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Periodontology 11

Basic Principles of Periodontal Surgery 5-Generalized enlarged fibrotic interdental


papillae of 2 months duration are interfering
1-A gingivectomy may be performed when with orthodontic treatment. There is no
there is/are evidence of attachment loss. Scaling and root
a. minimal horizontal bone loss. planing have not resolved the condition. Which
b. no infrabonydefects. of the following is the most appropriate
c. an adequate zone of attached intervention?
8in8iva. a. Gingival curettage.
d. agingival pocket. b. Gingivoplasty.
e. alloftheabove. c. Osseous resective surgery.
d. Guided tissue regeneration.
2-After periodontal surgery, sensitivity to
thermal change is reduced by
•.#-¥ On the vestibular aspect of tooth 2.3, there is
1. replaning the roots. 4mm of recession with a 3mm probing depth,
2. keeping the roots free of bacterial plaque. no keratinized gingiva and no radiographic
3. adjusting the occlusion. interproximal bone loss. The most predictable
4. desensitizing the roots with an appropriate esthetic outcome is achieved with a
medicament. a. freegingival graft.
a. (1)(2)(3) b. subepithelial connective tissue
b. (1)and(3) graft.
c. (2)and(4) c. coronally repositioned flap.
d. (4)only. d. guided tissue regeneration.
e. Alloftheabove.
Q`, 7-ln periodontal flap surgery, the initial incision
3-Which of the following is the best ictor is made to
for successful periodontal flap surgery? a. exposethe sulcular lining of the
a. Position oftheflap after pocket.
suturing. b. aidinhealing.
b. Extentofflap reflection. c. severthe attachment of the
c. Level of plaque control. oblique fibres of the
d, Type of initial incision. periodontal ligament.
d. excisethe keratinized gingiva.
4-ln a patient with an adequate band of
/`L i-----___..-----------------------_------------------------.--
keratinized tissue, gingivectomy is indicated for C- 8-Total removal of subgingival calculus in
all EXCEPT
pockets more than 5mm deep is best achieved
a. gingival pockets.
by
b. suprabony pockets.
c. gingival overgrowths. a. ultrasonicscaling.
d. infrabony pockets. b. rootplaningwith hand
instruments.
c. surgeryand scaling.
d. subgingival irrigation.
Periodontology 11

C,
i-
9-Which of the following is a reason to perform 14-The purpose of a periodontal dressing is to
initial periodontal debridement before a. enhancewound healing.
i periodontal surgery? b. protectthe wound from injury.
>`yl MtLtJ-
Ltt 1.. lil '- a. Increase the attachmentlevels. c.
d.
increase patient comfort.
AIIoftheabove.
ha crfu b.
c.
Reduce infrabony pockets.
Reduce bleeding duringthe
ho2LLLdi Surgery. 15-lf a periodontal probe is inserted 4 or 5mm
d. Increasethe width of to the base of a pocket on the mesialbuccal of a

quA3TJ:Jr keratinized tissue.


fro^qu`y-if.i..t±+.€:i:.i..L_¥.....fi7L4.£.+.t*-----------.
tooth and then pushed facially causing
blanching, this indicates that
10-ln periodontal flap surgery, the design of a. gingival hyperplasia exists.
the incision is influenced by the b. there is an inadequate zone of
a. frenum attachment. attached gingiva.
b. depth ofthevestibule.
c. amountofattached gingiva.
.Rl.g..A..L.!£.4€#Ufe:A.:±g|::4::::#.e:.:.:.D:.kg:.: i;|| |'t`
d. presence of infrabony defects. ut,4|t-1
e. Alloftheabove. CJ 16-Enlargement of the gingiva, described as
idiopathic fibromatosis, is best described as
11-Gingivectomy is recommended a. degeneration.
a. when the bottom of the pocket b. inflammation.
is apical to the mucogingival c. hyperplasia.

