Periodontics

Periodontics
Q1: All of the following statements concerning an autogenous free gingival graft are true EXCEPT one.
Which one is the EXCEPTION?
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 nonpathologic dehiscences and fenestrations
Answer: it retains its own blood supply and is not dependent on the bed of recipient blood vessels
Q2: Most root amputations involve the:
A. mandibular first and second premolars
B. maxillary first and second molars
C. maxillary canines
D. mandibular molars with buccal and lingual class II or III furcation involvements
Answer: maxillary first and second molars
Q3: The main goal of osseous recontouring (surgery) is:
A. to cure periodontal disease
B. to eliminate the existing microflora
C. to eliminate periodontal pockets
D. to change the existing microflora
Answer: eliminate periodontal pockets – to reshape the marginal bone to resemble that of the
alveolar process undamaged by periodontal disease
Q4: All of the following statements regarding periodontal flaps are true EXCEPT one. 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
Answer: flaps from the palate are considered easier to be displaced than those from any other
region
Q5: There are various distal flap approaches used for retromolar reduction. The simplest is the:
A. gingivectomy
B. apically positioned flap
C. distal wedge
D. laterally positioned flap
Answer: distal wedge
Q6: Contraindications to gingivectomy include all of the following EXCEPT one. Which one is the
EXCEPTION?
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
Answer: elimination of gingival enlargements

Q7: 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
Answer: to provide access to root surfaces for debridement – all the other choices are goals but
not a primary objective
Q8: The modified Widman flap (MWF) facilitates instrumentation and attempts to reduce pocket depth.
The apically displaced flap improves accessibility and eliminates the pocket, but it does the latter by
apically positioning the soft tissue wall of the pocket.
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
Answer: the first statement is false, the second is true
Q9: 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
C. connective tissue graft
D. frenectomy
Answer: pedicle graft
Q10: What is guided tissue regeneration?
A. a soft tissue graft used to correct mucogingival junction involvement
B. placement of nonresorbable barriers or resorbable membranes and barriers over a bony defect
C. a free gingival graft used to increase the amount of attached gingiva
D. placement of an autograft to treat a bony defect
Answer: placement of nonresorbable barriers or resorbable membranes and barriers over a bony
defect
Q11: The primary reason for the failure of a free gingival autograft is:
A. infection
B. edema
C. disruption of the vascular supply before engraftment
D. the formation of scar tissue
Answer: disruption of the vascular supply before engraftment
Q12: A variation of the laterally positioned flap is called:
A. a coronally positioned flap
B. a modified Widman flap
C. a double papilla flap
D. a free gingival flap
Answer: a double papilla flap
Q13: Which of the following statements is NOT true regarding the conventional flap design?
A. the entire papilla is incorporated in one of the flaps
B. used in cases where the flap needs to be displaced
C. used in instances of too narrow interdental spaces
D. none of the above
Answer: the entire papilla is incorporated in one of the flaps
Q14: Which of the following has a relatively high degree of predictability and is a "workhorse" of
periodontal therapy?
A. coronally displaced (positioned) flap
B. laterally displaced (positioned) flap
C. double papilla flap
D. apically displaced (positioned) flap
Answer: apically displaced (positioned) flap

Q15: A free mucosal autograft (subepithelial connective tissue graft) differs from a free gingival graft 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
Answer: connective tissue without an epithelial covering
Q16: Which of the following mucogingival surgical techniques is indicated in areas of narrow gingival
recession adjacent to a wide band of attached gingiva that can be used as a donor site?
A. free gingival autograft
B. double papilla flap
C. modified Widman flap
D. laterally displaced (positioned) flap
Answer: laterally displaced (positioned) flap
Q17: Positive and negative architecture refer to the relative position of interdental bone to radicular bone.
The architecture is said to be "positive" if the radicular bone (facial and lingual) is ______ to the interdental
bone.
A. apical
B. coronal
C. the same height
Answer: apical
Q18: The most common osseous defects are:
A. one-wall intrabony defects
B. two-wall intrabony defects (osseous craters)
C. three-wall intrabony defects
D. through-and-through furcation defects
Answer: two-wall intrabony defects (osseous craters)

Q19: All of the following microorganisms are the primary colonizers in dental plaque EXCEPT one. Which
one is the EXCEPTION?
A. Streptococcus mitis
B. Actinomyces odontolyticus
C. Treponema denticola
D. Capnocytophaga gingivalis
Answer: Treponema denticola
Q20: Smokers demonstrate more orange and red microbial complexes. Smokers have an increase
in Tannerella forsythia levels.
Answer: both statements are true
Q21: Mediators produced as a part of the host response that contribute to tissue destruction include all of
the following EXCEPT one. Which one is the EXCEPTION?
A. Free radicals
B. Proteinases
C. Prostaglandins
D. Cytokines
Answer: Free radicals
Q22: Inflammation, bleeding on probing, and pocket depths are the most important diagnostic aids or signs
of gingival or periodontal disease.
The presence or absence of stippling is not diagnostic.
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
Answer: Both statements are true

