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Name Seat #

Write your name on your Scantron scoring sheet.

DAPE 722 - Year II Periodontology Second Examination April 15, 2010 Hoag Hall

Neal W. Roller, D.D.S., M.S.

Multiple Choice (2.5 points each)

1. What percentage of mandibular molars has enamel projections?

A. 3% B. 7% C. 19% D. 29%

2. Williams et al in 2001 compared Scaling and Root Planing (SRP) alone to SRP plus

minocycline microspheres and found greater mean probing depth reduction in the group where Minocycline was used. The difference between the two groups was:

A. .24 mm B. .34 mm C. .44 mm D. 1.34 mm E. 1.44 mm

3. In an article by Becker et al., (Journal of Periodontology 1984), patients who declined Periodontal Maintenance (Supportive Periodontal Treatment) were evaluated for periodontal health. The article concluded:

A. Maintenance is needed every 3 months in most periodontal patients. B. Maintenance outcomes improved when chlorhexidine was applied

during ultrasonic instrumentation. C. Periodontal treatment without maintenance is ineffective in restoring

periodontal health. D. All of the above 4. Which of the following statements about toothbrushes are true?

A. The manner in which a brush is used and the abrasiveness of the dentifrice affects abrasion to a greater degree than the bristle hardness.

B. The toothbrush first appeared about the year 1800 in China C. Current data indicates that certain brush designs are superior to others. D. None of the above are true E. All of the above are true.

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5. Necrotizing ulcerative gingivitis (NUG):

A. Has a genetic predisposition. B. Will demonstrate spirochetes infiltrating connective tissue. C. Can result in permanent contour changes to the gingiva. D. A and B only. E. B and C only.

6. Supragingival plaque control

A. Treats and prevents gingivitis B. Affects the growth and composition of subgingival plaque thereby favoring a

healthier microflora C. Reduces calculus formation D. A and B only E. All of the above

7. In the 1965 Harold Low study:

A. The relationship between periodontal disease and dental plaque was established. B. The use of a toothbrush to stimulate the gingiva, thereby increasing blood flow was supported. C. The role of specific periodontal pathogens, unique to each participant, was demonstrated. D. All of the above are true. E. None of the above is true.

8. Which one of the following is a rare motile organism involved in periodontitis:

A. Pi Provetella Intermedia B. Tf Tannerella Forsythus C. Ec Eikenella Corrodens D. Cr Campylobacter Rectus E. Fn Fusobacterium Nucleatum

9. Chlorhexidine in a mouthwash has the following characteristics. A. Deeply penetrates dental biofilm. B. Does not produce bacterial resistance C. Is just as effective subgingival as supragingival D. A and B only E. B and C only

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10. In which of the following LDD systems must the delivery vehicle be removed a week after placement?

A. Actisite B. Elyzol C. Dentomycin D. PerioChip 11. What is the dosage of Doxycycline used in Periostat? A. 10 mg B. 20 mg C. 50 mg D. 100 mg 12. The face of a universal curette is a (at a) _________ to the lower shank when seen in

cross section from the tip. A. 45 to 90 degree angle B. 90 degree angle C. 45 degree angle D. 70 degree angle 13. The Gracey curettes in your clinical kit A. are designed to be very rigid B. have an offset blade C. are used with the instrument handle parallel to the long axis of the tooth D. A and B only E. all of the above are true 14. Your patient returns following several sessions of scaling and root planing. The home

care is adequate. What would be the most likely cause for persistent bleeding upon probing?

A. toothbrush trauma B. allergic reaction to a dentifrice C. calculus left on the root surface D. an unrecognized systemic condition E. mouth breathing

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15. Which of the following procedures are not routinely performed at each Periodontal Maintenance visit?

A. Radiographs B. Plaque evaluation C. Review of medical history D. Removal of all existing dental plaque E. Subgingival debridement of periodontal pockers

Short Answer (Point Values As Indicated)

1. In J. Perio. 1998, a study by Marjorie Jeffcoat was published evaluating Perio Chip (5 points)

A. What is the active ingredient in Perio Chip? CHLORHEXIDINE

B. At nine months, what was the difference in probing depth in patients with scaling and root planing alone, and scaling and root planing with the chip? 0.30_ mm.