junction. d. neoplasia.
b. toeliminatethe suprabony
pockets when the pocket Wall is c 17-Which of the following is the most
fibrous and firm. appropriate indication for resective osseous
c. totreat moderately deep periodontal surgery?
pockets with mild intrabony a. Advanced attachment loss.
defects. b. Class Ill furcation defect.
c. Inadequate clinical crown
12-The benefits of flap curettage include length.
a. direct accessforthorough d. Vertical root fracture.
debridement.
b. pocket reduction. 18-Resective osseous surgery is best suited for
c. increased opportunity for periodontal sites with
reattachment. a. severeattachment loss.
d. A.andB. b. severe intrabony defects.
e. Alloftheabove c. teeth with short roots.
d. earlyto moderate bone loss.
13-The most prevalent inflammatory cells
found in gingival tissue 24 hours following flap
surgery are
a. monocytes.
b. macrophages.
c. Iymphocytes.
<(-tt`„„ `y`-l-
d. polymorphonuclear leukocytes. +``

(i,\d-a- .1
•,,\,\{-
3T,¢i -i `f--
i(,, >¢-'`1^. -
Periodontology 11

19-Tooth 2.4 hassubgingival recurrent caries C 24-The treatment of choice of a deep pocket
on the distal aspect of a Class 11 amalgam whose base extends beyond the attached

restoration. The bite-wing radiograph reveals 8ingiva is


a. gingivectomy.
caries extending to within lmm of the alveolar
b. mucogingival surgery.
bone crest. To properly restore the tooth, which
c. rootplaning.
of the following is the most appropriate d. Noneoftheabove.
procedure?
25-When will infiltrating new blood vessels be
a. Gingivectomy. histologically detectable following a free
b. Modified widmanflap, gingival graft?
c. Open flap debridement. a. 2to3hours.

i
d. Resective osseous surgery. b. 2to3days.
c. 2to3weeks.
20-ln periodontal therapy, gingivectomy is the d. 2to3months.
treatment of choice to eliminate
a. osseous craters. 26-The blood vessel which may be injured
b. infrabony pockets. when harvesting a connective tissue graft from
c. suprabony pockets. the palatal mucosa is the
d. root hypersensitivity. a. sphenopalatine.
e. inadequate attached gingiva. b. nasopalatine.
c. posteriorsuperior alveolar.
21-Periodontal pockets can be eliminated by d. greater palatine.
a. surgical resection of the pocket
wall (gingivectomy). 27-Patients who have gingival enlargements
b. apically positionedflap surgery. surgically removed should be forewarned that
c. reattachment procedures. there is a high incidence of
d. Alloftheabove. a. altered tastesensation.
e. Noneoftheabove. b. dentinal hypersensitivity.
.-----i-=l=.----_---_-i_--_---i--.---i-ii=---====-.==:=\, c. reoccurrence ofgingival
22-Before performing periodontal surgery, it i; \ enlargement.
important to d. post-operative swelling.
1. prescribe a mouthwash.
2. prescribe an oral antibiotic. 28-Which of the following teeth is LEAST likely
3. control plaque. to develop a furcation involvement?
`,-T \\\,` 4. scale and root plane.
a. 1.4.
a. (1)and(3) b. 1.5.
b. (2)and(4) c. 1.6.
c. (3)and(4) d. 1.7.
a.---Altof-theabove.
+LL,r-td---------------------------------------------------------
' < 1€ ,Ttr,i)isi
23-Healing following a gingivectomy occurs by
I- `o"i- c~|
a. primary intention.
b. secondary intention. cJt,.lL,\,i
c. both primaryand secondary
intention.
d. tertiary intention.
Periodontology 11

Periodontal Regeneration Qu 6-The most likely cause of tooth loss following


a tunneling procedure to provide complete
1-During guided tissue regeneration therapy, access for a mandibular Class Ill furcation
the regenerative cells originate primarily from involvement is
the a. rootcaries.
a. Iamina propria. b. root sensitivity.
b. periodontal ligament. c. pulpal involvement.
c. cellularcementum.
d. collagen membrane.
i| ;-:i:#-:i-gd::-,L:z?e-C;Ug:I-:I:±:i:L{:eu:;.;g.:Z.|=.9c+..*. 'ro Cm 9
2-ln periodontal therapy, "guided tissue (`` selectively promotes the growth of all of the
regeneration" is most successful in treating following EXCEPT
1. horizontal bone loss. a. epithelialcells
2. a 3-walled infrabony defect. b. endothelial cells.
3. a mandibular class Ill furcation involvement. c. osteoblasts.
4. a mandibular Class 11 furcation involvement. d. cementoblasts.
a. (1)(2)(3)