Q23: In a clinically healthy periodontium, the microbial flora is largely composed of:
A. gram-negative obligate microorganisms
B. gram-negative facultative microorganisms
C. gram-positive obligate microorganisms
D. gram-positive facultative microorganisms
Answer: gram-positive facultative microorganisms
Q24: Endotoxins are the lipopolysaccharide component of the cell wall of:
A. gram-positive bacteria
B. gram-negative bacteria
C. both gram-positive and gram-negative bacteria
D. neither gram-positive and gram-negative bacteria
Answer: gram-negative bacteria
Q25: In a healthy sulcus, which of the bacteria below are most abundant?
A. Actinobacillus actinomycetemcomitans and Tannerella forsythus
B. Streptococcus and Actinomyces species
C. Treponema and Capnocytophaga species
D. Prevotella intermedia and Porphyromonas gingivalis
Answer: Streptococcus and Actinomyces species
Q26: Which of the following forms of periodontitis has been excluded from the classification of periodontal
disease at the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and
Conditions?
A. necrotizing periodontal disease
B. periodontitis as a direct manifestation of systemic diseases
C. localized aggressive periodontitis
D. periodontitis
Answer: localized aggressive periodontitis

Q27: Diseases that present clinically as desquamative gingivitis include all of the following EXCEPT one.
A. lichen planus
B. pemphigoid
C. Pemphigus vulgaris
D. leukemia
E. chronic ulcerative stomatitis
F. lupus erythematosus
Answer: leukemia
Q28: The lateral periodontal cyst is most commonly located in the midline between the maxillary central
incisors.
The lateral periodontal cyst is not the result of an inflammatory reaction.
Answer: the first statement is false, the second is true
Q29: All of the following are the characteristic features of periodontitis EXCEPT one. Which one is
the EXCEPTION?
alveolar bone loss
A. periodontal pocket
B. clinical attachment loss
C. hypertrophy of gingiva
Answer: hypertrophy of gingiva
Q30: 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
Answer: attachment loss

Q31: Gingivitis is most often caused by:
A. a hormonal imbalance
B. inadequate oral hygiene
C. occlusal trauma
D. a vitamin deficiency
E. aging
Answer: inadequate oral hygiene – this leads to the formation of bacterial plaque
and its products, which are the primary etiologic factors in gingivitis
Q32: _________ needs to be evident in making a diagnosis of periodontitis?
A. bleeding
B. pocket depths of 5 mm or more
C. radiographic evidence of bone loss
D. a change in tissue color and tone
Answer: radiographic evidence of bone loss
Q33: The degree of gingival enlargement can be scored as follows: Grade 0, Grade I, Grade II, and Grade
III. Enlargement that involves the papilla and marginal gingiva would be scored as:
A. grade 0
B. grade I
C. grade II
D. grade III
Answer: grade II
Q34: The most important plaque retentive factor is:
A. subgingival and/or overhanging margins of restorations
B. carious lesions that extend subgingivally
C. calculus
D. furcations exposed by loss of attachment and bone
E. crowded and malaligned teeth
F. root grooves and concavities
Answer: calculus
Q35: During pregnancy there is an increase in levels of both progesterone and estrogen.
The so-called pregnancy tumor should be removed as it is a true neoplasm.
Answer: the first statement is true, the second is false
Q36: Plasma cells are the predominant immune cells in which stage of gingivitis?
A. I
B. II
C. III
Answer: III
Q37: Medical conditions in which the influences of periodontal infection are documented include all of the
following EXCEPT one. Which one is the EXCEPTION?
A. coronary heart disease
B. atherosclerosis
C. stroke
D. cirrhosis of the liver
E. diabetes mellitus
F. low-birth-weight delivery
Answer: cirrhosis of the liver
Q38: The frequency of maintenance visits for a patient who has had previous periodontal treatment should
depend on which two factors?
A. on whether or not the patient feels that frequent visits will help maintain his/her periodontium
B. on the appearance and clinical condition of the gingival tissues
C. on the amount of attachment loss prior to the periodontal treatment
D. on the patient's ability to perform the proper home-care
Answer: on the appearance and clinical condition of the gingival tissues – this will determine if the
patient is maintaining adequate plaque control, on the patient's ability to perform the proper home-
care – this will determine the effectiveness of the patient's oral hygiene
Q39: If one of the steps in the fabrication of your implant restoration is attaching an analogue to the
impression post and then seating them both into the set impression material, you have made a/an:
A. open-tray impression
B. closed-tray impression
C. either of the above
D. neither of the above
Answer: closed-tray impression
Q40: An "implant level impression" means that:
A. the impression coping (or impression post) was attached to the implant
B. the impression coping was attached to the abutment
C. the impression captured or recorded the actual abutment attached to the implant
Answer: the impression coping (or impression post) was attached to the implant
Q41: Which of the following is NOT an advantage of retaining an implant-supported crown to an abutment
with a screw (rather than with cement)?
A. the crown is retrievable
B. the residual cement excess in the sulcus is avoided
C. the occlusal surface of the crown is left intact
D. a shorter abutment may be used
Answer: the occlusal surface of the crown is left intact
Q42: The purpose of the second-stage surgery in the creation of an implant restoration is to:
A. check on healing progress
B. remove the implant for cleaning
C. uncover the implant and place an abutment
D. determine which components will fit
E. all of the above
Answer: uncover the implant and place an abutment

