DAPE 722 - Year II Periodontology

Second Examination, April 14, 2011

Neal W. Roller, D.D.S., M.S.
1. What contributes to the bluish hue color of the gingiva as seen in gingivitis?
____________VENOUS STASIS____________.
2. Name the teeth evaluated in the PASS Plaque Index: _____3; 8; 14; 19; 30___.
3. . Williams (J. Perio.2011) compared SRP alone with SRP plus Arestin. The improvement in
probing depth with Arestin was _0.24_ mm.
4. Candidiasis has been implicated with what clinical finding in AIDS associated NUP?
___LINEAR GINGIVAL ERYTHEMA_______.
5. The JUPITOR study (2008) evaluated 17,800 patients who appeared to be in good cardiac
health except for ____ELEVATED CRP_____.
6. What is the anti-gingivitis agent in Colgate Pro-Clinical? ____NONE____.
7. In 2005 Bonito et al evaluated the impact of local adjuncts (LDD) to SRP in Periodontal Disease
Therapy. They found 50 articles that met their strict criteria and reported 5 results as discussed in
class. What were the two conclusions of this review article?
(4 points)
1. Supportive and follow-up care as well as self-care, may well affect the long-term periodontal status of patients as much if not
more than the use of adjuncts to SRP.
2. Dentist must determine if the results are clinically significant and worth the cost and added effort.

8. Tetracyclines exert antimicrobial activity by inhibiting __PROTEIN SYNTHESIS___.

9. Other than the teeth involved, list three ways to distinguish localized aggressive periodontitis
(LAP) from generalized aggressive periodontitis (GAP)?
10. Horizontal bone loss is usually associated with what type of pocket formation? SUPRABONY.
11. A smoker with a positive MyPerioID-PST will be _7.7_ times more likely to have tooth loss
than a nonsmoker with a negative PST test.
12. Name a periodontal surgical procedure that would be appropriately performed during initial
periodontal therapy.___MUCOGINGIVAL OR OPEN FLAP ACCESS___.
13. According to table 82-3 in your textbook what is the recall interval for a Class C maintenance
patient ___1 TO 3 MONTHS______.
14. Scaling and root planing can appropriately be the sole therapeutic modality in certain
circumstances, complete the list
1. Very aged individuals
2. Medically compromised patients
3. Psychologically unprepared patients
4. ESTHETIC CONSIDERATIONS WHERE SEVERE RECESSION IN THE ANTERIOR REGION
WOULD BE UNACCEPTABLE.
5. EXTREMELY ADVANCED CASES WHEREIN POCKET ERADICATION BY SURGERY WOULD
BE UNACCEPTABLE

15. State your most compelling, and succinctly written, reasons to support the importance of a
periodontal reevaluation after initial periodontal therapy.
At Reevaluation the clinician can confirm or modify the original diagnosis, identify missed etiologic
factors or areas that have not responded, modify the treatment plan for the benefit of the patient
and clinician, and determine additional treatment needs.

16. On what tooth are you most likely to observe a Palato-Radicular Groove? _Maxillary Lateral
Incisor _.
17. In 1965, Harold Loe had dental students withhold plaque removal and these students all
developed gingivitis in _7__ to _21__ days. Upon reinstitution of plaque removal, the clinical
signs of gingivitis were gone in _7__ days.
18. What site specific curette for the anterior teeth is utilized in our clinic? 3/4 Gracey.
19. What caveat should the clinician keep in mind regarding ADAPTION of a periodontal
instrument.
The lower third of the working end must be kept in contact with the tooth.
20. Name the fluoride that has anti-plaque activity ___stannous_____.
21. Your patient calls and says she missed a dose of Periostat. What would you do?
______Do not double up, resume normal dosage________________________.
22. When the terminal shank of a Gracey Curette is held parallel to the long axis of a tooth, the
angulation of the blade against the tooth would be (fill-in) _70_ degrees.
23. Why is sodium hydroxide (Lye) used in toothpastes? __pH stabilizer___.
24. Half of a subgingivally delivered drug is cleared in _12.5__ minutes.
25. Actisite, the first generation of LDD, claimed a gingival fluid concentration of tetracycline in
excess of _1,300_ g/ml compared to 4 to 8 g/ml after systemic tetracycline administration.
26. Name two Dental Biofilm characteristics that influence the effectiveness of antibiotics
1. Hard for antibiotics to penetrate the biofilm.
2. Some cells in a biofilm experience nutrient limitation and therefore exist in a slow- growing or
starved state and thus not susceptible to antibiotics
3. Biofilms contains microenvironments of bacteria that cross-feed and cross-communicate posing
a challenge to antibiotic effectiveness.

