ABP Surgical Procedures 3 — Questions and Answers
Question 1: Which instrument is specifically designed to remove calculus from furcation areas during periodontal surgery?
- Columbia 13/14 curette
- Gracey 11/12 curette
- Nabers probe
- Younger-Good 7/8 curette (Correct answer)
Correct answer: Younger-Good 7/8 curette
The Younger-Good 7/8 curette has an angulated shank that allows access to furcation areas and interproximal surfaces during surgical debridement.
Question 2: In guided bone regeneration (GBR), the primary function of the membrane is to:
- Deliver growth factors directly to the defect
- Exclude epithelial and connective tissue cells from the regenerating space (Correct answer)
- Provide a scaffold for osteoblast attachment
- Accelerate angiogenesis in the defect
Correct answer: Exclude epithelial and connective tissue cells from the regenerating space
GBR membranes act as barriers to prevent fast-proliferating epithelial and connective tissue cells from occupying the space needed for slower bone-forming cells.
Question 3: After a free gingival graft, the graft undergoes 'plasmatic circulation' during approximately which time period?
- 0–24 hours
- 24–72 hours (Correct answer)
- 4–7 days
- 7–14 days
Correct answer: 24–72 hours
During the first 24–72 hours, the graft survives via plasmatic diffusion from the recipient bed before revascularization (inosculaton) occurs.
Question 4: The 'trap door' or 'tunnel' technique for subepithelial connective tissue grafting is advantageous primarily because:
- It allows harvesting a thicker graft
- It avoids a releasing incision, preserving papillary blood supply (Correct answer)
- It provides greater root coverage than envelope techniques
- It requires no suturing of the graft
Correct answer: It avoids a releasing incision, preserving papillary blood supply
The tunnel technique avoids vertical releasing incisions, maintaining intact papillary blood supply and reducing scar formation while covering multiple recession defects.
Question 5: Semilunar coronally positioned flap is best indicated for which clinical situation?
- Multiple adjacent recession defects greater than 3 mm
- Miller Class I or II recession with adequate keratinized tissue width (Correct answer)
- Deep infrabony defects requiring regeneration
- Severe recession with loss of papilla height
Correct answer: Miller Class I or II recession with adequate keratinized tissue width
The semilunar technique is appropriate for shallow Miller Class I or II defects where adequate keratinized tissue exists, as it does not increase the zone of keratinized tissue.
Question 6: Which of the following local anesthetics is most commonly used for periodontal surgery due to its vasoconstrictive properties prolonging duration?
- 3% mepivacaine plain
- 4% prilocaine plain
- 2% lidocaine with 1:100,000 epinephrine (Correct answer)
- 0.5% bupivacaine plain
Correct answer: 2% lidocaine with 1:100,000 epinephrine
2% lidocaine with 1:100,000 epinephrine provides reliable anesthesia for 60–90 minutes and reduces surgical bleeding via vasoconstriction, making it the standard for periodontal surgery.
Question 7: When placing an implant in immediate extraction socket, which factor most increases the risk of failure?
- Patient age over 50
- Presence of active periapical or periodontal infection at the extraction site (Correct answer)
- Use of a narrow-diameter implant
- Single-stage versus two-stage placement
Correct answer: Presence of active periapical or periodontal infection at the extraction site
Active infection at the implant site is a contraindication for immediate placement, as bacteria compromise osseointegration and significantly increase implant failure risk.
ABP Surgical Procedures 3
Which instrument is specifically designed to remove calculus from furcation areas during periodontal surgery?