Q43: In implantology, "countersinking" refers to the process of:
A. flaring or enlarging the coronal end of the osteotomy
B. reversing the engine to remove the implant
C. placing the implant in a counterclockwise rotation
D. torquing the abutment to place
Answer: flaring or enlarging the coronal end of the osteotomy
Q44: The "macro design" of implants describes:
A. screw or cylinder shape
B. surface texture
C. alloy composition
D. surface coatings
E. none of the above
Answer: screw or cylinder shape
Q45: The soft tissue interface between the oral tissue and titanium can be? Select all that apply.
A. established by keratinized mucosa
B. established by nonkeratinized mucosa
C. dependent on hemidesmosomes
D. comparable with the interface on teeth
Answer: • established by keratinized mucosa

• established by nonkeratinized mucosa
• dependent on hemidesmosomes
• comparable with the interface on teeth
Q46: The advantage of using a screw-shaped implant instead of a straight cylinder implant without threads
is:
A. easier osteotomy preparation
B. increased initial stability
C. less force required to insert the implant
D. no antirotational components are necessary
Answer: increased initial stability

Q47: When considering probing depths around implants and the associated attachment level, what
landmark is used to determine the "clinical" attachment level?
A. CEJ
B. apical end of the implant
C. ball tip of the probe
D. implant shoulder or other permanent physical structure
E. radiograph
Answer: implant shoulder or other permanent physical structure
Q48: If the implant-to-abutment interface consists of a permanent extension on the top of an implant and a
receptacle inside the abutment, the implant connection is categorized as:
A. an internal connection
B. an external connection
C. a cone in a socket connection
D. a nonengaging connection
E. a rotational element
Answer: an external connection
Q49: Which of the following occlusal conditions would exert the lowest amount of biting force under normal
conditions?
A. complete dentures resting on soft tissue
B. complete dentures supported by implants
C. fully dentate occlusion
D. maxillary complete denture opposing natural teeth
Answer: complete dentures resting on soft tissue
Q50: Osseointegration can fail due to:
A. occlusal overload
B. bacterial plaque
C. micromotion during healing
D. excessive cantilevering of the prosthesis
E. failure to achieve primary stability of the implant
F. all of the above

Answer: all of the above
Q51: Which of the following is/are necessary for osseointegration to be successful?
A. primary stability of the implant
B. limited micromotion during healing
C. minimization of surgical trauma
D. uncontaminated implant surfaces
E. all of the above
Q52: "Site development" for implants includes the following techniques. Select all that apply.
A. guided tissue regeneration
B. socket grafting
C. bone grafting with cow bone
D. bisphosphonate supplementation for bone density
E. orthodontic tooth movement
Answer: • guided tissue regeneration

• socket grafting
• bone grafting with cow bone
• orthodontic tooth movement
Q53: "Antirotational" element is added to an implant to:
A. prevent rotation of multiunit restorations
B. prevent rotation of the implant
C. prevent rotation of the abutment in the implant
D. prevent overtorquing of the abutment screw
E. all of the above
Answer: prevent rotation of the abutment in the implant

Q54: A radiograph should be exposed and interpreted at which of the following points during implant
placement and restoration:
A. at the end of the surgical procedure
B. following the final torque application to an abutment
C. anytime the fit or seating of a component must be verified
D. intraoperatively to verify implant position
E. all of the above
Q55: The hole that is surgically created in the bone to receive the implant body is called the:
A. osteotomy
B. bone channel
C. smokestack
D. callus core
E. chimney
Answer: osteotomy
Q56: Which of the following was/were included in the 1986 Albrektsson et al criteria for functional implant
success?
A. implant is immobile and has no periimplant radiolucency
B. bone loss is less than 0.02 mm/year after the first year of service
C. absence of persistent and/or irreversible pain, infection, paresthesia or violation of the mandibular
canal
D. success rates of at least 85% at year 5 and 80% at year 10
E. all of the above

Q57: The most common source of patient dissatisfaction with implants is:
A. pain
B. appearance
C. mobility
D. loss of osseointegration
Answer: appearance
Q58: "Direct structural and functional connection between ordered, living bone and the surface of a load-
carrying implant" is the definition of:
A. a cold weld
B. ankylosis
C. osseointegration
D. metal callous formation
Answer: osseointegration
Q59: Implants should not be treatment planned in young individuals until skeletal growth has been
completed.
A. true
B. false
Answer: true
Q60: The highest rate of implant failure occurs in
A. type 1 bone
B. type 2 bone
C. type 3 bone
D. type 4 bone
Answer: type 4 bone

