Department of Periodontics

Department Of Periodontics
1)Which statement regarding an autogenous free gingival graft is NOT true?
A. It can be placed to prevent further recession

B. It can be used to effectively widen the attached gingiva
C. It retains its own blood supply and is not dependent on the bed of recipient blood vessels
D. The greatest amount of shrinkage occurs within the first 6 weeks
E. It is also useful for covering non pathologic dehiscences and fenestrations
2) The main goal of osseous recontouring (surgery) is:
A. To reshape the marginal bone

B. To eliminate periodontal pockets
C. To change the existing microflora
D. A and B
3) All of the following statements regarding periodontal flaps are true EXCEPT, which one is the
exception?
A. Full-thickness periodontal flaps involve reflecting all of the soft tissue, including the periosteum,
to expose the underlying bone
B. The partial-thickness periodontal flap includes only the epithelium and a layer of the underlying
connective tissue
C. Both full-thickness and partial-thickness periodontal flaps can be displaced
D. Flaps from the palate are considered easier to be displaced than those from any other region
E. Flaps should be uniformly thin and pliable
4) Contraindications to gingivectomy include all of the following EXCEPT, which one is not a
contraindication?
A. The need for bone surgery or examination of the bone shape and morphology
B. Situations in which the bottom of the pocket is apical to the mucogingival junction
C. Esthetic considerations, particularly in the anterior maxilla
D. Elimination of gingival enlargements
5) The primary objective and advantage of surgical flap procedures in the treatment of periodontal
disease is:
A. Reduce or eliminate periodontal pockets

B. To provide access to root surfaces for debridement
C. Regrowth of alveolar bone
D. Maintenance of biological width
E. Establishment of adequate soft tissue contours
6) A soft tissue graft that is rotated or otherwise repositioned to correct an adjacent defect is called a:
A. Free gingival graft

B. Pedicle graft
pg. 1 Department Of periodontics

By Dr.yaser Elkareimi
C. Connective tissue graft
D. Frenectomy
7) What is guided tissue regeneration?
A. A soft tissue graft used to correct mucogingival junction involvement

B. Placement of non-resorbable barriers or resorbable membranes and barriers over a bony defect
C. Free gingival graft used to increase the amount of attached gingiva
D. Placement of an autograft to treat a bony defect
8) A frenectomy is complete removal of the frenum.
A frenotomy is incision of the frenum, this procedure usually is sufficient for most periodontal
purposes.
A. Both statements are true

B. Both statements are false
C. The first statement is true, the second is false
D. The first statement is false, the second is true
9) Free gingival autografts involve taking a section of attached gingiva from another area of the mouth
(usually the hard palate or an edentulous region) and suturing it to the recipient site.
A. True
B. False
10) Which of the following terms refers to reshaping the bone without removing tooth-supporting
bone?
A. Ostectomy
B. Osteoplasty
C. Positive architecture
D. Negative architecture
11) One of the most common osseous defects is:
A. One-wall intrabony defects

B. Two-wall intra bony defects (osseous craters)
C. Three-wall intra bony defects
D. Through-and-through furcation defects
12) Smoking has been identified as a significant variable to predict the response to periodontal
treatment.
Smoking has a negative effect on periodontal therapy.


13) Which of the following clinical signs and symptoms is a characteristic of necrotizing ulcerative
gingivitis (NUG)?
A. Minimal bleeding
B. "punched-out" papillae
C. Painless
D. Periodontal pocket formation
14) Which of the following statements regarding periodontitis is incorrect?
A. Periodontitis does not always begin with gingivitis

B. Gingivitis and periodontitis cannot be induced without bacteria
C. There are no radiographic features of gingivitis
D. The presence of pockets cannot be determined from radiographs
E. Chronic gingivitis does not always lead to periodontitis
15) Which of the following is most significant in regard to the prognosis of a periodontally involved
tooth?
A. Pocket depth
B. Attachment loss
C. Anatomical crown length
D. Bleeding on probing
16) The purpose of periodontal dressings {packs} include which of the following?
A. Stop persistent bleeding

B. Maintain the sutured position of the flaps
C. Improve patient comfort
D. Prevent mechanical injury to healing tissues
17) Which of the following is not correctly matched with regards to a periodontal treatment plan?
A. Preliminary phase : plaque control

B. Phase I :mouth preparation
C. Phase II : periodontal surgery
D. Phase Ill : restorative
E. Phase IV: maintenance
18) All of the following are true of cementum EXCEPT, which one is not true?
A. The inorganic content of cementum (hydroxyapatite) is 97%

B. It is produced by cells of the periodontal ligament
C. The deposition of new cementum continues periodically throughout life whereby root fractures
may be repaired
D. The cementum is indistinguishable on radiographs

19) In combined endodontic-periodontic lesions, it is generally wise to treat:
A. The periodontic component first

B. The endodontic component first
C. Both components at the same time
D. Treat any one of both you want to first
20) Extrinsic dental stains include:
A. Green to brown stains caused by erythroblastosis fetalis

B. Brown, black, green, or orange stains caused by chromogenic bacteria in plaque
C. Red to brown stains caused by congenital porphyria
D. Gray or brownish stains caused by tetracycline
21) Trauma from occlusion can produce radiographically detectable changes in all of the following
EXCEPT, which one is the exception?
A. Lamina dura
B. Periodontal pockets
C. Width of the POL space
D. Morphology of the alveolar crest
E. Density of the surrounding cancellous bone
22) Water irrigation devices (oral irrigators) have been shown to:
A. Eliminate plaque
B. Clean nonadherent bacteria and debris from the oral cavity more effectively than toothbrushes
and mouth rinses
C. Disinfect pockets for up to 12 hours
D. Prevent calculus formation
23) Indications for use of Super Floss include plaque removal around all of the following EXCEPT,
which one is the exception?
A. Non-isolated teeth
B. Teeth separated by a diastema
C. Wide embrasures where interdental papillae have been lost
D. Fixed partial denture
24) The ADA has accepted which of the following agent/s for the treatment of gingivitis?
A. Prescription solutions of chlorhexidine digluconate oral rinse

B. Prescription solutions of tetracycline oral rinse
C. Nonprescription essential oil oral rinse
D. Nonprescription solutions of penicillin oral rinse
E. A and C

25) The attachment apparatus is composed of all of the following EXCEPT, which one is the exception?
A. Periodontal ligament
B. Cementum
C. Alveolar bone
D. Gingiva
26) Of the choices listed below, which one describes the boundaries that define the attached gingiva?
A. From the gingival margin to the interdental groove

B. From the free gingival groove to the gingival margin
C. From the mucogingival junction to the free gingival groove
D. From the epithelial attachment to the cementoenamel junction
27) The gingival fibers are arranged in three groups. Which of the following is not one of those
groups?
A. Circular group
B. Gingivodental group
C. Apical group
D. Trans septal group
28) Because of the high turnover rate, the connective tissue of the gingiva has a remarkably good
healing and regenerative capacity.
The reparative capacity of the gingival connective tissues is not as great as that of the periodontal
ligament or the epithelial tissue.

