DAPE 721 Year II; Periodontics I 8:00 – 9:50 AM Mid-Term Examination 9/04/2009
NAME __________________________ _____________________________ ___ SEAT NO _____________
Multiple Choice Questions: 50 Questions @ 2 Points Each 1.
The periodontal ligament is composed of 80 percent _________ collagen. A) B) C) D) E)
2.
Type V Type IV Type III Type II Type I
The width of the attached gingiva is an important clinical parameter in evaluating periodontal treatment outcome. The width of the attached gingiva primarily corresponds to the width of the free marginal gingiva. A) B) C) D)
Both statements are true. Both statements are false. The first statement is true and the second statement false. The first statement is false and the second statement is true.
3. Idiopathic gingival fibromatosis is primarily associated with: A) B) C) D) E) 4.
Plaque Genetics Medications A and B A only
The Lamina densa within the epithelial attachment is primarily composed of which collagen fiber type? A) B) C) D)
Type I Type 11 Type III Type IV
5.
The epithelial mitotic cell turnover rate is highest within __________. A) B) C) D)
Oral sulcular epithelium Keratinized gingiva Epidermis of skin Junctional epithelium
6. The primary secretion secretion by junction epithelial epithelial cells that provides adherence to the tooth root surface is _____________. A) Hydroxyglycine B) Laminin C) Fibrinogen D) Glycine E) None of the above 7. Which of the following statements accurately inter-relates the tooth and periodontium interface? 1. Junctional epithelial cells are oriented parallel to the root surface. 2. Periodontal ligament fibers insert in cementum and bone biochemically through fibronectin. 3. The junctional epithelial cells are non-secreting cells. 4. The Lamina densa primarily contains hemidesmosomal plaques. 5. Polymorphonuclear leukocytes can pass between junctional epithelium cells into the gingival sulcus/pocket. A) B) C) D) 8.
1, 2, 3, 4, 5 1, 3, 4 1, 2, 5 2, 3, 5
In the presence of abundant plaque formation, hyperplastic gingivitis can be associated with which of the following? 1. 2. 3. 4. 5. A) B) C) D) E)
Mouth breathing Cyclosporine Procardia Pregnancy Phenytoin
1, 2, 3, 4, 5 2, 3, 4, 5 2, 3,5 2 and 5 4 and 5
9.
In periodontal disease, loss of which of the following fiber bundles are primarily associated in preventing the progressive downward proliferation of the junctional epithelium into the periodontal ligament and alveolar bone?
A) B) C) D)
10.
The “looping” within the vasculature of the free gingival margin is indicative of: A) B) C) D)
11.
Junctional cells Internal basement membrane Collagen fibers External basement membrane All of the above
In the (Stage IV) advanced periodontal lesion, collagen fiber lysis is advanced permitting downward proliferation of the epithelial attachment on the root surface. The marginal gingival lamina propria is heavily infiltrated by plasma cells. A) B) C) D)
13.
Connective tissue pull upon the vasculature Capillary anastomosis within vasculature Leukocyte margination within vasculature Rapid collagen turnover within the connective tissue.
Glycosaminoglycans and/or glycoproteins are associated with which of the following gingival / periodontal histologic structures? A) B) C) D) E)
12.
Transseptal Circular Interradicular Alveolar gingival
Both statements statements are true. Both statements are false. The first statement is is true and the second statement statement false. The first statement is false and the second statement statement is true.
Macrophages contained within the periodontium function as which of the following? A) B) C) D) E)
Phagocytosis Collagen destruction enzymes Initiation of T-Cell production B and C All of the above
14.
The alveolar bone proper is also termed as which of the following? 1. 2. 3. 4. 5. A) B) C) D) E)
15.
Synthesis of glycoproteins Phagocytosis of collagen Secretion of trophocollagen Collagenase secretion All of the above
The periodontal ligament fiber bundle that least protects the tooth and alveolar bone during centric axial forces is which of the following? A) B) C) D)
17.
1, 2, 3, 4, 5 1, 3, 4 2, 4, 5 3, and 5 4 only
Depending upon its local periodontal environment, the fibroblast can function in which of the following? A) B) C) D) E)
16.
Cribriform plate Sharpey’s plate Lamina dura Bundle bone Trabecular bone
Horizontal Alveolar crestal Obique Apical
The predominant immune cell of Initial Lesion, (Stage I), gingivitis, is the: A) B) C) D) E)
NK lymphocyte Plasma cell Polymorphonuclear leukocyte T-lymphocyte B-Lymphocyte
18.