Q61: In patients with normal bone and normal healing capabilities, one should anticipate dental implant
success rates of:
A. 35%
B. 50% to 60%
C. 74%
D. 90% to 95%
E. 100%
Answer: 90% to 95%
Q62: The greatest esthetic challenge for the restorative dentist occurs in the patient having a:
A. high smile line, thick periodontal biotype
B. low smile line, thin periodontal biotype
C. low smile line, thick periodontal biotype
D. high smile line, thin periodontal biotype
Answer: high smile line, thin periodontal biotype
Q63: Implants are useful for orthodontic anchorage because implants:
A. do not move in response to orthodontic forces
B. do not have a periodontal ligament
C. can be placed and later removed
D. can be located to gain force advantage
E. all of the above
Q64: Assessment of the potential implant patient should include:
A. direct palpation of the bony ridges
B. determination of any limitations of mouth opening
C. cross-sectional imaging
D. all of the above

Q65: The "anterior loop" is descriptive of the:
A. circular course of the internal maxillary artery
B. maxillary sinus extension toward the canine tooth
C. course of the inferior alveolar nerve anterior to the mental foramen
D. necessity for angled abutments
E. none of the above
Answer: course of the inferior alveolar nerve anterior to the mental foramen
Q66: At the conclusion of surgical placement of a titanium implant, complete soft tissue coverage of the
implant is required for successful osseointegration to occur.
A. true
B. false
Answer: false
Q67: Where should the healing abutment be placed at the stage II (uncovering) surgery for a two-piece
implant system?
A. approximately 1 to 2 mm "taller" than the height of the tissue
B. out of occlusion
C. radiographically confirmed as seated
D. designed to shape or mold the tissue
E. all of the above
Q68: Cross-sectional imaging is produced by all of the following EXCEPT one. Which one is the
EXCEPTION?
A. cone beam computed tomography
B. panoramic radiography
C. conventional linear tomography
D. computed tomography scans
Answer: panoramic radiography

Q69: The clinical examination of osseointegrated dental implants should include:
A. soft tissue observation
B. radiographic assessment
C. probing
D. visual inspection of implant components
E. all of the above
Q70: Which of the following dimensions is not part of routinely recommended space requirements for root
form implants?
A. a minimum of 3 mm of space between adjacent implants
B. at least 2 mm of bone remaining between the implant and vital structures
C. at least 1 mm of bone surrounding the implant in all dimensions
D. a minimum of 16 mm of implant length for stability
E. placement of the restorative platform apical to the CEJ's of adjacent teeth
Answer: a minimum of 16 mm of implant length for stability
Q71: Of the following factors, which determine(s) the abutment that the restorative dentist should select?
A. soft tissue (mucosal or gingival) height
B. interarch space
C. implant angulation
D. esthetic requirements
E. all of the above
Q72: A "Morse taper" is one of many designs for:
A. the abutment to implant connection
B. the shape of the abutment's restorative part
C. press-fit implants
D. threads on a screw implant
E. an implant milling machine
Answer: the abutment to implant connection

Q73: A "polished collar," or the smooth polished exterior surface of the implant closest to or in the oral
cavity, is designed to:
A. provide a location for epithelial attachment
B. make the exposed surface cleansable
C. keep plaque from gaining access to deeper structures
D. inhibit biofilm formation
E. all of the above
Q74: If the space available for the abutment and the crown is limited vertically, i.e., a small interarch
space, which of the following abutment combinations would be least advantageous:
A. cemented crown to the abutment
B. screw-retained crown on the abutment
C. restoration that fits to the implant with no abutment
D. abutment with a ball extension for a removable prosthesis
Answer: cemented crown to the abutment
Q75: Which of the following is NOT acceptable for cleaning of titanium surfaces, either by the patient or the
dental clinician?
A. powered toothbrushes
B. end-tufted brushes
C. plastic curettes
D. conventional ultrasonic tips
E. floss, especially multifilament varieties
Answer: conventional ultrasonic tips
Q76: Which of the following conditions is NOT a contraindication to dental implant placement?
A. current chemotherapy for the treatment of cancer
B. history of radiation therapy to the maxillofacial complex
C. dysmorphophobia
D. advanced patient age
Answer: advanced patient age

Q77: "Platform switching" refers to:
A. replacing the implant to get a better abutment selection
B. changing to a wider abutment for molar contours
C. changing to a shorter abutment to hide margins
D. matching a smaller diameter abutment with a wider diameter implant
E. converting a round abutment to triangular
Answer: matching a smaller diameter abutment with a wider diameter implant
Q78: If two adjacent implants are surgically placed too close together:
A. the patient will have difficulty cleaning the area
B. bone loss will probably occur between the implants
C. the presence of a normal papilla is unlikely
D. optimum esthetic contours will be prevented
E. all of the above
Q79: Which cells control all three stages of inflammation?
A. plasma cells
B. red blood cells
C. leukocytes
D. Sertoli cells
Answer: leukocytes
Q80: Initially, the first group of cells to arrive at the site of injury are neutrophils. Later, _________ become
more numerous. In certain parasitic infections, ________ predominate. In viral infection, ________ rather
than neutrophils usually predominate.
A. plasma cells, basophils, eosinophils
B. macrophages, eosinophils, lymphocytes
C. macrophages, lymphocytes, basophils
D. lymphocytes, macrophages, eosinophils
Answer: macrophages, eosinophils, lymphocytes