29) Which of the following types of oral mucosa is not keratinized under normal conditions?
A. Buccal mucosa
B. Vermillion border of the lips
C. Hard palate
D. Gingiva
30) Bone consists of:
A. Two-thirds organic matter and one-third inorganic matrix

B. One-third organic matter and two-thirds inorganic matrix
C. One-half organic matter and one-half inorganic matrix
D. Two-thirds inorganic matter and one-third organic matrix
31) _____ are the most common cells in the periodontal ligament and appear as ovoid or elongated
cells oriented along the principal fibers, exhibiting pseudopodia like processes.
A. Cementoblasts

B. Osteoblasts
C. Fibroblasts
D. Macrophages
32) The principal fibers of the periodontal ligament are composed mainly of collagen type Ill.
The amount of collagen in a tissue can be determined by its glycine content.

33) The sulcular epithelium is a:
A. Thick, keratinized stratified squamous epithelium without rete pegs

B. Thick, nonkeratinized stratified squamous epithelium with rete pegs
C. Thin, keratinized nonstratified squamous epithelium with rete pegs
D. Thin, non keratinized stratified squamous epithelium without rete pegs
34) A/An of the saliva causes precipitation of calcium phosphate salts by lowering the precipitation
constants.
A. Decrease in the pH
B. Increase in the pH
C. Decrease in the viscosity
D. Increase in the viscosity
35) Dental plaque is defined clinically as a structured, resilient, yellow-grayish substance that adheres
tenaciously to the intraoral hard surfaces, including removable and fixed restorations.
Dental plaque is primarily composed of tissue cells

36) Angular defects are classified on the basis of:
A. The number of osseous walls that were destroyed by periodontal disease

B. The number of osseous walls left surrounding the tooth
C. The number of osseous walls that will remain after surgery
D. Periodontal probe readings
37) During the evaluation of an osseous defect radiographs will not show:
A. The number of walls left surrounding the tooth

B. The exact configuration of the defect
C. The location of the epithelial attachment
D. All of the above

38) Pockets of the same depth may be associated with different degrees of attachment loss and
pockets of different depths may be associated with the same amount of attachment loss.
A. True
B. False
39) The principal differences between intrabony and suprabony pockets are the relationship of the
soft tissue wall of the pocket to the alveolar bone, the pattern of bone destruction, and the direction
of the transseptal fibers of the periodontal ligament.
A. True
B. False
40) In intra-bony pockets:
A. The bone loss is vertical in nature

B. The bone loss is horizontal in nature
C. Trans-septal fibers are horizontal
D. Supra-crestal fibers follow the normal bone contour
41) Furcation involvements have been classified as grades I, II, Ill, and IV according to the amount of
tissue destruction. Grade II is:
A. Incipient bone loss

B. Partial bone loss (cul-de-sac)
C. Total bone loss with through-and-through opening of the furcation
D. Similar to the above, but with gingival recession exposing the furcation to view
42) When using the periodontal probe to measure pocket depth, the measurement is taken from the:
A. Base of the pocket to the CEJ

B. Free gingival margin to the CEJ
C. Junctional epithelium to the margin of the free gingiva
D. Base of the pocket to the mucogingival junction
43) How should the periodontal probe be inserted into the sulcus?
A. Perpendicular to the long axis of the tooth

B. With a firm pushing motion
C. With a short oblique stroke
D. Parallel to the tooth surface
44) When extensive scaling and root planing must be performed, the best approach would be:
A. A series of appointments set up to scale and root plane a segment or quadrant of teeth at a time
(thoroughly and completely)
B. Gross debridement (sub-and supragingival) of the entire mouth, followed by a series of
appointments for fine scaling and polishing
C. Perform everything in a single appointment
D. None of the above

45) Some degree of curettage is done unintentionally when scaling and root planing are performed;
this is called inadvertent curettage.
Curettage accomplishes the removal of the chronically inflamed granulation tissue that forms in the
lateral wall of the periodontal pocket.

46) The main objective of root planning is:
A. To remove chronically inflamed tissues

B. To change the bacterial microflora
C. To remove etiologic agents from the root surface
D. To eliminate pockets
47) Which of the following is the instrument of choice for removing deep subgingival calculus, for root
planing altered cementum, and, for removing the soft tissue lining the periodontal pocket?
A. Curette
B. Sickle scaler
C. Hoe
D. File
48) If a patient experiences sensitivity while being scaled with an ultrasonic scaling device, all of the
following actions will be appropriate to counter this problem EXCEPT, which one is not appropriate?
A. Proceeding to another tooth and then returning to the sensitive tooth later in the appointment
B. Moving the instrument slower
C. Making necessary adjustments to the water spray
D. Using less pressure
49) The primary function of which instrument is to fracture or crush large deposits of tenacious
calculus?
A. Hoe scalers
B. Files
C. Chisel scalers
D. Sickle scaler
50) A free mucosal autograft (subepithelial connective tissue graft) differs from a free gingival grafts in
that the transplant in a free mucosal graft is:
A. Connective tissue with an epithelial covering

B. Connective tissue without an epithelial covering
C. Epithelial tissue with its own blood supply

D. Epithelial tissue without its own blood supply
51) An 8 mm pocket is measured in which the junctional epithelium lies coronal to the cemento-
enamel junction, is:
A. True pocket
B. Pseudo pocket
C. Suprabony pocket
D. Infrabony pocket
52) Which the following is most useful differentiating an acute periodontal abscess from preapical
abscess
A. Type of exudate
B. Nature of swelling
C. Intensity of pain
D. Result of periodontal propping
53) The sever alveolar bone loss seen in patient with juvenile periodontitis is associated with:
A. Impaired osteoplastic activity

