ABO ABO Periodontics and Interdisciplinary Treatment 2 — Questions and Answers
Question 1: An orthodontic patient develops localized gingival enlargement (fibrous hyperplasia) around brackets. The FIRST step in management is:
- Immediate surgical excision of hyperplastic tissue
- Improved oral hygiene instruction and professional plaque removal (Correct answer)
- Changing to ceramic brackets
- Prescribing antibiotics
Correct answer: Improved oral hygiene instruction and professional plaque removal
Plaque-induced gingival hyperplasia during orthodontic treatment is reversible with proper oral hygiene; improved hygiene should be the first intervention.
Question 2: Root resorption during orthodontic treatment is most commonly detected using:
- Periodontal probing
- Periapical radiographs or CBCT (Correct answer)
- Clinical crown length measurements
- Pulp vitality testing
Correct answer: Periapical radiographs or CBCT
Periapical radiographs reveal root length changes due to resorption, and CBCT provides three-dimensional detail of root morphology and resorption extent.
Question 3: Which orthodontic tooth movement has the highest risk of root resorption?
- Molar rotation
- Upper incisor intrusion and torque (Correct answer)
- Posterior crossbite correction
- Molar mesialization
Correct answer: Upper incisor intrusion and torque
Upper incisor intrusion combined with palatal root torque applies prolonged apical forces that are strongly associated with external root resorption.
Question 4: Gingivectomy prior to orthodontic treatment may be indicated for a patient with:
- Gingival recession
- Gingival enlargement causing pseudopocket formation that impairs bracket placement (Correct answer)
- Bone loss on periapical radiograph
- Missing teeth requiring space opening
Correct answer: Gingival enlargement causing pseudopocket formation that impairs bracket placement
Enlarged gingival tissue can cover the clinical crown and interfere with bracket positioning, making pre-orthodontic gingivectomy beneficial.
Question 5: When planning orthodontic treatment for a patient with missing teeth, the orthodontist must consider the restorative space requirements because:
- All missing teeth must be replaced with implants
- Final space distribution determines restorative options (implant, bridge, or closure) (Correct answer)
- Missing teeth always require extraction of contralateral teeth
- Bridges are always preferred over implants
Correct answer: Final space distribution determines restorative options (implant, bridge, or closure)
The amount and location of space created or maintained orthodontically must meet the biometric requirements for the planned restoration type.
Question 6: Orthodontic tooth movement into a site of previous tooth loss with significant alveolar ridge deficiency may result in:
- Complete bone regeneration
- Fenestration or dehiscence if moved beyond the alveolar housing (Correct answer)
- Permanent tooth color change
- Increased crown length only
Correct answer: Fenestration or dehiscence if moved beyond the alveolar housing
Moving a tooth beyond the available alveolar bone envelope risks creating a fenestration (window in bone) or dehiscence (loss of facial bone plate).
ABO ABO Periodontics and Interdisciplinary Treatment 2
An orthodontic patient develops localized gingival enlargement (fibrous hyperplasia) around brackets.
The FIRST step in management is: