ABP Evaluations 2 — Questions and Answers
Question 1: When evaluating a patient for periodontal surgery, which radiographic feature most strongly contraindicates an osseous resective procedure?
- Vertical bone defects exceeding 3 mm (Correct answer)
- Furcation involvement Class II on a maxillary molar
- Horizontal bone loss limited to the crestal region
- Interproximal calculus below the alveolar crest
Correct answer: Vertical bone defects exceeding 3 mm
Vertical (angular) bone defects are better managed with regenerative approaches rather than osseous resection, which would sacrifice additional bone.
Question 2: A patient presents with a probing depth of 5 mm and bleeding on probing at site #14 mesial. Radiographically, there is 2 mm of horizontal bone loss. What is the most accurate classification for this defect?
- Stage I Grade A
- Stage II Grade B (Correct answer)
- Stage III Grade B
- Stage II Grade A
Correct answer: Stage II Grade B
Stage II is indicated by probing depths 4–5 mm with 15–33% bone loss, and Grade B reflects moderate rate of progression without systemic modifiers.
Question 3: Which clinical parameter is most predictive of tooth loss over time during periodontal maintenance evaluation?
- Full-mouth plaque score above 30%
- Residual probing depth ≥6 mm after active therapy (Correct answer)
- Bleeding on probing at more than 25% of sites
- Furcation involvement Class I on mandibular molars
Correct answer: Residual probing depth ≥6 mm after active therapy
Residual probing depths ≥6 mm after active periodontal therapy are the strongest clinical predictor of future attachment loss and tooth loss.
Question 4: During a re-evaluation 8 weeks after scaling and root planing, which finding would most indicate the need for surgical intervention?
- Reduction of pocket depth from 7 mm to 5 mm
- Bleeding on probing at 15% of sites
- Persistent probing depths of 6 mm with no attachment gain (Correct answer)
- Generalized plaque score of 25%
Correct answer: Persistent probing depths of 6 mm with no attachment gain
Persistent deep pockets without clinical attachment gain after thorough non-surgical therapy indicate that surgical access is necessary.
Question 5: Which parameter is used in the 2017 AAP/EFP classification to distinguish generalized from localized periodontitis?
- Number of teeth involved (more than 2 non-adjacent teeth) (Correct answer)
- Presence of furcation involvement on any tooth
- Full-mouth bleeding on probing above 20%
- Bone loss exceeding 1 mm at more than 5 sites
Correct answer: Number of teeth involved (more than 2 non-adjacent teeth)
Generalized periodontitis is defined as involvement of more than 2 non-adjacent teeth; localized involves ≤2 non-adjacent teeth or a molar-incisor pattern.
Question 6: When evaluating furcation involvement of a maxillary first molar, which probe is specifically recommended for assessing the palatal furcation?
- Straight WHO probe
- Nabers 1N probe from the mesio-palatal approach (Correct answer)
- Nabers 2N probe from the buccal approach
- UNC-15 probe from the distal approach
Correct answer: Nabers 1N probe from the mesio-palatal approach
The Nabers 1N curved probe inserted from the mesio-palatal line angle is the standard approach for accessing the palatal furcation of maxillary molars.
Question 7: A patient with poorly controlled type 2 diabetes (HbA1c = 9.5%) presents with Stage III periodontitis. According to ABP guidelines, how does this affect Grade assignment?
- It has no effect on grade if bone loss pattern is horizontal
- It upgrades the case to Grade C regardless of bone loss rate
- It modifies Grade B to Grade C due to a primary risk factor (Correct answer)
- It only affects staging, not grading
Correct answer: It modifies Grade B to Grade C due to a primary risk factor
Poorly controlled diabetes (HbA1c ≥7%) is a Grade modifier that can upgrade a case from Grade B to Grade C due to increased risk of rapid progression.
ABP Evaluations 2
When evaluating a patient for periodontal surgery, which radiographic feature most strongly contraindicates an osseous resective procedure?