A 27 year-old male presents to your office with the following signs: loss of interdental and marginal stippling, blue-red tissue color, the junctional epithelium at the CEJ, and bleeding upon gentle probing. Your diagnosis is __________________. A) B) C) D) E)
19.
In gingivitis, (Stage II), the predominant cell is the plasma cell. Numerous plasma cells become phagocytic causing destruction of the horizontal and oblique fibers of the periodontal ligament. A) B) C) D)
20.
Free gingival margins Interdental grooves McCall’s festoones Stillman clefts
In periodontal health the gingival sulcus primarily contains the following contents with the exception of: A) B) C) D)
22.
Both answers are true. Both answers are false. The first statement is true and the second is false. The first statement is false and the second is true.
Linear-to-curved facial indentations that originate from the apex of the free gingival margin and extend parallel to the root surface in an apical direction are termed: A) B) C) D)
21.
Gingival recession Systemic infection Advanced periodontal disease, (perodontitis) Melanin pigmentation Chronic gingivitis
Desquamated epithelial cells PMN’s Transudate RBC’s
The oral mucous consists of which of the following? A. B. C. D. E.
Attached gingival Alveolar mucosa Free gingival margin Mucogingival junction All of the above
23.
In health and good tooth alignment, the width of the keratinized gingiva is primarily narrowest on the facial/ buccal of which of the following teeth? A) B) C) D)
24.
The space bounded by the tooth and free gingiva, and having the Junctional epithelium at its base is termed: A) B) C) D) E)
25.
Interdental groove Mucogingival junction Free gingival groove Gingival sulcus Interdental papillae
The basic function of the gingival fiber groups (apparatus) is to maintain the free gingiva and junctional epithelium in close approximation to the tooth. The gingival epithelium lamina propria is similar to other tissues of the body (i.e., consists of fibroblasts, mesenchymal cells, mast cells, and macrophages). A) B) C) D)
26.
Maxillary lateral incisor Mandibular second molar Mandibular first premolar Maxillary canine
Both answers are true. Both answers are false. The first statement is true and the second is false. The first statement is false and the second is true.
Which of the following parameters are indicative of gingival health? A) B) C) D)
27.
Bleeding upon probing Gingival enlargement Inverted interdental gingival contours Firm consistency of gingival margin
A stippled appearance is normal to the attached gingiva. This stippling is caused by projections of elastic fiber bundles into the papillary layer of the lamina propria, which elevate the epithelium into rounded prominences that alternate with indentations of the epithelium. A) B) C) D)
Both answers are true. Both answers are false. The first statement is true and the second is false. The first statement is false and the second is true.
28.
In the adult periodontium, the junctional epithelium: A) B) C) D)
29.
Recession of junctional cells apical from the CEJ, is related to which of the ollowing? A) B) C) D) E)
30.
Endosteal arterioles and capillaries Periosteal arterioles and capillaries Interdental artery Crevicular plexus
The periodontal ligament is capable of transmitting tactile pressure and pain sensations by the trigeminal nerve pathways. The sense of localization during closure is imparted through the high elastic fiber co ntent of the periodontal ligament. A) B) C) D)
32.
Position of the tooth in the arch Infection associated with plaque Calculus formation Toothbrush trauma All of the above
The blood vessels within the connective tissue adjacent the junctional epithelium are named: A) B) C) D)
31.
have fewer hemidesmosomes coronally the junctional cells are 1-2 cell thick does not secrete glycoprpteins or glycoaminoglycans during all stages of eruption, the junctional cell adhesion is limited to the CEJ.
Both answers are true. Both answers are false. The first statement is true and the second is false. The first statement is false and the second is true.
Bundle bone is named because of which of the following reasons?
A) B) C) D) E)
The formation of multiple lacunae within alveolar cortical bone. The site of embedded Sharpey’s fibers. The incorporation of intrinsic fibers within the alveolar bone proper. Collagen arrangement within trabecular spaces. Remnents of cementum deposition in the alveolar bone proper.
33.
Generally, acellular cementum is not: A) B) C) D) E)
34.
The dento-gingival unit is a “dynamic structure”. This refers to which of the following? A) B) C) D) E)
35.
Advancing periodontal disease Position of the tooth in the arch Mucogingival involvement caused by frenum pull Occlusal traumatism All of the above
Tooth # 24 has 3mm. of exposed lingual root as measured by a probe from the CEJ to the free gingival margin. Your periodontal diagnosis is: A) B) C) D) E)
37.
Remodels bone and cementum Adapts to compensatory eruption Permits mesial drift of the tooth Performs a formative function All of the above
Gingival recession may be associated with which of the following? A) B) C) D) E)
36.
Is not replaced when root planed to dentin Is associated with supragingival calculus Primarily involved in root ankylosis Is laid down in appositional layers Is formed before the tooth erupts into the oral cavity
Gingivitis Fenestration Gingival enlargement Gingival abscess Recession
With recession, which of the following best describes ACTUAL POSITION? A) B) C) D) E)
The level of the crest of the gingival margin on the tooth. The level of the epithelial attachment on the tooth. The depth of the gingival sulcus or periodontal pocket. Measured by use of the periodontal probe B and D
38.
Generalized diffuse gingivitis includes the following periodontal tissue: A) B) C) D) E)
39.
During an acute gingival inflammatory response, which of the following cell types can destroy virulent bacteria by phagocytosis and T-cell mediation? A) B) C) D) E)
40.
Attached gingiva Interdental gingiva Marginal gingiva Alveolar mucosa All of the above
Plasma cell Mast cell B-Lymphocyte Macrophage Polymorphonuclear leukocyte
In health, mesial drift results in changes within periodontal alveolar bone; these changes are best described as: 1. osteoclastic activity and loss of collagen on the pressure side. 2. necrosis and osteoclastic activity on the tension side. 3. Osteoblastic activity and collagen formation/mineralization on the tension side. 4. cementoblastic and collagen mineralization on the pressure side. 5. apical osteoblastic ankylosis. A) B) C) D) E)
41.
1, 2, 5 1 and 2 1 and 3 3 and 4 3, 4, 5
In health, the color of the attached gingiva is blue-red in color. This color of the healthy attached gingiva is produced by the vascular supply, thickness of the keratinized epithelium, and/or the presence of pigmentation. A) B) C) D)
Both answers are true. Both answers are false. The first statement is true and the second is false. The first statement is false and the second is true.
42.
A fenestration primarily occurs: 1. 2. 3. 4.
A) B) C) D) E) 43.
5-10 % 30-50 % 60-65 % over 65 %
Enamel projections can extend varying distances from the dentoenamel junction to the mid-facial furcation areas. An epithelial attachment associated with these enamel pearls is potentially weaker than a comparable epithelial attachment on cementum. A) B) C) D)
45.
1, 2, 3, 4 1 and 3 2 and 3 3 and 4 1 only
Clinical research reports that ____________of erupted teeth have a partial absence of cervical cementum forming a space of exposed dentin. This exposed dentin space may be associated with an increased incidence of caries and root sensitivity. A) B) C) D)
44.
In lingual bone rather than facial bone. Where facial buttressing bone is heavy apically. Where a root is facially prominent in the arch. Where the denuded root area is located apical to the marginal bone.
Both answers are true. Both answers are false. The first statement is true and the second is false. The first statement is false and the second is true.
Gingival bleeding with gentle probing may be associated with which of the following? A) B) C) D) E)
Chronic gingivitis Overzealous tooth brushing Leukemias Violation of the biologic width All of the above
46.
In periodontal health, the distance between the epithelial attachment to the crest of the alveolar bone remains relatively constant at 2 .04 mm. As the epithelial attachment moves apically in periodontal disease, the crest of the alveolar bone is resorbed in attempt to re-establish this 2.04 mm distance. A) B) C) D)
47.
Which of the following histologic structures are generally absent within the periodontal ligament? A) B) C) D) E)
48.
Both answers are true. Both answers are false. The first statement is true and the second is false. The first statement is false and the second is true.
angioblasts and undifferentiated cells mylenated nerve fibers interstitial spaces fibronectin mature elastic fibers
Remodeling of the periodontal ligament and bone by fibroblasts, cemenoblasts, osteoblasts, and osteoclasts is an example of ______________ cellular function? A) Physical B) Formative C) Sensory D) Anatomical E) None of the above
49.
Tooth number 25 has a nonkeratinized gingival margin and probes 5 mm loss of attachment from the CEJ. There is facial alveolar a lveolar mucosal elastic pull associated the pull of the mandibular labial frenum. These presented diagnostic findings are consistent with a diagnosis of: A) Hyperplatic gingivitis B) Gingival recession C) Mucogingival defect D) None of the above
50.
Tooth number 14 has been without an antagonist for 18 months. You place a mandibular bridge from teeth numbers 18 – 20, restoring occlusal function to number 14. Histologic changes within the periodontium of tooth number 14 now include: 1. 2. 3. 4.
A functional periodontal ligament space. Decreased density within supporting bone. Increased density of the alveolar bone proper. Reorganization, formation, and orientation of periodontal fiber groups. 5. Deposition of acellular cementum. A) B) C) D) E)
1, 2, 3, 4, 5 1, 3, 4 2, 3, 4, 5 2 and 3 1 only
