Make up examination
Christina Wrobel
April 2005
Multiple Choice Questions.
1. Which term best describes the technique that would be used to reduce a
large buccal exostosis in the area of tooth #6?
A.
B.
C.
D.
Osteoplasty
Ostectomy
Debridement
Vertical Grooving
2. Osseous Resection involves several steps. Which steps are purely
osteoplastic techniques that do not remove supporting bone?
A.
B.
C.
D.
E.
Gradualizing marginal bone
Radicular blending
Flattening Interproximal Bone
B and C only
none of the above
3. Which commercial product utilizes a protein derived from porcinie tooth
buds for periodontal regenerative procedures?
A.
B.
C.
D.
E.
Interpore®
HTR®
Atrisorb®
Emdogain®
Capset®
4. On the facial surface of teeth 20 through 22 there is probing depths less
than 3 mm, slight gingival inflammation as noted by bleeding upon probing
and no gingival recession. Alveolar mucosa is acting as the marginal
gingiva. What is the treatment of choice in this area?
A.
B.
C.
D.
E.
Coronally displaced flap
Connective tissue autograft
Free gingival graft
Laterally positioned flap
Apically displaced flap
5. The following statements can be made regarding periodontal regeneration
procedures.
A.
B.
C.
D.
E.
It is better to graft an infrabony defect than not grafting.
Following acceptable regenerative procedures you can expect a
mean defect fill of approximately 90% in most cases.
Allografts, Zenografts and non-bone products have all
demonstrated periodontal regeneration.
A and B only
B and C only
6. When evaluating a tooth for surgical crown lengthening, you need to
evaluate the root trunk. If the root trunk is less than normal, a possible
problem during the crown lengthening procedure would be:
A.
B.
C.
D.
E.
Pulpal exposure
Increased chance of tooth sensitivity
Inability to remove adequate bone to restore the biologic width
Increased chance of root fracture
Furcation exposure
7. A 50-year-old male presents with deep fibrotic pockets and significant
vertical bony defects. The dentist reflects a flap, debrides the narrow two
and three walled defects, and performs scaling and root planing. Which
procedure should the dentist do next?
A.
B.
C.
D.
Osseous grafts
Osseous resection to obtain an ideal bone contour
Coronally position the tissues and suture
Apically position the tissue and suture
8. The common goal of a periodontal flap procedure is to
A.
B.
C.
D.
remove diseased sulcular epithelium.
remove diseased granulation tissue.
provide access for instrumentation.
add bone support where it has been lost.
9. The initial incision for a Gingivectomy is made apical to which structure?
A.
B.
C.
D.
The crest of bone
The junctional epithelium
The periodontal ligament
The mucogingival junction
10. A patient with 1-2 mm probing depths needs 4mm of crown lengthening.
Which is the best surgical procedure to accomplish the crown lengthening
surgery?
A.
B.
C.
D.
Osseous surgery with apically positioned flap
Gingivectomy
Modified ENAP
Modified Widman
11. A Modified Widman flap would be indicated when the goal of therapy is to
provide:
A.
B.
C.
D.
complete pocket elimination.
regeneration of the periodontium.
access to root surfaces for thorough debridement.
increased keratinized tissue.
12. Grade three furcations can be managed by
A. using a polytetrafluoroethylene membrane to enhance bone
regeneration.
B. root resection or hemisection.
C. recalls and attention to plaque removal.
D. B and C only
E. All of the above
13. Guided tissue regeneration works by
A. favoring repopulation of the area by cells from the periodontal
ligament and the bone
B. blocking the downgrowth of epithelium.
C. destroying migrating epithelial cells.
D. inhibiting the maturation of epithelial and connective tissue cells.
E. A and B only
14. Calcium phosphate biomaterials have been used since the mid 1970s as
a graft material. These products
A.
B.
C.
D.
have excellent tissue compatibility.
are osteoinductive.
elicit a foreign body response.
All of the above
15. What is the main difference in the Apically Positioned Flap procedure and
the Modified Widman procedure?
A.
B.
C.
D.
E.
the initial incision
the final position of the flap margin
the utilization of a post-operative periodontal dressing
the degree of root instrumentation
A and B only
16. Under what circumstances would you not use a partial thickness flap?
A.
B.
C.
D.
E.
the presence of hyperkeratosis
the presence of thick tissue
a patient with diabetes
a patient with an allergy to the material in periodontal dressings
none of the above
17. Which of the following technique(s) surgically remove the pocket wall?
A.
B.
C.
D.
E.
The apically displaced flap
The gingivectomy
The undisplaced flap
A and B only
B and C only
18. Guided tissue regeneration is best used for which classification of
furcation defect?
A.
B.
C.
D.
class one
class two
class three
class four (no tissue in furcation)
19. A healthy 60 year old patient with fibrotic gingiva, deep pockets, and
multiple bone defects undergoes periodontal surgery. You reflect the
tissue debride the two- and three-walled defects, scale and root plane.
What is the next immediate step?
A. treat the adjacent bone with citric acid and place a bone graft
B. treat the adjacent bone with tetracycline and place an occlusive
membrane
C. decortification of the adjacent bone and placement of a bone graft
D. any of the above procedures are acceptable
20. Which of the following characterizes a freeze-dried bone allograft?
A.
B.
C.
D.
21.
It is usually rejected by the host.
It is exfoliated after a short time.
It contains viable cells with osteogenic potential.
It is eventually replaced by the host bone.
Deep periodontal pockets are often treated by access flap. Successful
cases result in reduction of pocket depth, even if there is no change in
the position of gingival margins. In these cases, the reduced pocket
depth most likely results from
A. rekeratinization of pocket epithelium.
B. formation of a long junctional epithelium.
C. formation of new bone, cementum and periodontal ligament.
D. formation of new collagen fibers that attach the gingiva to root
surfaces.
22. Alloderm® is an acellular dermal matrix graft that
A.
B.
C.
D.
E.
Is immunologically inert
Contains a variety of hydrophobic proteins known as amelogenins
Has been associated with the formation of acellular cementum
Contains a Type 1 collagen binding site known as P-15
C and D only
23. Apical migration of the epithelial attachment with corresponding
recession of the marginal gingiva results in
A.
B.
C.
D.
no pocket formation.
gingival pocket formation.
infrabony pocket formation.
periodontal pocket formation.
24. Freeze dried bone allografts:
A. Are best used with particle size less than 250 microns.
B. Are treated with hydrochloric acid to inhibit the bone inductive
proteins.
C. Are normally not decalcified when used for ridge augmentation or
extraction site fill.
D. Have been known to transmit viral disease.
E. All of the above
25. Which of the following are likely to occur if marginal bone over a facial root
surface is left exposed during healing?
1.)
2.)
3.)
4.)
5.)
Healing will be delayed.
The site will heal with residual pockets.
The gingival margin will recede.
After healing, resultant tissue will be nonkeratinized.
The bone will be subjected to more resorption than if it had been
covered by the flap.
A.
B.
C.
D.
E.
1, 2, and 5
1, 3, and 4
1, 3, and 5
2, 4, and 5
3, 4, and 5
26. Which of the following has the greatest impact on success of pocket
reduction surgery?
A.
B.
C.
D.
E.
type of initial incision
complete debridement of the root surface
position of the flap at closure
postoperative width of attached gingiva
C and D only
27. A patient has an isolated 8 mm. pocket and incipient furcation
involvement at the distal aspect of the maxillary right second molar. This
tooth is the only distal abutment for a four-unit bridge. Clinical inspection
reveals an enamel pearl (2 mm. in diameter) located 5 mm. apical to the
gingival margin. This site should be treated by
A. extraction.
B. scaling and root planing at six-month intervals.
C. resection of the palatal root followed by regular recall appointments.
D. flap surgery and odontoplasty followed by regular recall
appointments.
E. flap surgery and bone grafting followed by regular recall
appointments.
28. The distance from the marginal gingiva to the mucogingival junction is
5mm and the probing depth in this area is 7mm. Which of the following
treatment is acceptable treatment?
A.
B.
C.
D.
a soft tissue autograft
an apically positioned flap
a laterally positioned flap
a double papillae flap
29. In order to apically position a surgical flap, you must
A.
B.
C.
D.
E.
remove all the attached gingiva.
reflect the flap past the mucogingival junction.
reduce some radicular bone.
use a partial thickness flap reflection.
suture the flap with periosteal sutures
30. Positive Bone Architecture refers to
A. alveolar bone with a distinct crestal lamina dura on radiographs
B. alveolar bone that is more apical interdentally than facially or
lingually.
C. alveolar bone that has undergone even resorption over a long
period of time.
D. a bone pattern that results after osseous grafting.
E. none of the above
31. Periodontal bony defects which offer the best possibility for bone
regeneration are classified as
A.
B.
C.
D.
interproximal crater.
one-wall infrabony.
two-wall infrabony.
three-wall infrabony.
32. Tooth #25 has a buccal mucogingival defect associated with 3mm of
recession. Some possible dental problems associated with this area are
A.
B.
C.
D.
root caries.
tooth sensitivity.
esthetics.
all of the above.
33. Vertical incisions should be made at
A.
B.
C.
D.
E.
the middle of the tooth.
the middle of a papilla.
at the line angle of a tooth.
A and C
A and B
34. Which of the following refers to bone fragments obtained by a bur from
such areas as exostoses or thick bone ledges during a surgical
procedure?
A.
B.
C.
