Question 1

Jim's periodontal screening and recording score for sextants 1 through 6 are as follows: 3,2,3,4,2,2.What is the course of action?

Accepted Answer

The periodontal screening and recording score indicates the presence of moderate or severe periodontitis in multiple sextants, so a full periodontal evaluation is required to assess the severity and extent of the disease and to develop an appropriate treatment plan.

Question 2

Which of the following is NOT a part of the comprehensive periodontal evaluation?

Accepted Answer

Decay is not a part of the comprehensive periodontal evaluation as it is related to dental caries (cavities) which affects the tooth structure rather than the supporting gum tissues. The other options- probing depths, mobility, and furcation- are all important parameters evaluated in a comprehensive periodontal evaluation to assess the health of the gums and supporting bone.

Question 3

True periodontal pockets are a result of

Accepted Answer

Periodontal pockets are formed when the junctional epithelium migrates apically, creating a deeper space between the tooth and the gingival tissues. This can lead to the accumulation of bacteria and other debris, which can cause inflammation and further destruction of the periodontal tissues. Enlargement of gingival tissues (A) may occur in response to inflammation, but it does not directly result in the formation of periodontal pockets. Apical migration of the sulcular epithelium (B) is a normal process that occurs as the gingival tissues adapt to the presence of a toothbrush or other oral hygiene instrument, but it does not result in the formation of true periodontal pockets. Apical migration of the oral epithelium (D) is not a normal process and would not result in periodontal pockets.

Question 4

All periodontitis begins as gingivitis,but not all gingivitis progresses to periodontitis.Therefore,the progression of the disease should not be assumed to be linear.

Accepted Answer

The first statement is accurate because periodontitis is indeed a progression from gingivitis, which is the initial inflammation of the gums. The second statement is also true because not all cases of gingivitis will advance to periodontitis, indicating that the progression from gingivitis to periodontitis is not guaranteed or linear for every individual.

Question 5

Which of the following make up the attachment apparatus?

Accepted Answer

The attachment apparatus is made up of the alveolar bone, periodontal ligament, and cementum.

Question 6

Your patient demonstrates generalized probe depths of 3 to 4 mm,with localized areas of bleeding on probing.There is generalized gingival recession of 2 to 3 mm and class II furcation involvement on teeth 3,14,15,and 31.The periodontal case type is

Accepted Answer

The presence of class II furcation involvement on multiple teeth and generalized gingival recession with localized bleeding on probing indicates a more severe periodontal disease. This corresponds to a class III periodontal case type according to the American Academy of Periodontology classification system.

Question 7

Ends of the periodontal ligament fibers that are embedded in the cementum and alveolar bone describe

Accepted Answer

Sharpey's fibers are the ends of the periodontal ligament fibers that are embedded in the cementum and alveolar bone.

Question 8

Periodontal screening and recording is a quick and easy screening tool used to eliminate the need for comprehensive periodontal evaluations.The mouth is divided into six sextants and a single code is recorded for each sextant based on the highest code number achieved for that sextant.

Accepted Answer

The first statement is false because periodontal screening and recording (PSR) does not eliminate the need for comprehensive periodontal evaluations; it is used to determine if such an evaluation is necessary. The second statement is true as it accurately describes the PSR process.

Question 9

If the migration of the junctional epithelium is above the crest of the alveolar bone,the pocket is an infrabony periodontal pocket.If the migration of the junction epithelium is below the alveolar bone crest,it is a suprabony periodontal pocket.

Accepted Answer

Both statements are false. An infrabony pocket occurs when the junctional epithelium migrates below the crest of the alveolar bone, while a suprabony pocket occurs when it migrates above the crest.

Question 10

Which of the following is NOT keratinized tissue?

Accepted Answer

The junctional epithelium is a non-keratinized tissue that lines the base of the gingival sulcus. The attached gingiva, hard palate, and labial aspect of the free gingiva are all keratinized tissues.

Question 11

Which of the following is a principal fiber group?