B. Increased phagocytosis
C. Increased macrophages migration
D. Impaired neutrophils chemotaxis
54) Tobacco chewing thought to be a contributing / predisposing factor in which condition?
A. Desquamative gingivitis
B. ANUG
C. Juvenile periodontitis
D. Erythema multiform
55) Graft taken from different individuals of the same species is:
A. Allograft
B. Isograft
C. Autograft
D. Xerograft
56) Interproximal necrosis, ulceration, pain and bleeding are significant criteria used in the clinical
diagnosis of:
A. lichen planus
B. ANUG
C. Gingival enlargement
D. Chronic infectious periodontal disease
57) as per the concept of periodontal disease activity:
A. Periodontal disease has an immunologic cause

B. Periodontal disease is a slow but continuously progressive phenomenon

C. Periodontal disease goes through periods of quiescence and exacerbation
D. Periodontal distraction occurs with the help of a systemic predisposing factor
58) a purulent discharge from a periodontal pocket:
A. Signifies the severity of periodontal destruction

B. Signifies the depth of periodontal pocket
C. Consists, among other constituents, of living, degenerated and necrotic mononuclear leukocytes
D. Is only a secondary sign
59) Localized generalized juvenile periodontitis is usually best described as:
A. Pink
B. Coral pink
C. Pale pink
D. Reddish pink
60) Lamina dura is:
A. Alveolar bone proper

B. Appears as thin white line on radiograph
C. Is thickened in ostitis deformans
D. All of the above
61) effected use of dental floss can be expected to:
A. Significantly reduce caries activity

B. Improve gingival health
C. Restrict plaque development
D. Effectively alter the oral environment
62) The critical structure for bone regeneration is?
A. Periosteum
B. Vascularity
C. Bone tissue
D. None
63) Which of the following is true about modified stillman’s brushing technique?
A. Used in patients with severe gingival recession & to prevent abrasive tissue destruction
B. Used in patient after periodontal surgery to help in healing of wound
C. Indicated in patient with severe gingival inflammation associated with deep periodontal pocket
D. Used to stimulate the gingival and initiate the profuse bleeding
64) The punched out, crater-like depressions at the crest of the gingiva, covered by
pseudomembranous slough which is demarcated from remainder of gingiva, by linear erythema is
characteristic of:
A. Diphtherial gingivitis
B. Vincent’s stomatitis

C. Erythema multiform
D. Lichen planus
65) A case presenting with a grey color pseudomembrane whose removal is difficult & painful, can be:
A. Acute Necrotizing Ulcerative Gingivitis

B. Diphtheritic lesion
C. Secondary stage of syphilis
D. Desquamative gingivitis
66) A 36 years old female patient presents with extensive vesicles formation over gingiva, lips, cheeks
& tongue. 2 – 4 days later the vesicles rupture to form psuedomemebrane. There are few skin lesions
also present, the condition can be:
A. Acute herpetic gingivitis

B. Erythema multiform
C. ANUG
D. Stevens Johnson syndrome
67) 6 years old child with diffuse erythema & vesicular eruption on gingiva & on rupture the vesicles
leave slightly depressed oral ulcers. It appears to be contagious it can be:
A. ANUG
B. Acute herpetic gingivostomatitis
C. Acute tubercular gingivostomatitis
D. Congenital latent syphilitic lesion
68) The suggested cause/s of desquamative gingivitis is/are:
A. Dermatosis
B. Endocrine imbalance
C. Aging, nutritional imbalance
D. All of the above
69) Pregnancy-related gingivitis:
A. Is associated with significant increase in bacteroides gingivalis levels

B. Is most prominent in II trimester of pregnancy
C. Both of the above
70) Local sources of halitosis include:
A. Artificial dentures
B. Rhinitis
C. Tonsillitis
D. All of the above
71) Calculus:
A. By or in itself, is the irritating cause

B. Is always covered always by non-mineralized layer of plaque
C. Is formed as all plaque undergo mineralization
D. Formation can not be obtained in germ-free animals
72) Interlukin-1 (IL-1) produced by various positive host defense cells:
A. Induces proliferation of T-cells, B-cells & fibroblasts

B. Enhances production of osteoclast activating factor
C. Enhances production of collagenase
D. All of the above
73) The first antibody to be formed after encounter with an antigen is of following class:
A. IgM
B. IgA
C. IgD
D. IgG
74) In grade II furcation defect:
A. There is partial bone loss with or without gingival recession

B. The prognosis for regeneration of periodontal tissue is good
C. There is total bone loss without gingival recession
D. The prognosis for regeneration of periodontal tissue is poor
75) Gingival fluid is a:
A. Transudate
B. Exudate
C. Can be either of two
D. Neither of two
76) When using the periodontal probe to measure pocket depth, the measurement is taken from the:
A. Base of the pocket to the CEJ

B. Free gingival margin to the CEJ
C. Junctional epithelium to the margin of the free gingiva
D. Base of the pocket to the mucogingival junction
77) The new designation “ Aggressive Periodontitis" include patients previously diagnosed with all
the following EXCEPT, which one is the exception?
A. Localized juvenile periodontitis
B. Generalized juvenile periodontitis
C. Rapidly progressive periodontitis
D. Refractory periodontitis

78) Gingivectomy is not likely to be the treatment-of-choice for the elimination of pockets when the
base of the pocket is located at the mucogingival junction or:
A. Apical to the alveolar crest
B. Below the free gingival groove
C. Coronal to the cementoenamel junction
D. Apical to the cervical convexity of the tooth crown
E. None of the above
79) On furcation involvement the upper second premolar has poor prognosis, because the roots are
placed bucco-lingually and the furcation is usually located more apically compared to molars:
80) Absence of what form of tissue is considered a contraindication for treatment planning a
Gingivectomy?
A. Specialized Mucosa
B. Lining mucosa
C. keratinized gingiva
81) Systemic factors/disorders do not initiate chronic periodontitis.

However they may predispose, accelerate, or otherwise increase its progression towards periodontal
tissue destruction
82) PERIOCHIP
A. Tetracycline Containing Fibers
B. Minocycline Hydrochoride
C. Doxycycline Hydrochoride
D. Chlorhexidine Gluconate
83) Which statement regarding an autogenous free gingival graft is false?

