ADEX Periodontal Concepts 4 — Questions and Answers
Question 1: Which of the following best describes the biologic width?
- Distance from the gingival margin to the alveolar crest
- Combined length of junctional epithelium and supracrestal connective tissue attachment (Correct answer)
- Distance from the CEJ to the base of the sulcus
- Width of the attached gingiva
Correct answer: Combined length of junctional epithelium and supracrestal connective tissue attachment
Biologic width refers to the combined dimension of junctional epithelium (~1 mm) and supracrestal connective tissue attachment (~1 mm), totaling approximately 2 mm.
Question 2: A patient taking phenytoin (Dilantin) is most likely to exhibit which periodontal condition?
- Necrotizing ulcerative gingivitis
- Gingival enlargement (overgrowth) (Correct answer)
- Aggressive bone loss
- Gingival recession
Correct answer: Gingival enlargement (overgrowth)
Phenytoin causes drug-induced gingival enlargement due to increased fibroblast proliferation and altered collagen metabolism.
Question 3: What is the role of matrix metalloproteinases (MMPs) in periodontal destruction?
- They promote collagen synthesis and tissue repair
- They degrade collagen and extracellular matrix proteins in periodontal tissues (Correct answer)
- They inhibit osteoclast differentiation
- They enhance neutrophil migration into healthy sulcus
Correct answer: They degrade collagen and extracellular matrix proteins in periodontal tissues
MMPs, particularly MMP-8 and MMP-13, degrade collagen and extracellular matrix components, contributing to connective tissue destruction in periodontitis.
Question 4: Necrotizing periodontal disease is characterized by all of the following EXCEPT:
- Interdental papilla necrosis
- Fetid odor
- Painless presentation (Correct answer)
- Pseudomembrane formation
Correct answer: Painless presentation
Necrotizing periodontal diseases (NUG/NUP) are characteristically painful; pain differentiates them from other forms of periodontal disease.
Question 5: Which radiographic bone pattern is characterized by bone loss that is NOT parallel to an imaginary line drawn between the CEJ of adjacent teeth?
- Horizontal bone loss
- Vertical (angular) bone loss (Correct answer)
- Furcation bone loss
- Generalized bone loss
Correct answer: Vertical (angular) bone loss
Vertical or angular bone loss occurs at an angle to the long axis of the tooth and is typically associated with intrabony defects.
Question 6: The 'red complex' pathogens in periodontal microbiology include which combination?
- A. actinomycetemcomitans, Fusobacterium nucleatum, Campylobacter rectus
- Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola (Correct answer)
- Prevotella intermedia, Peptostreptococcus micros, Eubacterium nodatum
- Streptococcus sanguis, Actinomyces naeslundii, Veillonella parvula
Correct answer: Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola
The red complex, identified by Socransky et al., consists of Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola and is most strongly associated with severe periodontitis.
Question 7: Which of the following best describes a pseudo-pocket (false pocket)?
- Increased probing depth due to apical migration of the junctional epithelium
- Increased probing depth due to coronal enlargement of the gingival margin without loss of attachment (Correct answer)
- A pocket that forms secondary to furcation involvement
- A pocket caused by subgingival calculus deposits
Correct answer: Increased probing depth due to coronal enlargement of the gingival margin without loss of attachment
A pseudo-pocket forms when gingival enlargement increases the probing depth without actual apical migration of the junctional epithelium or loss of attachment.
ADEX Periodontal Concepts 4
Which of the following best describes the biologic width?