b. (1)and(3) A 8-Successfulrepairofbonydefectsis
c. (2)and(4) dependent upon
d. (4)only. a. itsdepth.
e. Alloftheabove. b. thenumberofwalls.
c. the distance between the
3-Tooth 3.3 has a 9mm probing depth with a buccal and lingual walls.
6mm three-wall infrabony mesial defect. It tests d. the distance from the crest of
vital and is not mobile. Which of the following is the defect to thecemento-
the most appropriate treatment? enamel junction.
a. Gingival curettage.
b. Modified widman flap. Cl; 9-Two importantwound healing principles for
c. Osseous resective surgery. guided tissue regeneration are
d. Guidedtissue regeneration. a. space creation and wound
stabilization.
1\ 4-Periodontal pockets CANNOT be reduced by b. space creation and intramarrow
a. occlusal adjustment. penetration.
b. scalingand root planing c. root surface biomodification
(debridement). and wound stabilization.
c. open flap curettage. d. rootsurface biomodification
d. guided tissue regeneration and intramarrow penetration.

5-A furcation involvement in which bone loss 10-Radjographs of a periodontally-related


allows the probe to extend completely through osseous defect can be used to confirm the
the furcation is classified as a. numberof bonywalls.
a. incipient, b. measurement of the defect.
b. Classl. c. location of the epithelial
c. Classll. attachment.
d. Classlll. d. presence of a furcation
e. chronic. involvement.
Periodontology 11

11-Which of the following procedures is NOT Ct_ 17-A common clinical sign of occlusal
indicated for the management of infrabony traumatism is
defects? a. tooth mobility.
a. Gingivectomy. b. pocket formation.
b. Regenerative surgery. c. gingival recession.
c. Flapsurgery. d. temporomandibularjoint pain -
d. Gingival graft. dysfunction syndrome.
e. pulp calcifications.
fl 12-The most likely cause of tooth loss following
a tunneling procedure to provide complete e 18-lnfraosseous defects mayoccuratthe
access for a mandibular Class Ill furcation 1. palatal surface of maxillary anterior teeth.
involvement is 2. buccal and lingual surfaces of molars.
a. rootcaries. 3. interproximal areas.
b. rootsensitivity. 4. bifurcations and trifurcations.
c. pulpal involvement. a. (1)(2)(3)

d. recurrent pocketing. b. (1)and(3)


c. (2)and(4)

C|, 13-The most appropriate radiograph for


examining an interproximal vertical bony defect
d. (4)only
of the above.
'_T T1
c7Li2|~ C9 C~L+J^ A,ty€t,`.`-i
of the alveolar process is the
a. bitewin8. 19-The prognosis of guided tissue regeneration
b. periapical. (GTR) is best for the treatment of
c. occlusal. a. horizontal bone loss.
d. panoramic. b. onewall osseous defects.
c. twowall osseous defects.
14-in periodontics, the best prognosis for bone d. threewall osseous defects.
regeneration follows the surgical treatment
of Cl, 20-Softtissue pockets CANNOT be reduced by
a. suprabony pockets. a. occlusal adjustment.
b. one-wall infrabony pockets. b. scaling and root planing
c. two-wall infrabonypockets. (debridement).
d. three-wall infrabony pockets c. open flap curettage.
d. guided tissue regeneration.
15-ln periodontics, the best prognosis for bone
regeneration follows the surgical treatment of 21-Guided tissue regeneration is a surgical
a. suprabony pockets. procedure to
b. one-wall infrabony pockets. a. repairnon-mineralized
c. two-wall infrabony pockets. connective tissue.
d. three-wall infrabony pockets. b. repaircemental defects.
c. regenerate longjunctional
16-The best prognosis for reattachment of epithelial attachment.
periodontal ligament is in a d. regeneratethe periodontium.
a. narrow infrabony pocket.
b. narrowsuprabony pocket.
c. wide infrabony pocket.
d. wide suprabony pocket
Periodontology 11

22-In which of the following defects is bone fill 4-Regular use of oral irrigators (e.g. "Water
most likely to occur? Pik") will

a. One-wall bony defect. a. prevent plaque formation.


b. Two-wall bonydefect. b. removeplaque.
c. Combination one-wall and two- c. removecalculus.
wall bony defect. d. removedebris.
d. Three-wall bonydefect. e. prevent bacteremia.

23-Following periodontal surgery, the curetted


C 5-ln order to prevent gingival recession, a full
root surface is repopulated by cells derived gold crown should have
from all of the following tissues EXCEPT a. a slightly narrow food table.
a. periodontal ligament. b. a slightly overcontoured tooth
b. cementum. form.
c. alveolarbone. c. normal contour reproduced.
d. epithelium. d. the margins extended lmm into
the gingival crevice.
-&-¥---&Liiin8-i:-g-i:i-i-C-i,n-i-nfe4C-:i-Y:--t-i:-s-:-::------
Periodontal Maintenance 6-Maintenance care for a patient treated for
periodontal disease includes periodic
1-A periodontal screening and recording (PSR) assessment of
score of 3 for a sextant indicates that the 1. tooth mobility.
pockets are NOT deeper than 2. gingival sulcus depth.
a. 3.Omm. 3. signs of gingival inflammation.
b. 3.5mm. 4. oral hygiene status.
c. 4.Omm. a. (1)(2)(3)

d. 5.5mm. b. (1)and(3)
e. 6.Omm. c. (2)and(4)
d. (4)only
2-When a patient fails to demonstrate effective e. Alloftheabove.
plaque control during initial periodontal therapy
for moderate periodontitis, the best course of 7-Following periodontal flap surgery, the most
action is common cause of recurrence of pockets is
a. gingival curettage. a. systemic disease.
b. an apically positioned flap. b. traumaticocclusion.
c. continued initial therapy. c. failuretosplint.
d. gingivectomy. d. poororalhygiene.

3-Water irrigation devices have been shown to 8-After completion of initial therapy which
a. eliminate plaque. included root planing and curetage, a patient
b. dislodge food particles from has suprabony pockets of 5mm. Despite good
between teeth. plaque control, these pockets exhibit bleeding
c. disinfect pockets for up to 18 on probing. The treatment of choice is
hours. a. additional root planing.
d. prevent calculus formation b. occlusal adjustment.
c. gingivectomy.
d. periodontal flap surgery.
e. Noneoftheabove.
Periodontology 11

~b :-,dvyhh,;:h structure(S) Comprlse(s) the "bio|ogicai I


3-The primary reason for placing a surgical
dressing after a gingivectomy is to
a. Connective tissue attachment. a. prevent hemorrhage.
b. Connective tissue attachment b. protectthewound.
and epithelial attachment. c. stabilizetheteeth.
c. Connective tissue attachment, d. protectthe sutures.
epithelial attachment and the
sulcus depth. 4-The gingivectomy approach to pocket
d. Periodontal ligament space, elimination results in
connective tissue attachment, a. healing by primary intention.
epithelial attachment and the b. adequate accessto correct
sulcus depth. irregular osseous contours.
c. retention of all or most of the
10-The biologic width on average is attached gingiva.
a. 1mm. d. Noneoftheabove.
b. 2mm.
c. 3mm. 5-The design of a mucoperiosteal flap should
d. 4mm. 1. provide for visual access.
2. provide for instrument access.
Periodontal Plastic Surgery and Management 3. permit repositioning over a solid bone base.
of Mucogingival Defects 4. be semilunar in shape.
a. (1)(2)(3)

1-Correction of an inadequate zone of attached b. (1)and(3)

gingiva on several adjacent teeth is best c. (2)and(4)


accomplished with a/an d. (4)only
a. apically repositioned flap. e. Alloftheabove.
b. laterally positioned sliding flap.
c. double-papilla pediclegraft. 6-Gingival recession at the buccal surface of a
d. coronally positionedflap. tooth is most likely caused by
e. freegingival graft. a. impropertooth brushing
technique.
2-A surgical flap not repositioned over a bony b. chronic bruxism.
base will result in c. improperflossingtechnique.
1. slower healing. d. cigarettesmoking.
2. foreign body inflammatory reaction.
7-Which mucogingival surgical procedure does
:: :e°cur::,sd::jbs::::e,. t\ ,,`, ,.b t,`T NOT increase the zone of attached gingiva?
a. (1)(2)(3) a. Free autogenous gingival graft.
b. (1)and(3) b. Laterally positionedflap.
c. (2)and(4) c. Coronally positioned flap.
d. (4)only d. Subepithelial connective tissue
e. Alloftheabove. graft for root coverage.