C. How much time was spent on the initial scaling and root planing? HOUR

D. Was additional scaling and root planing performed at the 6 week and 3, 6,

and 9 month recalls? YES NO

E. Above what probing depth was the chip replaced at 3 and 6 months? _5_mm

2. Where would you use a plastic periodontal instrument? (2 points) IMPLANTS 3. The Bass tooth brushing technique places the bristles at the gingival margin,

pointing at a _45_ degree angle to the long axis of the tooth. (2 points) 4. Clinical findings that would indicate periodontal re-treatment are: (4 points) A. Attachment loss > 2mm. B. Persistent bleeding sites C. Increased tooth mobility

D. Radiographic evidence of additional bone loss

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5. Which power brush works by pulsation, rotation and oscillation? Oral B. (2 points) 6. In suggesting Plackers to your patient, list three important points to demonstrate: (3 points) A. keep the device horizontal

B. put slight pressure on the tooth and move up and down not, in and out C. it takes several movements to adequately remove the biofilm

(do not cross over the papilla) 7. Although root smoothness is the criterion by which scaling and root planing are

immediately evaluated, the ultimate evaluation is based on Tissue Response. (2 points) 8. Name three categories of drugs that are most associated with gingival enlargement:

(3 points) A. Anticonvulsants

B. Immunosuppressants C. Calcium channel blockers

9. In evaluating a full mouth series of radiographs, the more accurate appearance of the

crestal lamina dura and the interproximal bone is seen on (circle) bite-wing or periapical films. (2 points)

10. Only about _50_% of the oral microbiota can be grown in the laboratory by using

modern cultivation techniques. It is highly likely that the other, yet-to-be cultivated microorganisms are of etiologic importance or play important roles in biofilm ecology. JADA Sept. 09. (2 points)

11. What does the MyPerioID-PST test identify from the patients DNA?

Interleukin-1 genotype (2 points) 12. Candidiasis has been implicated in what clinical finding in AIDS associated NUP?

Linear Gingival Erythema. (2 points)

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13. The PSR probe is darkened (colored black) from 3.5 mm to 5.5 mm. (2 points) 14. Clinically what is the difference between scaling and root planing? (3 points) Scaling removes plaque and calculus with short powerful strokes whereas root planing removes residual calculus and smoothes the root surface using less pressure with more rapid, longer and multidirectional strokes. 15. What does RDA signify when evaluating toothpaste? (2 points) Radioactive Dentin Abrasion measures toothpaste abrasiveness. 16. Dentin abrades 25 times faster and cementum 35 times faster than enamel, thus a

concern when root surfaces are exposed. (2 points) 17. Is root planing always performed subgingival? (2 points)

YES 18. Name two different ingredients in mouthwashes that directly effect volatile sulfur

compounds thereby assist in controlling halitosis: (2 points) A. Zinc Salts B. Chlorine Dioxide 19. What are the two active ingredients in Crest pro-health . (be specific).

(2 points) A. stannous fluoride

B. CPC

20. According to the table in your textbook, a patient in periodontal maintenance will be in Class A when: (2 points)

A. The patient displays good oral hygiene, minimal calculus, no occlusal problems, no

complicated prostheses, no remaining pockets, and no teeth with less than 50% of alveolar bone remaining.

And B. Excellent results well maintained for 1 year or more.

21. In a study by Goodson et al in 2007, Arestin was evaluated for its ability to reduce Red

Complex Bacteria (RCB) in patients with periodontitis. At baseline, 14% of the periodontal bacteria were RCB. Thirty days after treatment, subjects treated with SRP alone had 10 % RBC, compared to 7% for those who received SRP plus Arestin.

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(2 points) 22. In 2005 Bonito et al evaluated the impact of local adjuncts to SRP in Periodontal Disease

Therapy. They found 50 articles that met their strict criteria and reported 5 results as discussed in class. What were the two conclusions of this review article? (3 points)

A. Supportive and follow-up care as well as self-care, may well affect the long-term periodontal status of patients as much if not more than the use of adjuncts to SRP. B. Dentist must determine if the results are clinically significant and worth the cost and added effort. 23. The facial of #28 has 3 mm of recession, 10 mm of attached gingiva and 12 mm of

keratinized gingiva. What is the attachment loss on this tooth? 5 mm. (3 points) 24. Data from 27 different studies indicated a probing depth reduction of 1.29 mm in cases

of moderate periodontitis. (2 points) 25. Name the two periodontal scalers in your instrument kit: (3points) A. SIU 13/14 B. SIU FW 204 26. Give a guideline for instrument ADAPTATION during scaling and root planing: (2 points) The lower third of the working end must be kept in contact with the tooth.

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