D.
bone blend
osseous coagulum
trephination
bone allocation
35. Which suturing technique is best utilized with the distal wedge procedure?
A.
B.
C.
D.
E.
the horizontal mattress suture
the vertical mattress suture
the interrupted figure eight suture
the anchor suture
the continuous sling suture
36. Why is a periodontal dressing used after a surgical procedure?
A.
B.
C.
D.
to hold the tissues in their final position
to keep dental plaque from forming at the surgical site
to protect the tissues from trauma from mastication
all of the above
37. During wound healing, which cell type has the quickest proliferation rate?
A.
B.
C.
D.
Osteoblast
Cementoblast
Gingival fibroblast
Gingival epithelium
38. Why would you want to augment an area of minimal or no attached
gingiva?
A.
B.
C.
D.
to minimize the chance of additional recession.
to improve access for removing plaque
to stabilize the area if a subgingival crown margin is needed
all of the above
39. Palatal tissue requires unique management during periodontal surgery
because
A. the mucogingival junction is located more apical
B. the tissue is often very thin and requires careful management
C. the tissue can't be positioned apically
D. None of the above
40..
Which of the following methods is the most accurate for
determining that new attachment and bone regeneration has occurred?
A.
B.
C.
D.
radiographic methods
surgical re-entry
careful clinical probing
histologic methods
41. You are performing a guided tissue regeneration on tooth #19 with a
buccal class two furcation involvement. Which of the following
circumstances would enhance regeneration in this area?
A.
B.
C.
D.
E.
short root trunk
a large vertical component to the furcation
a large horizontal component to the furcation
low or minimal interproximal bone
a combination of B and C
42. What is the term used to describe the condition where there is only one
wall of bone remaining in a periodontal defect?
A.
B.
C.
D.
Hemiseptal defect
Moat defect
Trough
Osseous crater
43. The difference between gingival curettage and subgingival curettage
involves the removal of
A.
B.
C.
D.
sulcular epithelium
granulation tissue.
junctional epithelium.
A and B only
44. The most effective and efficient way to perform subgingival curettage
would be:
A.
B.
C.
D.
Using a sharp curette
Performing the modified excisional new attachment procedure
Using a ultrasonic instrument
Placing caustic drugs subgingivally
45. The facial surface of tooth #8 has 9 mm of keratinized gingiva, a probing
depth of 5 mm, and 2 mm of gingival recession. How much attached
gingiva is in this area?
A. 14 mm
B. 4 mm
C. 3 mm
D. 7 mm
E. You can’t determine the amount of keratinized gingiva from the
above information.
46. The papilla preservation flap is utilized
A.
B.
C.
D.
When it is difficult to suture palatal tissue
Because of its simplicity of execution
During regenerative periodontal procedures
All of the above
47. When performing a crown lengthening procedure there is a difference
when you are working in the posterior region with a crown margin
supragingival and when you are working in the anterior region with the
crown margin subgingival because:
A. the final sutured tissue position is different
B. the final bone contours will not be ideal in the posterior region.
C. you will need to wait different time periods before taking
impressions
D. A and C only
E. All of the above
48. Failure to perform crown lengthening when indicated can lead to the
following concerns:
A.
B.
C.
D.
E.
chronic gingival inflammation
pain when probing or pain in the gingiva
localized periodontitis
A and C only
all of the above
49. McClain and Schallhorn in 1993 reported the following 5 year results.
A.
B.
C.
D.
E.
Guided tissue regeneration (GTR)was a failure in smokers
GTR was not enhanced with root conditioning
GTR was enhanced when GTR was combined with bone grafting
GTR was more successful in older patients
B and C only
50. Which of the following is considered the most conservative approach in
treating periodontitis?
A.
B.
C.
D.
the Modified Widman Flap
Interdental denudation
the apically displaced (positioned) flap
a full flap with mesial and distal vertical releasing incisions
51. Which of the following procedures can be considered an internal beveled
gingivectomy?
A.
B.
C.
D.
E.
the papillary preservation flap
the semilunar flap
the modified Widman flap
the undisplaced flap
an apically positioned flap
52. If you anticipate a bony dehiscence or fenestration is present, the best
approach would be:
A.
B.
C.
D.
E.
utilizing a full thickness flap
utilizing a partial thickness flap
suturing the flap with very thin (5-0) silk suture
suturing the flap with a very thin absorbable suture
placing the patient on an antibiotic to prevent bone infection
53. Freeze dried bone allografts are decalcified because
A.
B.
C.
D.
E.
the product is made safer.
calcium activates the complement system
without decalcification the product is difficult to manipulate.
all of the above.
none of the above
__________________________________
54. In the anterior region of the mouth why would you do a Modified
Widman Flap rather than an apically displaced flap?
55. List and briefly describe the four steps in osseous resection as mentioned
in the textbook.