(c) c6j`,ut Si`ltlt-L|


-i.` _```3.` k`D.ircJ
i-- \{`,-`, CL,l,&t`
Periodontology 11
a iiii= a
t'±zJperiodontaldressinglsplacedfollowlnga€
13-A gingivectomy may be performed when
gingivectomyto: there is/are
a. Promote wound healing. a. horizontal bone loss.
b. prevent microbial colonization b. no intrabonydefects.
of the wound. c. an adequate zone of attached
c. protectthewound from 8in8iva.
mechanical injury. d. a gingival pocket.
d. achieve hemostasis. e. AIIoftheabove.

9-Areas of isolated gingival recession are most 14-A risk factor for gingival recession is
frequently seen on teeth that are
a. nonvital, #~>VlbecLfi:leL4:irrii+-
b, moderately mobile. tooth position.
c. ankylosed. traumatic occlusion
d. Iabially prominent in the arch,
15-Res.idual soft tissue interdental craters not
10-Examination reveals an area of gingival associated with underlying bony changes are
recession that exposes a wide area of denuded eliminated by
root. The procedure of choice to obtain a. rootplaning.
coverage of this root surface is b. subgingival curettage.
a. free gingival autograft. c. flapoperation.
b. apically positioned flap. d. gingivoplasty.
c. laterally positioned pedicle e. Noneoftheabove.
graft.
d. coronally positioned flap
q`' ::;sG::gjov:::::t¥.is indicated for

11-A patient presents with 5mm of gingival 2. suprabony pockets.


recession on the labial of tooth 1.3. The most 3. fibrotie gingival enlargements.
predictable surgical procedure to achieve root 4. infrabony pockets.
coverage on this tooth is a a. (1)(2)(3)

a. free gingival graft. b. (1)and(3)


b. subepithelial connective tissue c. (2)and(4)

graft. d. (4)only
c. lateral sliding pediclegraft. e. Alloftheabove
d. double papilla pediclegraft. .----------.,::-i--i-/---.,--,i-T`--tlJ--+Ji-li-------------------------

12-Following periodontal surgery, the most t|,::I::=#itnog::ae'Le::::,i::,,J:::uenTt:::,,naa|d


important factor to promote healing is there is loss of interdental tissue, the likelihood
a. asaltwaterrinse. of complete root coverage after gingival
b. thorough plaque control. grafting is
c. gingival massage. a. greaterthan75%.
d. Ieavingthe site undisturbed for b. between25and50%.
a period of 3 months. c. Iessthan20%.
Periodontolog}' 11

18-A surgical flap approach to periodontal I-`.'== I, =;:eeth WITHOUT loss of bone
pocket elimination permits S-===1S-ggeS---
a. healing by primary intention. :. 2 primarytraumatjcocclusion.\+
b. retention ofgingiva. D. a secondarytraumatic
c. accessto perform osseous occius,on.t+u~``ct,.~>ctry`prio giv
recontouring. \,I.
)1,U~
-J^
d. Alloftheabove. A \t 'giv
: ;:::;:oo:nht,,cu:a_:::\::{T::{t{::e\,th _\
19-The most likely cause of localized facial _a=.d..:..... i.r.i.t.,.`=Uji.q.`£+};*.;I) 1# ¥
gingival recession in a healthy 17 year old S-Too:ri mobility may be due to
ne\-t!::tl,``
individual is 1. excessive occlusal force.
a. minimal attached gingiva. 2. cjgc.eased osseous support.
b. occlusal trauma. 3. penodontal abscess.
c. traumatictooth brushing. £. gingival inflammation.