27. Name the antibiotic used in the treatment of periodontal disease that should not be taken with
alcohol, inhibits Coumadin metabolism, and should be avoided in patients with AIDS:
____Metronidazole (Flagyl) ___.
28. In humans, the periodontal probe tip usually penetrates:
A.
B.
C.
D.

1 mm coronal to the attachment of the junctional epithelium.

To the most coronal site of attachment of the junctional epithelium.
1 mm above the crest of bone.
To the most coronal intact fibers of the connective tissue attachment.*

29. Which of the following grade of mobility (Miller) is distinguished by depressability (vertical
displacement)?
A.
B.
C.
D.

Grade One.
Grade Two.
Grade Three.*
Grade Four.

30. What information is provided on the laboratory report of the MyPeroPath test?
A.
B.
C.

11 pathogens are reported as present or absent.

The clinician is given a suggestion for systemic antibiotic treatment.
A second sample is suggested 6 to 8 weeks post therapy.
2

D.
E.

A. and B. only
B. and C. only *

31. Which of the following mouthrinses has in clinical trials consistently demonstrated greater than
50% reduction in gingivitis
A. Chlorhexidine
B. Listerine
C. Plax
D. A and B only
E. none of the above*
32. Which of the following about chlorhexidine are true?
A. In USA is dispensed by prescription only*
B. Is effective in caries control
C. Best used four times daily, before meals and at bedtime
D. A and B only
E. all are true
33. Periodontal findings that suggest the presence of trauma from occlusion include:
A.
B.
C.
D.
E.

Excessive tooth mobility.

Pathologic migration especially of the anterior teeth.
Localized gingival recession.
A and B only. *
All of the above.

34. Your 22 year old patient with moderate localized gingivitis returns for a maintenance visit. The
patient now exhibits localized heavy plaque, stain and localized supragingival calculus. What
procedure is appropriate for this patient?
A.
B.
C.
D.

Periodontal debridement.
Adult prophylaxis.*
Periodontal prophylaxis.
All of the above can be appropriate depending on the judgment of the dentist.

35. Drug induced gingival enlargement

A.
B.
C.
D.
E.

Rarely resolves after tooth extraction.

Initially is painless.*
Will resolve with a dose reduction in the causative agent.
A and B only.
None are true.

36. Periostat is a low dose (20 mg) Doxycycline tablet which is approved by the FDA as an adjunct
to subgingival scaling and root planing. Periostat is effective because of its:
A.
B.

Antimicrobial effects.
Inhibition of tissue destructive enzymes.*
3

C.
D.
E.

Anti-phagocytic effects.
A and C only.
All are true

37. The Original Listerine mouth rinse has:

A.
B.
C.
D.
E.

An alcohol content of 21%.

Denatured alcohol which can be tolerated by a recovering alcoholic.
Substantivity equal to a product containing Chlorhexidine.
Methyl salicylate as an antibacterial component.*
Eucalyptol as an antibacterial component.

38. Which of the following commercial mouth rinses contains Quaternary Ammonium
Compounds?
A.
B.
C.
D.
E.

Cepacol.
Scope.
Oxyfresh
A and B only*
None of the above

39. Which of the following agents has proven effective in treating tooth sensitivity?
A.
B.
C.
D.
E.

Chlorhexidine.
Strontium Chloride.*
Soluble Pyrophosphates.
A and B only.
B and C only.

40. Corby (J. Perio 2008) evaluated tongue brushing, toothbrushing, and flossing in 51 twin pairs
aged 12 to 21 years. What were the findings?
A.
B.
C.
D.
E.

Toothbrushing the tongue plays a significant role in periodontal health.

Without flossing there was an increase in periodontal pathogens.*
Motivating this age group to obtain ideal dental health is unpredictable.
A and B only
B and C only.