Accepted Answer

The circular fiber group is a principal fiber group of the periodontal ligament, which plays a key role in attaching the teeth to the surrounding alveolar bone and maintaining the integrity of the gingival margin.

Question 12

Movement of a tooth greater than 2 mm in a facial-lingual direction is indicative of what type of mobility?

Accepted Answer

Class III mobility is indicated by movement of a tooth greater than 2 mm in any direction or vertical displacement in the socket, which signifies severe mobility.

Question 13

The distance between the junctional epithelium and the cementoenamel junction yields a reading for the

Accepted Answer

The distance between the junctional epithelium and the cementoenamel junction (CEJ) yields a reading for the clinical attachment level (CAL), which measures the amount of attachment loss of the periodontal tissues. This is an important indicator of periodontal disease progression and helps determine the appropriate treatment approach. Pocket depth (A) measures the depth of the periodontal pocket and is important in determining the severity of periodontal disease. The width of attached gingiva (B) is measured by the distance from the gingival margin to the mucogingival junction and is important in determining the potential for recession and implant placement. The mucogingival junction level (D) is the boundary between the attached gingiva and the alveolar mucosa and is important in determining the potential for recession and aesthetic procedures.

Question 14

Which of the following classifications is used to classify a probe passing completely through a furcation when the entrance to the furcation is not visible?

Accepted Answer

Class III is used to classify a probe passing completely through a furcation when the entrance to the furcation is not visible. Class I is used when the probe does not pass into the furcation, Class II is used when the probe passes through the entrance of the furcation but does not pass completely through, and Class IV is used when the furcation is clinically visible.

Question 15

Although bleeding on probing (BOP)has not been found to be a good predictor of future disease progression,the absence of BOP is typically viewed as a good indicator of gingival health and stability.It should be noted that the absence of BOP is indicative of health or absence of disease,especially in patients who smoke.

Accepted Answer

BOP is not a good predictor of future disease progression, but the absence of BOP is typically viewed as a good indicator of gingival health and stability. However, the absence of BOP may not necessarily indicate health in patients who smoke, meaning the second statement is false. Therefore, the correct choice is C.

Question 16

Which of the following is the proper way to calculate the width of attached gingiva?

Accepted Answer

The width of attached gingiva is calculated by subtracting the probing depth from the total width of gingiva, which is measured from the free gingival margin to the mucogingival junction.

Question 17

Which of the following is the single best indicator of periodontal support?

Accepted Answer

Clinical attachment level (CAL) is the distance from the cementoenamel junction (CEJ) to the base of the sulcus or periodontal pocket. It reflects the amount of periodontal support around a tooth and is considered the best overall indicator of periodontal health. Radiographs, probing depths, and mobility are also important clinical parameters in periodontal evaluation but are not as accurate or reliable as CAL for determining the extent of periodontal damage.

Question 18

Healthy sulcus depths range from 0.5 to 3.0 mm.However,for implants the desired probing depth is between 4 and 5 mm.

Accepted Answer

The first statement is true because healthy sulcus depths range from 0.5 to 3.0 mm. The second statement is also true because for implants the desired probing depth is between 4 and 5 mm.

Question 19

When completing the periodontal assessment,the Naber's probe indicated complete bone loss resulting in a through-and-through opening in the furcation without visualization on tooth #14.What furcation grade does this describe?

Accepted Answer

Complete bone loss resulting in a through-and-through opening in the furcation without visualization is indicative of Grade III furcation involvement. Grades I and II involve less severe bone loss, while Grade IV involves complete passage through the furcation with visualization from the buccal and lingual aspects.

Question 20

Furcation involvement should be suspected when the clinical attachment level on a multi-rooted tooth is at least

Accepted Answer

Furcation involvement is suspected when the clinical attachment level on a multi-rooted tooth is at least 5 mm. This is because the furcation is the area where the roots of a tooth meet, and it is a common site for periodontal disease. When the clinical attachment level is at least 5 mm, it means that the periodontal disease has progressed to the point where it is affecting the furcation.

Quiz 11: The Periodontal Examination