d, factitious injury. a, (1)(2)(3)

b. (1)and(3)
Post Operative and Emergency Care c. (2)and(4)
d. (4)only
I.`. , ? 1-Trauma from occlusion may e. Alloftheabove.
SroJCL5L a. initiate marginal gingivitis.

c¢ b. affectthe blood supplyto


8in8iva.
6-The most appropriate treatment of a true
combined endodontic-periodontal lesion is
c. initiate periodontitis. a. periodontal surgical therapy
d. affectthe progression of Only.

periodontitis. b. nonsurgical root canal therapy


only-
2-Trauma from occlusion c. periodontal surgicaltherapy
a. initiates marginal gingivitis. before nonsurgical endodontic
b. affectsthe blood supplyto treatment.
8in8ivae. d. nonsurgical rootcanal therapy
c. initiates periodontitis. before periodontal therapy.
d. Alloftheabove.
7-Fremitus is
3-Which of the following is NOT a sign of a. tooth mobilityofgrade ll.
occlusal trauma? b. mobilityduringocclusion.
a. Fremitus. c. vertical tooth mobility.
b. Gingival recession. d. tooth pain upon percussion.
c. Widened periodontal ligament.
d. Tooth migration.
Periodontology 11

Miscellaneous r_\. 5-The width of the attached gingiva can be

accurately measured if
1-A patient with a history of infective a. gingival inflammation in the
endocarditis is currently taking penicillin for an area has been eliminated.
unrelated condition. The most appropriate b. there is an increase in crevicular
management for periodontal therapy for this fluid.

patient is to c. theprobingdepthis3mmor
a. prescribe a different antibiotic. less.
b. increasethe dosage of d. scalinghasnotbeendone.
penicillin.
c. maintain penicillinatthe 6-Which one of the following oral preventive
present level. aids does not remove plaque?
d. use chlorhexidinesolution as a a. Toothbrush.
pre-therapy rinse. b. Dentalfloss.
c. Stimudents.
2-Patients who are positive for the interleukin- d. Proxybrush.
e. Irrigating devices..
CL 1 (lL-1)

a. are at increased riskforsevere 7-Plaque becomes more cariogenic when


huh d bec„
periodontal disease. a. ithas become heavilycalcified.
a , L ,- I L3L
b. have a decreased inflammatory b. pyogenic organisms

flit zg ra H response in the presence of predominate.


bacteria. c. acidogenic bacteria and
`.\,A-s.11[\-
c. are more likelyto respond fermentable carbohydrate are
•`\c,.-lol Lif e
favourably to periodontal Present.
cl therapy. d. it is heavyand associated with
d. have decreased bacterial an orange stain.
pathogens associated with
ri` 8-Regular useoforal irrigatorswill
active periodontal disease.
a. prevent plaque formation.
nl
3-Destruction of bone in periodontal disease b. removeplaque.
occurs c. removecalculus.
a. continuously. d. removedebris.
b. in cycles lastingforabout e. prevent bacteremia.
3~months.
c. inrandomcycles. 9-The Silness-L6e Index measures
d. Noneoftheabove. a. periodontal disease.
b. oral hygiene.
4-The tissues of the epithelial attachment c. attachment level.
a. are dynamic ratherthan static. d. probingdepth.
b. can be reconstituted by repair.
c. exhibit a high rateofbiologic
turnover.
d. Alloftheabove.
e. Noneoftheabove.

10
Periodontology 11

10-The host defense mechanisms of the


gingival sulcus do NOT include
a. production ofagglutinins and
antibodies.
b. flushingaction ofcrevicular
fluid.

c. local antibody production.


d. Iowtissueturnover rate.

11-A dental restoration with marginal


discrepancy (void) located lmm subgingivally
can affect gingival health by
a. creatingan environment
conducive to an altered
microbial flora.
b. impingingon the biologicwidth.
c. causingfurcation involvement.
d. causing leaching of restorative
materials into the gingival
crevice.

12-When probing a healthy periodontium using


light forces, the probe tip will most likely extend
to the

a. attached gingiva.
b. I.unctional epithelium.
c. transverse fibres of the
periodontal ligament.

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