gingival hyperplasia may also be treated by gingivectomy and plaque control. Discontinuation of drug use often results in cessation and even regression of the gingival enlargement.

83. Ans. B. The purpose of oral irrigation is to reduce harmful bacteria and therefore the risk and severity of periodontal disease. Studies have shown that daily oral irrigation has the potential to suppress periodontal pathogens located within the pocket. the oral irrigation device are also used for orthodontic patients and for patients with food impaction or tooth positioning problems.

84. Ans. B. Periodontal pocket is a deep space between the gingiva and the crown or root of a tooth. It can be the result of hyperplasia of the gingiva (false pocket or pseudopocket) or migration of the epithelial attachment toward the apex (true pocket).

85. Ans. B. A periodontal pocket is a dental term indicating the presence of an abnormally deepened gingival sulcus as it contacts a tooth.The normal sulcular depth is three millimeters or less.If the depth of the sulcus has moved apically, or towards the root of the adjacent tooth, but has not yet breached the connective tissue fibers that connect the gingiva to the tooth, it would be termed a gingival pocket.If, however, the original depth has been violated so much that the gingival fibers that initially attached the gingival tissue to the tooth have been irreversibly destroyed, the sulcus is termed a periodontal pocket. The depth is measured from the base of the pocket to the height of the gingival margin.

86. Ans. B. Humectants retain water and help maintain a consistent paste-like quality in the toothpaste, preventing a separation of the liquid and solids in the toothpaste. Humectants in some cases can affect flavor, coolness and sweetness. Examples: sorbitol, pentatol, glycerin, propylene glycol, polyethylene glycol, water, xylitol (uncommon, but superior). The following basic ingredients are common to most toothpastes:
Abrasives Active ingredients Coloring agents Detergents Flavoring Humectants Thickeners
Preservatives Sweeteners Water Whiteners Other

87. Ans. B. Anodynes. Medicines which allay pain. Some act by actually assuaging pain; others by inducing sleep; a third class give ease by stupefying the senses, or lessening the susceptibility to pain. Among the principal anodynes are opium, morphine, camphor, ether, chloroform, nitrous oxide etc.

88. Ans. A.

89. Ans. D. Occlusal trauma is a dental term that refers to the damage incurred when teeth are left in traumatic occlusion without proper treatment.Hemorrhage and thrombosis in periodontal ligament(earliest) ,Necrosis & Widening of the periodontal ligament, or PDL (also serves as a very common radiographic feature) ,Bone resorption, Cemental resorption and tears are some of its features.

90. Ans. D. Treatment for bruxism varies depending on the cause. Ongoing management of bruxism is based on prevention of the abrasion of tooth surfaces by the wearing of an acrylic occlusal dental guard, created to the shape of the individual's upper teeth from a bite mould.

91. Ans. A. The production of certain extracellular polymers, particularly insoluble adhesive polysaccharides of the dextran and levan type, plays a vital role in the formation of the plaques.some streptococci synthesize gelatinous polysaccharides of the dextran and levan type from sucrose, but not from other sugars commonly found in the mouth.Dextrans are more important than levans in initiating plaque, for they are more resistant to attack by oral bacteria and are generally less soluble.

92. Ans. A. An abrasive is a material, often a mineral, that is used to shape or finish a workpiece through rubbing which leads to part of the workpiece being worn away. While finishing a material often means polishing it to gain a smooth, reflective surface it can also involve roughening as in satin, matte or beaded finishes.

93. Ans. A. Sterilization refers to any process that effectively kills or eliminates transmissible agents (such as fungi, bacteria, viruses, and spore forms etc.) from a surface, equipment, foods, medications, or biological culture medium. Sterilization does not, however, remove prions. Sterilization can be achieved through application of heat, chemicals, irradiation, high pressure or filtration.There are two types of sterilization: physical and chemical.
Physical sterilization includes:
Heat sterilization Radiation sterilization Chemical sterilization includes: Ethylene oxide Ozone
Chlorine bleach Glutaraldehyde Formaldehyde Hydrogen peroxide

94. Ans. A. Chronic desquamative gingivitis is characterized by deep red, painful gingival tissue that bleeds easily. Vesicles may precede desquamation. The gingiva is soft because the keratinized cells that resist abrasion by food particles are absent. A similar gingival lesion may be associated with pemphigus vulgaris, bullous pemphigoid, benign mucous membrane pemphigoid, or atrophic lichen planus.T/t steroids.

95. Ans. D. Supra-gingival calculus is found on the tooth surface next to the tongue (lingual) on the mandibular incisors and on the buccal surfaces (area near the cheek) of maxillary molars. Subgingival calculus forms on root surfaces below the gingival margin and can extend deep into periodontal pockets. A more irregular subgingival cemental surface allows deposits to form into the cemental irregularities. This makes the attachment of the subgingiva calculus more tenacious and difficult to remove. Subgingival calculus can often be seen on radiographs but explorer detection is needed to evaluate the amount of calculus present.It also tends to be darker or black in color. All calculus can however absorb extrinsic stains (coffee; tea; tobacco;etc) and appear dark brown or black.

96. Ans. C.

97. Ans. B.

98. Ans. B. The collagen fibers of the gingiva are subdivided into 8 principal fiber groups. These are largely composed of collagenous fibers. The dentogingival fibers (A) insert into the supracrestal root cementum and fan out into the adjacent connective tissue. The dentoperiosteal fibers (B) insert into the supracrestal root cementum and blend with the periosteal covering of the adjacent alveolar process. The alveologingival fibers (C) insert into the alveolar crest and fan out into the adjacent gingival connective tissue. The circumferential fibers (D) follow a circular course around individual dental units. The semicircular fibers (E) insert on the approximal surfaces of a tooth and follow a semicircular course to insert on the opposite side of the same tooth. The transgingival fibers (F) insert into the approximal surface of a tooth and fan out toward the oral or vestibular surface. The intergingival (G) fibers course along the oral or vestibular surfaces of the dental arch. The transseptal fibers (H) course from one approximal tooth surface to the approximal surface of the adjacent tooth.

99. Ans. D. The periodontal ligament, commonly abbreviated as the PDL is a group of specialized connective tissue fibers that essentially attach a tooth to the alveolar bone within which it sits. These fibers help the tooth withstand the naturally substantial compressive forces which occur during chewing and remain embedded in the bone. Another function of the PDL is to serve as a source of proprioception, or sensory innervation, so that the brain can detect the forces being placed on the teeth and react accordingly

100. Ans. B. An oral rinse with chlorhexidine (0.12% or 0.2%), an anti-bacterial agent, has been found to be effective in reducing supragingival plaque and gingivitis. Side effects associated with chlorhexidine use includes increased calculus formation, bad taste, and staining of teeth.

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