A. it can be placed to prevent further recession
B. it can be used to effectively widen the attached gingiva
C. it retains its own blood supply and is not dependent on the bed of recipient blood vessels
D. it can treat multiple recession

84) 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
A. It serves as a mechanical irritant
B. It causes food impaction
C. It serves to retain plaque
D. It tears gingival fibers
85) Biologic width comprises of

A. Junctional epithelium and supracrestal fibres
B. Junctional epithelium, supracrestal fibres & gingival sulcus
C. Junctional epithelium and Gingival sulcus
D. Gingival sulcus and supracrestal fibres

Q1) C
It retains its own blood supply and is not dependent on the bed of recipient blood vessels
Autogenous free gingival grafts retain none of their own blood supply and are totally dependent on the
bed of recipient blood vessels. In some instances, it can be used to cover a root surface with a narrow
denudation. The procedure yields a high degree of successful results when used for increasing the width
of the attached gingiva. The free gingival graft may be used therapeutically to widen the gingiva after
recession has occurred. It may be used prophylactically to prevent recession where the band of gingiva
is narrow and of a thin, delicate consistency. The free gingival graft is an autogenous graft of gingiva that
is placed on a viable connective tissue bed where initially, buccal or labial mucosa was present. In most
cases, the donor site from which the graft is taken is an edentulous region or the palatal area.
Q2) D
A and B
It does not cure periodontal disease. The technique is performed in combination with apically positioned
flaps, and the procedure eliminates periodontal pocket depth and improves tissue contour to provide a
more easily maintainable environment. Before employing osseous resection or recontouring to treat an
infrabony defect, the therapist should consider the following alternative treatments:
Maintenance with periodic root planing
• Bone grafts
• Reattachment-fill procedures
• Hemisection or root amputation
Q3) D
Flaps from the palate are considered easier to be displaced than those from any other region
***This is false; palatal flaps cannot be displaced (owing to the absence of unattached gingiva).
A periodontal flap is a segment of marginal periodontal tissue that has been surgically separated
coronally from its underlying support and blood supply and attached apically by a pedicle of supporting
vascular connective tissue. Flap procedures are the most commonly used of all periodontal surgical
techniques. The most commonly used flaps are full-thickness mucoperiosteal flaps. These flaps include
the surface mucosa {defined as epithelium, basement membrane, and connective tissue lamina propria)
and the contiguous periosteum of the underlying alveolar bone. A partial-thickness flap includes only
the epithelium and part of the connective tissue, which is separated from the periosteum by sharp
dissection

Q4) D
Elimination of gingival enlargements
Gingivectomy means excision of the gingiva. By removing the pocket wall, gingivectomy provides
visibility and accessibility for complete calculus removal and thorough smoothing of the roots, creating a
favorable environment for gingival healing and restoration of a physiologic gingival contour. A beveled
incision is made apical to the pocket depth, the tissue is removed, the area is debrided, and a surgical
pack is placed. The gingivectomy technique may be performed for the following indications:
• Elimination of suprabony pockets, regardless of their depth, if the pocket wall is fibrous and firm
• Elimination of gingival enlargements
• Elimination of suprabony periodontal abscesses
Q5) B
To provide access to root surfaces for debridement
all the other choices are goals but not a primary objective
The techniques vary with the goal that is sought. However, the common goal of all flap procedures is to
provide access for instrumentation. It gives the clinician the opportunity to visualize the roots so that
calculus may be removed more completely.
Without direct visualization provided by a flap, it is rare that a clinician can effectively root plane beyond
5 mm of probing depth or into furcation of lesser depth. It also makes removal of granulomatous tissue
from the region of the periodontal defect difficult. It is important to remove this, due to the fact it contains
epithelium and the potential presence of bacterial infiltration.
Q6) B
Pedicle graft
The pedicle graft was the first periodontal plastic surgery procedure to be used for root coverage. It
provides a superior result from an esthetic standpoint, but is less versatile than the connective tissue graft.
Important: The base of the graft remains attached to the donor site to maintain the blood supply.
With pedicle grafts, there is less concern about nutrient flow from graft bed to graft. The properly
performed pedicle graft never loses its blood supply during the surgical procedure.
The major advantages of pedicle grafting include:
• Predictable correction of gingival recession is possible, because the graft has an uninterrupted blood
supply

• Postoperative discomfort is usually minor
• Since the color of the graft matches the adjacent gingiva, the procedure provides good esthetics
Indications include:
• To widen an inadequate zone of attached gingiva
• To repair an isolated area of gingival recession
Contraindications include:
• The prospective donor site lacks sufficient attached gingiva
• The donor site has a fenestration or dehiscence of its supporting bone
Q7) B
Placement of non-resorbable barriers or resorbable membranes and barriers over a bony defect
The method for the prevention of epithelial migration along the cemental wall of the pocket that has
gained wide attention is guided tissue regeneration (GTR). This method is based on the assumption that
only the periodontal ligament cells have the potential for regeneration of the attachment apparatus of
the tooth. GTR consists of placing barriers of different types to cover the bone and periodontal ligament,
thus temporarily separating them from the gingival epithelium. Excluding the epithelium and the gingival
connective tissue from the root surface during the postsurgical healing phase not only prevents epithelial
migration into the wound, but also favors repopulation of the area by cells from the periodontal ligament
and the bone.
Q8) A
Both statements are true
Q9) A
True
Free gingival autografts involve taking a section of attached gingiva from another area of the mouth
(usually the hard palate or an edentulous region) and suturing it to the recipient site. The success depends
on the graft being immobilized at the recipient site. Free gingival grafts are used to create a widened zone
of attached gingiva with the possibility of gaining root coverage as well. The difficulty in getting complete
root coverage lies in the fact that an avascular graft is placed over a root surface also devoid of a blood
supply.