Q81: Which cells of the immune system possess receptors for the complement component (C3a and C5a)
as well as receptors for the Fc portion of the antibody molecules IgE and IgG?
A. peripheral dendritic cells
B. dermal dendrocytes (histiocytes)
C. mast cells
D. natural killer (NK) cells
Answer: mast cells
Q82: The main cells involved in chronic infection are lymphocytes and:
A. plasma cells
B. mast cells
C. neutrophils
D. macrophages
Answer: macrophages
Q83: The _________ has emerged as a unique immune cell that could be activated by many nonimmune
processes, including acute stress, and could participate in a variety of inflammatory diseases in the
nervous system, skin, joints, as well as cardiopulmonary, intestinal, and urinary systems.
A. neutrophil
B. epithelioid cell
C. mast cell
D. eosinophil
Answer: mast cell
Q84: The purposes of periodontal dressings (packs) include all of the following EXCEPT one. Which one is
the EXCEPTION?
A. stop persistent bleeding
B. maintain the sutured position of the flaps
C. improve patient comfort
D. prevent mechanical injury to healing tissues
Answer: stop persistent bleeding (all bleeding should be controlled

before the periodontal dressing is placed)
Q85: Which one of the following will increase the abrasive action of a polishing agent?
Select all that apply.
A. using an agent with nice large particles
B. using an agent containing particles that are dull and round
C. using a thick, viscous mixture of polishing paste
D. applying the polishing agent with firm pressure and increasing to a heavy constant pressure
E. polishing at a low speed with light pressure
Answer: • using an agent with nice large particles

• using a thick, viscous mixture of polishing paste
• applying the polishing agent with firm pressure
and increasing to a heavy constant pressure
Q86: Gingival fibers consist of:
A. type I collagen
B. type II collagen
C. type III collagen
D. type IV collagen
Answer: type I collagen
Q87: Microorganisms that colonize the periodontal abscess have been reported to be primarily:
A. gram-positive aerobic cocci
B. gram-negative aerobic rods
C. gram-negative anaerobic rods
D. gram-positive anaerobic cocci
Answer: gram-negative anaerobic rods

Q88: All of the following are clinical signs of bruxism EXCEPT one. Which one is the EXCEPTION?
A. TMJ symptoms
B. muscle soreness
C. periodontal pocket formation
D. cracked teeth or fillings
E. wear facets on teeth
F. widened PDL spaces on radiographs
Answer: periodontal pocket formation – periodontal pockets are inflammatory

lesions that are not caused by occlusal trauma or bruxism
Q89: All of the following are contraindications to selective grinding in the natural dentition EXCEPT one.
A. when pulp chambers are small
B. in the presence of tooth sensitivity
C. when major occlusal discrepancies may require orthodontics or full mouth reconstruction
D. in patients who are poor candidates for full mouth reconstruction because of psychologic factors
Answer: when pulp chambers are small
Q90: 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 III: restorative
E. phase IV: maintenance
Answer: preliminary phase: plaque control
Q91: Which of the following statements regarding the assessment of tooth mobility is false?
A. teeth normally have a very slight physiologic mobility
B. mobility can result from multiple causes
C. mobility is unacceptable and should be treated
D. periodontal disease can result in tooth mobility
Answer: mobility is unacceptable and should be treated

Q92: All of the following statements concerning T cells are true EXCEPT one. Which one is the
EXCEPTION?
A. antigens are recognized by T cells in association with either MHC class I or class II molecules on the
surface of the antigen-presenting cell
B. they recognize diverse antigens using a low-affinity transmembrane complex, the T-cell antigen
receptor (TCR)
C. they are subdivided based on whether they possess the co-receptors CD4 or CD8
D. they are important in humoral (antibody-mediated) immunity
Answer: they are important in humoral (antibody-mediated) immunity
Q93: The major proportion of the organic matrix of cementum is composed of:
A. Type I and Type II collagens
B. Type III and Type IV collagens
C. Type I and Type III collagens
D. Type II and Type IV collagens
Answer: Type I and Type III collagens
Q94: All of the following statements concerning cementum are true EXCEPT one. Which one is the
EXCEPTION?
A. it is produced by cells of the periodontal ligament
B. the main function is to compensate for tooth wear
C. the deposition of new cementum continues periodically throughout life whereby root fractures may be
repaired
D. the cementum is indistinguishable on radiographs
E. it is lighter in color than dentin, contains 45% to 50% inorganic substance, and its permeability
diminishes with age
Answer: the main function is to compensate for tooth wear

Q95: When occlusal forces increase in magnitude, the periodontium responds with the following changes
EXCEPT one. Which one is the EXCEPTION?
A. widening of the periodontal ligament space
B. an increase in the number of periodontal ligament fibers
C. an increase in the density of alveolar bone
D. a decrease in the width of periodontal ligament fibers
Answer: a decrease in the width of periodontal ligament fibers
Q96: 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. them any way you want to
Answer: the endodontic component first
Q97: The most common indication to splint mobile teeth is to:
A. improve patient comfort and to provide better control of the occlusion if the anterior teeth are mobile
B. improve oral hygiene
C. prevent a natural unopposed tooth from migrating
D. prevent maxillary central incisors from separating after closure of diastema
Answer: improve patient comfort and to provide better control of the occlusion if the anterior teeth
are mobile
Q98: 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
Answer: brown, black, green, or orange stains caused by chromogenic bacteria in plaque
Q99: Trauma from occlusion can produce radiographically detectable changes in all of the following
EXCEPT one. Which one is the EXCEPTION?
A. lamina dura
B. periodontal pockets
C. width of the PDL space
D. morphology of the alveolar crest
E. density of the surrounding cancellous bone
Answer: periodontal pockets
Q100: Water irrigation devices (oral irrigators) have been shown to:
A. eliminate plaque
B. clean non-adherent 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
Answer: clean non-adherent bacteria and debris from the oral cavity more effectively than
toothbrushes and mouth rinses
Q101: Abrasives:
A. compose 5% to 10% of dentifrices
B. compose 10% to 20% of dentifrices
C. compose 20% to 40% of dentifrices
D. compose 50% to 65% of dentifrices
Answer: compose 20% to 40% of dentifrices
Q102: Which component of Super Floss® is most effective in cleaning around appliances and between
wide spaces?
A. stiffened end
B. spongy floss
C. regular floss
Answer: spongy floss

Q103: The effectiveness of toothbrushing is best measured by:
A. the amount and location of plaque
B. the caries experience
C. the toothbrushing frequency
D. the condition of the toothbrush
Answer: the amount and location of plaque
Q104: To date, the ADA has accepted two agents for the treatment of gingivitis, these are:
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
Answer: • prescription solutions of chlorhexidine digluconate oral rinse

• nonprescription essential oil oral rinse
Q105: Which of the following oral hygiene aids are of primary importance in gingival massage?
A. Stim-U-Dent®
B. interproximal brushes
C. Perio-Aid® (aka "tooth pick")
D. oral irrigator
Answer: Stim-U-Dent®
Q106: Which of the following is the only local delivery system of antibiotics accepted by the ADA and is
available in the United States and a number of other countries?
A. 10% doxycycline gel
B. 2% minocycline microspheres
C. 25% metronidazole gel
D. Chlorhexidine® (2.5 mg) in gelatin matrix
Answer: 10% doxycycline gel

Q107: The attachment apparatus is composed of all of the following EXCEPT one. Which one is the
EXCEPTION?
A. periodontal ligament
B. cementum
C. alveolar bone
D. gingiva
Answer: gingiva
Q108: 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
Answer: from the mucogingival junction to the free gingival groove (base of the sulcus)
Q109: The gingival fibers consist of type I collagen.
The gingival fibers are mainly arranged in two groups.
both statements are true
A. both statements are false
B. the first statement is true, the second is false
C. the first statement is false, the second is true
Q110: 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 better than that of the periodontal ligament or
the epithelial tissue.

Q111: The principal fibers of the periodontal ligament are arranged in six groups.
The molecular configuration of collagen fibers in the periodontal ligament provides them with a tensile
strength greater than that of steel.
Q112: The length of the junctional epithelium ranges from:
A. 0.1 to 0.75 mm
B. 0.25 to 1.35 mm
C. 0.5 to 2.0 mm
D. 2.0 to 2.5 mm
Answer: 0.25 to 1.35 mm
Q113: Cervical line contours are closely related to the attachment of the gingiva at the neck of the tooth.
The greatest contour of the cervical lines and gingival attachments occur on:
A. the distal surface of anterior teeth
B. the distal surface of posterior teeth
C. the mesial surface of anterior teeth
D. the mesial surface of posterior teeth
Answer: the mesial surface of anterior teeth
Q114: The narrowest band of attached gingiva is found:
A. on the lingual surfaces of maxillary incisors and the facial surfaces of maxillary first molars
B. on the facial surfaces of mandibular second premolars and the lingual surface of canines
C. on the facial surfaces of the mandibular canine and first premolar and the lingual surfaces adjacent to
the mandibular incisors and canines
Answer: on the facial surfaces of the mandibular canine and first premolar and the lingual surfaces
adjacent to the mandibular incisors and canines
Q115: 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
Answer: buccal mucosa
Q116: 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
Answer: two-thirds inorganic matter and one-third organic matrix
Q117: ________ 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
Answer: fibroblasts
Q118: Which of the following is a source of blood supply to the gingiva? Select all that apply.
A. vessels of the periodontal ligament
B. supraperiosteal arterioles
C. arterioles from the crest of the interdental septa
Answer: • vessels of the periodontal ligament
•supraperiosteal arterioles
•arterioles from the crest of the interdental septa

