ABP Non-Surgical Therapy 2 — Questions and Answers
Question 1: Which systemic condition is most strongly associated with increased susceptibility to periodontal disease and poorer response to non-surgical therapy?
- Hypothyroidism
- Poorly controlled type 2 diabetes (Correct answer)
- Osteoarthritis
- Hypercholesterolemia
Correct answer: Poorly controlled type 2 diabetes
Poorly controlled diabetes impairs neutrophil function and collagen synthesis, leading to increased periodontal destruction and reduced response to non-surgical therapy.
Question 2: During SRP of a deep furcation-involved molar, which instrument is most effective for debridement of the furcation fornix?
- Gracey 11/12 curette
- Nabers probe
- Furcation curette (e.g., Younger-Good 7/8) (Correct answer)
- Universal curette (Barnhart 5/6)
Correct answer: Furcation curette (e.g., Younger-Good 7/8)
Furcation-specific curettes such as the Younger-Good 7/8 have angled shanks designed to access and debride the concave furcation fornix effectively.
Question 3: What is the primary goal of subgingival debridement during non-surgical periodontal therapy?
- Complete sterilization of the pocket
- Disruption of the subgingival biofilm and removal of calculus (Correct answer)
- Elimination of pocket depth to 1 mm
- Removal of junctional epithelium
Correct answer: Disruption of the subgingival biofilm and removal of calculus
The primary goal is disruption and removal of the subgingival biofilm and calculus to reduce the microbial challenge and allow host healing.
Question 4: Which antimicrobial agent used as an adjunct to SRP works primarily by disrupting bacterial cell membranes and denaturing proteins?
- Doxycycline
- Chlorhexidine (Correct answer)
- Metronidazole
- Azithromycin
Correct answer: Chlorhexidine
Chlorhexidine is a cationic bisbiguanide that disrupts bacterial cell membranes and denatures intracellular proteins, providing broad-spectrum antibacterial activity.
Question 5: A patient presents with generalized Stage III Grade C periodontitis and is a current smoker. Which statement best describes the expected treatment outcome after SRP?
- Outcomes are identical to non-smokers
- Smokers show significantly less clinical attachment gain and pocket reduction (Correct answer)
- Smoking only affects surgical outcomes, not SRP outcomes
- Smoking accelerates healing after SRP
Correct answer: Smokers show significantly less clinical attachment gain and pocket reduction
Smoking impairs neutrophil chemotaxis, reduces gingival blood flow, and blunts the inflammatory response, leading to significantly reduced clinical gains after SRP compared to non-smokers.
Question 6: The critical probing depth below which surgical therapy is more likely to produce additional attachment gain compared to SRP alone is generally accepted to be:
- 3 mm
- 4 mm
- 5–6 mm (Correct answer)
- 7–8 mm
Correct answer: 5–6 mm
Research (Lindhe, Serino) indicates that for pockets ≥5–6 mm, surgical therapy tends to produce greater attachment gain than SRP alone, while SRP may be superior in shallower pockets.
Question 7: Which local drug delivery agent releases doxycycline hyclate in a controlled manner directly into periodontal pockets as an adjunct to SRP?
- PerioChip (chlorhexidine gluconate chip)
- Atridox (doxycycline hyclate 10%) (Correct answer)
- Arestin (minocycline microspheres)
- Elyzol (metronidazole gel)
Correct answer: Atridox (doxycycline hyclate 10%)
Atridox is a subgingival controlled-release formulation containing 10% doxycycline hyclate in a bioresorbable polymer that is injected into periodontal pockets.
ABP Non-Surgical Therapy 2
Which systemic condition is most strongly associated with increased susceptibility to periodontal disease and poorer response to non-surgical therapy?