Q10) B
Osteoplasty
Procedures used to correct osseous defects have been classified in two groups:
• Osteoplasty: refers to reshaping the bone without removing tooth-supporting bone
• Ostectomy (or osteoectomy): includes the removal of tooth-supporting bone
Q11) B
Two-wall intra bony defects (osseous craters)
Horizontal bone loss is the most common pattern of bone loss in periodontal disease. The bone is reduced
in height, but the bone margin remains approximately perpendicular to the tooth surface. The interdental
septa and facial and lingual plates are affected, but not necessarily to an equal degree around the same
tooth.
Vertical or angular defects are those that occur in an oblique direction, leaving a hollowed-out trough in
the bone alongside the root; the base of the defect is located apical to the surrounding bone. In most
instances, angular defects have accompanying intrabony periodontal pockets; intrabony pockets,
however, always have an underlying angular defect.
Angular defects are classified on the basis of the number of osseous walls. Angular defects may have one,
two, or three walls. The number of walls in the apical portion of the defect may be greater than that in its
occlusal portion, in which case the term "combined osseous defect" is used.
Q12) A

Most investigations that evaluated the effect of smoking on nonsurgical therapy have demonstrated less
reduction in probing depth and smaller gains in attachment levels in smokers compared with nonsmokers.
Depending on which clinical parameters are used to assess periodontal disease, smokers are 2.6 to 6 times
more likely to develop periodontal disease than nonsmokers.
Important point: Smoking is one of the most significant risk factors currently available to predict the
development and progression of periodontitis.
Q13) B
"punched-out" papillae
Two forms of necrotizing ulcerative periodontal diseases are necrotizing ulcerative gingivitis (NUG) and
necrotizing ulcerative periodontitis (NUP). These conditions represent acute forms of periodontal

destruction typically associated with some form of host compromise. The essential components of NUG
are:
• Interdental gingival necrosis:
often described as "punched-out" papillae
Pain
Bleeding
Q14) A
Periodontitis does not always begin with gingivitis
Periodontitis always begins as a gingivitis, which is usually due to local irritation, primarily plaque, and the
inflammation then spreads from the gingiva and soft tissues into the underlying structures. Gingivitis and
periodontitis cannot be induced without bacteria (plaque).
Periodontitis is inflammation that affects and destroys the attachment apparatus. The clinical feature that
distinguishes periodontitis from gingivitis is the presence of clinically detectable attachment loss. This
often is accompanied by periodontal pocket formation and changes in the density and height of subjacent
alveolar bone.
Important: The progress of periodontitis may be arrested with proper therapy. Remember: There are no
radiographic features of gingivitis. In periodontitis, radiographic changes are noted, which may include
the following:
• loss of lamina dura
• horizontal or vertical bone resorption
• thickening (widening) of the periodontal ligament space
Clinical signs of inflammation, such as changes in color, contour, and consistency and bleeding on probing,
may not always be positive indicators of ongoing attachment loss. However, the presence of continued
bleeding on probing at sequential visits has proven to be a reliable indicator of the presence of
inflammation and the potential for subsequent attachment loss at the bleeding site
Q15) B
Attachment loss
Attachment loss is much more significant than periodontal pocketing (actually it is the most significant
factor) because with attachment loss, supportive structures are being destroyed. Pocket depth is the
distance between the base of the pocket and the gingival margin. The level of attachment on the other
hand, is the distance between the base of the pocket and a fixed point on the crown, such as the CEJ.

Changes in the level of attachment can be caused only by gain or loss of attachment and, thus, provide a
better indication of the degree of periodontal destruction.
Important: The two most critical parameters for the prognosis of a periodontally involved tooth are
attachment loss (most critical) and mobility.
Q16) A
Stop persistent bleeding
Purposes of the periodontal dressing (periodontal packs):
• Provide mechanical protection for the surgical wound and, therefore, facilitate healing
• Helps prevent postoperative bleeding by keeping the initial clot in place
• Supports mobile teeth during healing
• Mechanically maintains postsurgical position of the flaps
• Helps in shaping or molding the newly formed tissue
• Provide patient comfort by isolating area from external irritations or injuries
Characteristics of acceptable dressing material:
• Nontoxic or nonirritating to the tissue
• Conveniently prepared, placed, and removed with minimal discomfort to patient
• Should maintain adhesion to itself and to the teeth, kept in place mechanically by interlocking in
interdental spaces

Q17) A
Preliminary phase: plaque control
Q18) A
The inorganic content of cementum (hydroxyapatite) is 97%
Important: the main function is the attachment of principal fibers of the PDL.
Other functions include:
1. Compensates for the loss of tooth surface due to occlusal wear by apical deposition of cementum
throughout life.
2. Protects the root surface from resorption during vertical eruption and tooth movement.

3. Has a reparative function; allows reattachment of connective tissue following periodontal treatment.
Note: Cementum repair requires the presence of viable connective tissue. If epithelium proliferates into
an area of resorption, repair will not take place. Cementum repair can occur in devitalized as well as vital
teeth.
Q19) B
The endodontic component first
In patients with a dental abscess, the differential diagnosis between periodontal and endodontic origin
can usually be established by the history, clinical examination, and radiographs. The true combined lesion
results from the development and extension of an endodontic lesion into an existing periodontal lesion
{pocket). The pain from the loss of pulpal vitality is the most common presenting complaint of patients
with combined lesions. The symptoms reported are those most often found with pulpal disease. Thermal
pulp testing provides information relative to the status of the pulp, and dental radiographs can confirm
the presence of apical changes and the extent of bone loss. Careful probing confirms the presence and
morphology of any periodontal pocket and permits location of the communication with the apical lesion.
In combined endodontic-periodontic lesions, it is generally wise to treat the endodontic component first,
because in many cases, this will lead to complete resolution of the problem.
After successful endodontic treatment, the residual periodontal pocket that remains can be more
predictably treated. The periodontal therapeutic objectives vary with the extent and configuration of the
residual periodontal lesion.
Q20) B
Brown, black, green, or orange stains caused by chromogenic bacteria in plaque
Stains can be identified by location:
• brown, black, green, or orange stains caused by chromogenic bacteria in plaque
• Intrinsic - stains that occur within the tooth substance
• Extrinsic - stains that occur on the external surface of the tooth
Stains can be identified by sources of the discoloration:
• Endogenous - stain that originates from within the tooth. Endogenous stains are always intrinsic and
frequently are discolorations of the dentin reflected through the enamel. Examples of sources: drugs
(tetracycline, systemic .fluoride), changes in pulp tissue of pulpless teeth, imperfect tooth development
(amelogenesis imperfect)
• Exogenous - stain that originates from an external source.
Brown, black, green, and orange stains are generally seen on the labial surface of anterior teeth and are
usually caused by poor oral hygiene. Some theories attribute the change in color to by-products of some
bacteria. Black stain is generally seen in the cervical portion of molar teeth in children. Green and orange