Q119: Although the average width of the periodontal ligament space is documented to be about
___________, considerable variation exists.
A. 0.002 mm
B. 0.2 mm
C. 2.0 mm
D. 20 mm
Answer: 0.2 mm
Q120: 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, nonkeratinized stratified squamous epithelium without rete pegs
Answer: thin, nonkeratinized stratified squamous epithelium without rete pegs
Q121: 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
Answer: increase in the pH
Q122: The source of mineralization for supragingival calculus is:
A. desquamated epithelial cells
B. gingival crevicular fluid
C. phosphatases formed by bacterial plaque
D. saliva
Answer: saliva
Q123: Which of the following forms the major component of dental plaque?
A. materia alba
B. microorganisms
C. desquamated epithelial cells
D. minerals
Answer: microorganisms
Q124: Nearly all human oral bacteria exhibit __________, cell-to-cell recognition of genetically distinct cell
types.
A. adhesion
B. pleomorphism
C. coaggregation
D. organization
Answer: coaggregation
Q125: Specific bacteria are implicated in periodontal disease and are commonly found at the site of
infection. The Orange complex of bacteria consists of all of the following EXCEPT one. Which one is the
EXCEPTION?
A. fusobacterium
B. prevotella
C. Porphyromonas gingivalis
D. campylobacter species
Answer: Porphyromonas gingivalis
Q126: As plaque ages:
A. the number of cocci increases and the number of rods, fusiform, filaments, and spirochetes decreases
B. the number of aerobic bacteria increases and the number of anaerobic bacteria decreases
C. the number of gram-positive organisms decreases and the number of gram-negative organisms
increases
Answer: the number of gram-positive organisms decreases and the number of gram-
negative organisms increases
Q127: All of the following constitute materia alba EXCEPT one. Which one is the EXCEPTION?
A. bacteria
B. desquamated epithelial cells
C. leukocytes
D. minerals and their ions
Answer: minerals and their ions
Q128: 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
Answer: the number of osseous walls left surrounding the tooth
Q129: When evaluating an osseous defect, the only way to determine the number of walls left surrounding
the tooth is by:
A. periodontal probing
B. radiographs
C. exploratory surgery
D. testing for mobility
Answer: exploratory surgery
Q130: Which of the following is the most reliable method for determining the location and extent of
periodontal pockets?
A. probing the gingival margin
B. use of a flowable radiopaque material
C. use of scalers and curettes
D. intraoral radiography
Answer: probing the gingival margin

Q131: 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.
In intrabony pockets, the base of the pocket is coronal to the crest of the alveolar bone, and the pattern of
destruction of the underlying bone is horizontal.
Q132: Match the types of pockets on the left with their correct descriptions on the right.
• 1. Gingival pocket
• 2. Suprabony pocket
• 3. Infrabony pocket
• A. Bone loss is vertical
• B. No destruction of the supporting periodontal tissues
• C. Bone loss is horizontal
Answer: 1. B, 2. C, 3. A
Q133: Furcation involvements have been classified as grades I, II, III, and IV according to the amount of
tissue destruction. Grade III 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
Answer: total bone loss with through-and-through opening of the furcation

Q134: Drug-induced gingival enlargement consists of a pronounced hyperplasia of the connective tissue
and epithelium.
Drug-induced gingival enlargement may occur in mouths with little or no plaque and may be absent in
mouths with abundant deposits.
Q135: 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
Answer: junctional epithelium to the margin of the free gingiva
Q136: How should a periodontal probe be adapted in an interproximal area?
A. it should be parallel to the long axis of the tooth at the point angle
B. it should be parallel to the long axis of the tooth at the contact area
C. it should touch the contact area and the tip should angle slightly beneath and beyond the contact area
D. it should be perpendicular to the long axis of the tooth in front of the contact area
Answer: it should touch the contact area and the tip should angle
slightly beneath and beyond the contact area
Q137: 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
Answer: parallel to the tooth surface

Q138: If you should meet resistance after inserting the periodontal probe into the sulcus, you should:
A. remove the probe and reinsert it in a different spot
B. lift the probe away from the tooth and attempt to move it apically
C. force the probe beyond the obstruction
D. remove the probe and select one with a narrower diameter
E. record the measurement where the probe stopped
Answer: lift the probe away from the tooth and attempt to move it apically
Q139: Which of the following is the most common error when performing periodontal probing?
A. using the wrong type of probe
B. incorrectly reading the periodontal probe
C. excessively angling the probe when inserting it interproximally beyond the long axis of the tooth
D. forgetting to also probe the lingual of every tooth
Answer: excessively angling the probe when inserting it interproximally

beyond the long axis of the tooth
Q140: Toothbrush trauma (abrasion) usually occurs on:
A. centrals and laterals
B. canines and premolars
C. second and third molars
D. first and second molars
Answer: canines and premolars
Q141: The most accepted theory as to the cause of root sensitivity is the:
A. Bayer's theory
B. chemiosmotic theory
C. hydrodynamic theory
D. quantum theory
Answer: hydrodynamic theory

Q142: The most important factor in the control of hypersensitive roots among patients with periodontal
disease after gingival recession has exposed the cervical portions of teeth is:
A. prescription of home fluoride rinses
B. minimal removal of tooth structure during root planing
C. the application of desensitizing agents that contain fluoride
D. thorough daily plaque control
Answer: thorough daily plaque control
Q143: 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
Answer: a series of appointments set up to scale and root plane a segment or quadrant of teeth at
a time (thoroughly and completely)
Q144: Which of the following presents the most difficulty in performing a thorough scaling and root
planing?
A. mesial surfaces of maxillary premolars
B. proximal surfaces of mandibular incisors
C. trifurcations of maxillary molars
D. distal surfaces of mandibular molars
Answer: trifurcations of maxillary molars
Q145: 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.

Q146: The main objective of root planing 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
Answer: to remove etiologic agents from the root surface
Q147: Maximum shrinkage after gingival curettage can be expected from tissue that is:
A. fibrotic
B. edematous
C. fibroedematous
D. formed within an intrabony pocket
Answer: edematous
Q148: Ultrasonic instrumentation is accomplished with a:
A. heavy touch and light pressure, keeping the tip perpendicular to the tooth surface and constantly in
motion
B. light touch and heavy pressure, keeping the tip parallel to the tooth surface and stationary
C. light touch and light pressure, keeping the tip parallel to the tooth surface and constantly in motion
D. heavy touch and heavy pressure, keeping the tip perpendicular to the tooth surface and stationary
Answer: light touch and light pressure, keeping the tip parallel to the tooth surface and constantly
in motion
Q149: The Nabers probe is an instrument used to measure the furcation involvement in multi-rooted teeth.
When detecting an interdental crater the probe should be positioned parallel to the long axis of the tooth.
A. both statements are false
B. the first statement is true, the second is false
C. the first statement is false, the second is true
D. both statements are true

Q150: In magnetostrictive ultrasonic units, the pattern of vibration of the tip is linear.
In piezoelectric ultrasonic units, the pattern of vibration of the tip is elliptical.
Answer: both statements are false
Q151: 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 two. Which two are inappropriate?
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. turning up the power of the device
E. using less pressure
Answer: • moving the instrument slower • turning up the power of the device
Q152: Air is used to deflect the free gingival margin to detect:
A. the CEJ
B. smooth root surfaces
C. subgingival calculus
D. inflammation
Answer: subgingival calculus
Q153: The primary function of which instrument is scaling of ledges or rings of calculus?
A. hoe scalers
B. files
C. chisel scalers
D. Quétin furcation curettes
Answer: hoe scalers

Q154: While scaling subgingivally, the tip of the curette breaks off. All of the following are appropriate
actions to take to try and remove this tip EXCEPT one. Which one is the EXCEPTION?
A. use a push stroke to force the tip out of the sulcus
B. gently examine the gingival sulcus
C. take a periapical radiograph of the area
D. place the patient in an upright position
Answer: use a push stroke to force the tip out of the sulcus
Q155: It is impossible to carry out periodontal procedures efficiently with dull instruments.
A sharp instrument cuts more precisely and quickly than a dull instrument.
Q156: When sharpening, a wire edge is produced:
A. only when using a coarse artificial stone
B. when using a mounted ruby stone only
C. when no oil is used for lubrication of the stone
D. when the last stroke of the stone is drawn away from the cutting edge
Answer: when the last stroke of the stone is drawn away from the cutting edge
Q157: A curette designed to scale and root plane anterior teeth with deep pockets will have a:
A. short, straight shank
B. long, straight shank
C. short, angled shank
D. long, angled shank
Answer: long, straight shank

Q158: Which of the following instruments is best suited for root planing?
A. explorers
B. hoe
C. curette
D. ultrasonic instruments
Answer: curette

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Periodontics

A. it can be placed to prevent further recession

B. it can be used to effectively widen the attached gingiva

D. the greatest amount of shrinkage occurs within the first 6 weeks

E. it is also useful for covering nonpathologic dehiscences and fenestrations

Q2: Most root amputations involve the:

A. mandibular first and second premolars

B. maxillary first and second molars

Answer: maxillary first and second molars

Q3: The main goal of osseous recontouring (surgery) is:

A. to cure periodontal disease

B. to eliminate the existing microflora

C. to eliminate periodontal pockets

D. to change the existing microflora

C. both full-thickness and partial-thickness periodontal flaps can be displaced

E. flaps should be uniformly thin and pliable

B. apically positioned flap

D. laterally positioned flap

Answer: distal wedge

C. esthetic considerations, particularly in the anterior maxilla

D. elimination of gingival enlargements

Answer: elimination of gingival enlargements

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

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

Answer: the first statement is false, the second is true

A. free gingival graft

C. connective tissue graft

Answer: pedicle graft

Q10: What is guided tissue regeneration?

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

C. a free gingival graft used to increase the amount of attached gingiva

D. placement of an autograft to treat a bony defect

C. disruption of the vascular supply before engraftment

D. the formation of scar tissue

Answer: disruption of the vascular supply before engraftment

Q12: A variation of the laterally positioned flap is called:

A. a coronally positioned flap

B. a modified Widman flap

C. a double papilla flap

D. a free gingival flap

Answer: a double papilla flap

A. the entire papilla is incorporated in one of the flaps

B. used in cases where the flap needs to be displaced

C. used in instances of too narrow interdental spaces

D. none of the above

Answer: the entire papilla is incorporated in one of the flaps

A. coronally displaced (positioned) flap

B. laterally displaced (positioned) flap

C. double papilla flap

D. apically displaced (positioned) flap

Answer: apically displaced (positioned) flap

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

Answer: connective tissue without an epithelial covering