stains are supposedly associated with an increased amount of caries and, actually, they represent
pigmentation of dental plaque. Black line, tobacco, orange and green stains are all exogenous extrinsic
stains, initially at least. With time, both green and tobacco stains may become incorporated within the
tooth. At this point, their classification changes. They become exogenous intrinsic stains. Silver amalgam
and topical fluoride are also examples of exogenous intrinsic stains. An exogenous intrinsic stain is one
that originates from a source outside the tooth and subsequently becomes incorporated within the tooth
structure.
Q21) B
Periodontal pockets
*** Periodontal pockets are not caused by occlusal trauma. A local irritant and inflammation are necessary
to cause apical shift of the epithelial attachment. The most common clinical sign of occlusal trauma is
tooth mobility. Other clinical signs of occlusal trauma include migration of teeth and the tenderness of
teeth to percussion. Traumatic lesions manifest more clearly in the faciolingual aspects because,
mesiodistally, the tooth has the added stability provided by the contact areas with adjacent teeth.
Radiographic signs of trauma from occlusion:
• Widening of the periodontal ligament space
• Thickening of the lamina dura
• Angular bone loss and infrabony pocket formation
• Root resorption
• Hypercementosis
Note: Trauma from occlusion is reversible, that is, the body can repair the damage if the excessive occlusal
forces are eliminated.
Other findings associated with excessive occlusal forces:
• Alternating areas of resorption and repair of the alveolar bone
• Fibrosis of the alveolar bone marrow spaces
• Cemental resorption leading to dentinal resorption
• Cemental tears
• Possible ankylosis
• Occasional pulpal necrosis and calcification
Radiographic changes that may be seen on teeth that are no longer in function:
• Reduced trabeculation of bone
• Narrowing of the periodontal ligament space

Q22) B
Clean non-adherent bacteria and debris from the oral cavity more effectively than toothbrushes and
mouth rinses
Oral irrigators for daily home use by patients work by directing a high-pressure, steady or pulsating stream
of water through a nozzle to the tooth surfaces. Most often, a device with a built-in pump generates the
pressure. Oral irrigators clean nonadherent bacteria and debris from the oral cavity more effectively than
toothbrushes and mouth rinses. When used as adjuncts to toothbrushing, these devices can have a
beneficial effect on periodontal health by reducing the accumulation of plaque and calculus and
decreasing inflammation and pocket depth.
Q23) A
Non-isolated teeth
Super Floss® is ideal for cleaning braces, bridges, and wide gaps between teeth. Its three unique
components - a stiffened end, spongy floss, and regular floss - all work together for maximum benefits.
Three components:
• Stiff-end threader so you can floss under appliances
• Spongy floss cleans around appliances and between wide spaces
• Regular floss removes interproximal subgingival plaque
Indications for use of Super Floss® include plaque removal around the following:
 Isolated teeth Teeth separated by a diastema

 Wide embrasures where interdental papillae have been lost Fixed partial dentures (bridgework)
Orthodontic appliances
 Implants
Q24) E
A and C
Q25) D
Gingiva
The periodontium consists of the investing and supporting tissues of the tooth: gingiva, periodontal
ligament, cementum, and alveolar bone. It has been divided into two parts:
1. Gingiva: the main function of which is protecting the underlying tissues

2. Attachment apparatus: composed of the:
• Periodontal ligament
• Cementum
• Alveolar bone
The cementum is considered a part of the periodontium because, with the bone, it serves as the support
for the fibers of the periodontal ligament.
Q26) C
From the mucogingival junction to the free gingival groove
Q27) C
Apical group
The gingival fibers are arranged in three groups:
• Gingivodental group: these fibers are those on the facial, lingual, and interproximal surfaces. They are
embedded in the cementum just beneath the epithelium at the base of the gingival sulcus.
• Circular group: these fibers course through the connective tissue of the marginal and interdental
gingivae and encircle the tooth in ring like fashion. They resist rotational forces.
• Transseptal group: these fibers are located interproximally and form horizontal bundles that extend
between the cementum of approximating teeth into which they are embedded. They lie in the area
between the epithelium at the base of the gingival sulcus and the crest of the interdental bone. They are
sometimes classified with the principal fibers of the PDL
Q28) A
Q29) A
Buccal mucosa
Q30) D
Two-thirds inorganic matter and one-third organic matrix

Q31) C
Fibroblasts
Types of cells identified in the periodontal ligament:
• Connective tissue cells: fibroblasts, cementoblasts, and osteoblasts. Fibroblasts are the most common
cells; they synthesize collagen and possess the capacity to phagocytize "old" collagen fibers. Note:
Cementoclasts and osteoclasts are also seen in the cemental and osseous surfaces of the PDL.
• Epithelial rest cells: the epithelial rests of Malassez form a latticework in the PDL and are considered
remnants of Hertwig root sheath, which disintegrates during root development. They are distributed
close to the cementum throughout the PDL of most teeth and are most numerous in the apical and
cervical areas.
• Defense cells: include neutrophils, lymphocytes, macrophages, mast cells, and eosinophils. These cells,
as well as those associated with neurovascular elements, are similar to the cells in other connective
tissue
Q32) A
The principal fibers of the periodontal ligament are composed mainly of collagen type I
lysine, and hydroxyproline. The amount of collagen in a tissue can be determined by its hydroxyproline
content.
Q33) D
Thin, non-keratinized stratified squamous epithelium without rete pegs
Q34) B
Increase in the pH
Q35) C
The first statement is true, the second is false
Dental plaque is defined clinically as a structured, resilient, yellow-grayish substance that adheres
tenaciously to the intraoral hard surfaces, including removable and fixed restorations.

Plaque is primarily composed of bacteria in a matrix of salivary glycoproteins and extracellular
polysaccharides. The microorganisms exist within an intercellular matrix that also contains a few host
cells, such as epithelial cells, macrophages, and leukocytes.
Q36) B
The number of osseous walls left surrounding the tooth
Q37) D
All of the above
***This is because a dense buccal and/or lingual plate of bone will tend to mask the defect, blocking it
out on the radiographs. This information can only be determined by exploratory surgery.
Important: Radiographs will not show:
I. The number of walls left surrounding the tooth
2. The exact configuration of the defect
3. The location of the epithelial attachment
The two most critical parameters for the prognosis of a periodontally involved tooth are mobility and
attachment loss
Q38) A
True
Q39) A
True
Q40) A
The bone loss is vertical in nature
• lntrabony (infrabony, subcrestal, or intra-alveolar): in which the bottom of the pocket is apical to the
level of the adjacent alveolar bone
• Supra bony (supracrestal or supra-a/veola1): in which the bottom of the pocket is coronal to the
underlying alveolar bone.

Q41) B
Partial bone loss (cul-de-sac)
The term furcation involvement refers to the invasion of the bifurcation and trifurcation of multi-rooted
teeth by periodontal disease. The denuded furcation may be visible clinically or covered by the wall of
the pocket. The extent of involvement is determined by exploration with a blunt probe, along with a
simultaneous blast of warm air to facilitate visualization.
Furcation involvements have been classified as grades I, II, III, and IV according to the amount of tissue
destruction.
• Grade I: is incipient bone loss
• Grade II: is partial bone loss (cul-de-sac)
• Grade III: is total bone Joss with through-and-through opening of the furcation
• Grade IV: is similar to Grade III, but with gingival recession exposing the furcation to view
Q42) C
Junctional epithelium to the margin of the free gingiva
Periodontal probes are used to measure the depth of pockets and to determine their configurations.
The typical probe is a tapered, rod like instrument calibrated in millimeters, with a blunt, rounded tip.
Ideally, probes are thin, and the shank is angled to allow easy insertion into the pocket
Q43) D
Parallel to the tooth surface
Q44) A
A series of appointments set up to scale and root plane a segment or quadrant of teeth at a time
(thoroughly and completely)
Q45) A
The word curettage is used in periodontics to mean the scraping of the gingival wall of a periodontal
pocket to separate diseased soft tissue. Scaling refers to the removal of deposits from the root surface,

whereas planing means smoothing the root to remove infected and necrotic tooth substance. A
differentiation has been made between gingival and subgingival curettage.
• Gingival curettage: consists of the removal of the inflamed soft tissue lateral to the pocket wall
• Subgingival curettage: refers to the procedure that is performed apical to the epithelial attachment,
severing the connective tissue attachment down to the osseous crest.
Q46) C
To remove etiologic agents from the root surface
he major objective of scaling and root planing is to remove etiologic agents that promote gingival
inflammation in the periodontal tissues. Removal of plaque, calculus, and endotoxins results in a
subsequent shift from disease-associated, gram-negative anaerobes to health-associated, gram-positive,
facultative microorganims.
Q47) A
Curette
Q48) B
Moving the instrument slower
*** The opposite of these is true!! All of the rest are appropriate actions to be considered in that
situation.
If sensitivity is encountered during use:
• Lighten the pressure
• Adjust the water spray: increase water flow to cool the tip
• Move to another tooth and then return later to the sensitive tooth
• Decrease the power
Power-driven instruments work best with quick hand movement -- rapid, controlled movements.
Remember: *** The ultrasonic principle is based on the use of high-frequency sound waves.

Q49) B
Files
They have a series of blades on a base. Their primary function is to fracture or crush large deposits of
tenacious calculus or burnished sheets of calculus. Files can easily gouge and roughen root surfaces
when used improperly. Therefore, they are not suitable for fine scaling and root planing.
Q50) B
Connective tissue without an epithelial covering
A free mucosal autograft (sub-epithelial connective tissue graft) differs from a free gingival graft in that
the transplant in a free mucosal graft is connective tissue without an epithelial covering.
Q51) B
Pseudo pocket
A pseudopocket is a pocket formed by gingival enlargement without apical migration of the junctional
epithelium. It does not involve the loss of bone. Pseudo pockets are also referred to as gingival, false, or
relative pockets. All pseudopockets are suprabony (the base of the pocket is coronal to the crest of the
alveolar bone).
Q52) D
Result of periodontal probing
Periodontal abscess Preapical abscess

Pulp test vital Pulp test maybe non vital
Associated with pre-existing periodontal pocket Associated with deep restoration
Swelling is located around the involved tooth and Swelling located often with a fistulous opening in
gingival margin, seldom with fistula the apical area. This may be located away from
the offending tooth
Pain is dull, constant, localized and the patient Pain is sever, throbbing and my last for days
can usually locate the offending tooth Patient not able to locate the offending tooth
Pain on percussion is not as sever as with Pain on percussion is sever
preapical abscess

Q53) D
Impaired neutrophils chemotaxis
Immunology – some immune defect have been implicated in the pathogenesis of juvenile periodontitis
several investigator showed that patients with juvenile periodontitis display functional defect of PMNs
and or monocytes. These defects can impair ether the chemotactic attraction of the PMN to the site or
its ability to phagocytose and digest the microorganisms. The defect maybe induced by the invading
bacteria.
Q54) B
ANUG
 Predisposing factors of ANUG
Local
Smoking
Pericoronal flaps
Injury to the gingiva
Systemic
Nutritional deficiency
Debilitating disease
Psychosomatic
 Factors causing recurrence of ANUG
Pericoronal flap
Inadequate local therapy
Anterior overbite
Q55) A
Allograft

Q56) B
ANUG
 Ulcerative lesion localized to the marginal gingiva which is covered by a pseudo membrane and is
easily detachable but painful
 ANUG lesion i9s ulcerative lesion, infectious but not contagious
 In ANUG, the surface of gingival crater is covered by a gray, pseudo membranous slough
demarcated from the reminder of gingival mucosa by pronounced linear erythemia.
 spontaneous gingival hemorrhage or pronounced bleeding on the slightest stimulation is clinical sign
of ANUG
 woody gums ‘pasty saliva’ is seen in ANUG
 oral symptoms in ANUG – the lesions are extremely sensitive to touch constant radiating gnawing
pain, metallic foul taste, excessive amount of pasty saliva are seen
Q57) C
Periodontal disease goes through periods of quiescence and exacerbation
Q58) D
Is only a secondary sign
Pus formation is a common feature of periodontal disease but it is no indication of depth of the pocket or
the severity of destruction of supporting tissue. Further, pus consists of living, degenerated and necrotic
leukocytes among which poilymorphonuclear types are predominant. Even though formation of pus is a
dramatic clinical finding, it is only a secondary sign
Q59) C
Pale pink
Q60) B
Appears as thin white line on radiograph

Q61) B
Improve gingival health
The purpose of dental flossing is to remove plaque not to dislodge fibrous threads of food wedged in
between two teeth or impacted in the gingiva but to improve gingival health
Q62) A
Periosteum
Q63) A
Used in patients with severe gingival recession & to prevent abrasive tissue destruction
Technique Direction of bristles Comment

Scrub tech Horizontal Most common to cause
abrasion
Bass pointing apically, at sulcular Most common recommended
tech
Roll tech Pointing apically, parallel to long axis of teeth Least efficient
Mod. Pointing occlusally, at 45 degree to long axis of teeth Recommended if gingival
stillmans recession and root exposure
Charters Pointing occlusally, at 45 degree to long axis of teeth Recommended after gingival
tech surgeries
Fones tech Horizontal Recommended in children
Stillmans Pointing apically, at 45 degree to long axis of theeth
Q64) B
Vincent’s stomatitis
Or ANUG presents what is mentioned. In diphtheritic gingivitis, marginal gingival is rarely involved.
Erythema multiform is characterized by presence of hyperemic papules, macules or vesicles. Also involves
skin, characterized by ‘target iris’ or ‘bulls eye’ lesion

Q65) B
Diphtheritic lesion
Important:
The question gives clinical picture of diphtheritic gingivitis. In ANUG the pseudomembrane can be easily
removed. In desquamative no such membrane forms.
Q66) B
Erythema multiform
Erythema multiform presents with ‘bulls eye’ lesion of the skin with mucosal involvement.
Important: ANUG and AHG do not present skin lesion
Q67) B
Acute herpetic gingivostomatitis
AHG is an infection of the oral cavity caused by herpes simplex virus. It most frequently occurs in infants
and children below age of 6 years. The question gives the clinical picture of AHGS. ANUG is relatively
uncommon in children and choice C and D do not present vesicular lesions.
Q68) D
All of the above
Q69) D
None of the above
Pregnancy gingivitis is associated with High level of B. intermedius. it has been demonstrated, that
increased plasma estrogen and progesterone levels serves as nutrient for this particular species. The
accentuation of gingivitis is pregnancy occurs in two peaks: first and third trimester which coincide with
increased hormonal levels in plasma
Q70) A
Artificial dentures
Rhinitis and tonsillitis are considered as the extraoral or remote cause of halitosis.

Q71) B
Is always covered always by non-mineralized layer of plaque
Calculus dose not irritate the gingiva directly but it provides a fixed nidus for continued accumulation of
irritating surface plaque and holds the plaque against the gingiva.
Q72) D
All of the above
Q73) A
IgM
Q74) A
There is partial bone loss with or without gingival recession
The Grade II furcation involvement can be subclassified as having a good, fair or bad prognosis for
regeneration depending upon the presence or absence of the complex anatomic problems. Like root
proximity, root shape, root trunk or enamel projection, etc.
Q75) C
Can be either of two
Q76) C
Junctional epithelium to the margin of the free gingiva
Q77) D
Refractory periodontitis
Q78) A
Apical to the alveolar crest
Q79) A

Q80) C
keratinized gingiva
Q81) A
Q82) D
Chlorhexidine Gluconate
Q83) C
it retains its own blood supply and is not dependent on the bed of recipient blood vessels
Q84) C
It serves to retain plaque
Q85) A
Junctional epithelium and supracrestal fibres


Department of Periodontics

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Department of Periodontics

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Department Of Periodontics

1)Which statement regarding an autogenous free gingival graft is NOT true?

A. It can be placed to prevent further recession

2) The main goal of osseous recontouring (surgery) is:

A. To reshape the marginal bone

A. Reduce or eliminate periodontal pockets

A. Free gingival graft

pg. 1 Department Of periodontics

7) What is guided tissue regeneration?

A. A soft tissue graft used to correct mucogingival junction involvement

8) A frenectomy is complete removal of the frenum.

A. Both statements are true

11) One of the most common osseous defects is:

A. One-wall intrabony defects

Smoking has a negative effect on periodontal therapy.

A. Both statements are true

pg. 2 Department Of periodontics

14) Which of the following statements regarding periodontitis is incorrect?

A. Periodontitis does not always begin with gingivitis

A. Stop persistent bleeding

A. Preliminary phase : plaque control

A. The inorganic content of cementum (hydroxyapatite) is 97%

pg. 3 Department Of periodontics

A. The periodontic component first

20) Extrinsic dental stains include:

A. Green to brown stains caused by erythroblastosis fetalis

A. Prescription solutions of chlorhexidine digluconate oral rinse

pg. 4 Department Of periodontics

A. From the gingival margin to the interdental groove

A. Both statements are true

30) Bone consists of:

A. Two-thirds organic matter and one-third inorganic matrix

pg. 5 Department Of periodontics

The amount of collagen in a tissue can be determined by its glycine content.

A. Both statements are true

33) The sulcular epithelium is a:

A. Thick, keratinized stratified squamous epithelium without rete pegs

Dental plaque is primarily composed of tissue cells

A. Both statements are true

36) Angular defects are classified on the basis of:

A. The number of osseous walls that were destroyed by periodontal disease

A. The number of walls left surrounding the tooth

pg. 6 Department Of periodontics

40) In intra-bony pockets:

A. The bone loss is vertical in nature

A. Incipient bone loss

A. Base of the pocket to the CEJ

A. Perpendicular to the long axis of the tooth

pg. 7 Department Of periodontics

A. Both statements are true

46) The main objective of root planning is:

A. To remove chronically inflamed tissues

A. Connective tissue with an epithelial covering

pg. 8 Department Of periodontics

A. Impaired osteoplastic activity

54) Tobacco chewing thought to be a contributing / predisposing factor in which condition?

57) as per the concept of periodontal disease activity:

A. Periodontal disease has an immunologic cause

pg. 9 Department Of periodontics

58) a purulent discharge from a periodontal pocket:

A. Signifies the severity of periodontal destruction

59) Localized generalized juvenile periodontitis is usually best described as:

60) Lamina dura is:

A. Alveolar bone proper