ADEX Periodontal Concepts 5 — Questions and Answers
Question 1: What is the significance of the mucogingival junction (MGJ) in periodontal assessment?
- It marks the coronal border of alveolar bone
- It is the boundary between attached gingiva and alveolar mucosa (Correct answer)
- It defines the depth of the gingival sulcus
- It indicates the location of the cemento-enamel junction
Correct answer: It is the boundary between attached gingiva and alveolar mucosa
The MGJ is the fixed anatomical boundary between keratinized attached gingiva and the non-keratinized, mobile alveolar mucosa.
Question 2: A patient on long-term bisphosphonate therapy for osteoporosis requires periodontal surgery. The primary concern is:
- Increased risk of gingival enlargement
- Risk of medication-related osteonecrosis of the jaw (MRONJ) (Correct answer)
- Accelerated bone regeneration post-surgery
- Reduced post-operative bleeding
Correct answer: Risk of medication-related osteonecrosis of the jaw (MRONJ)
Bisphosphonates inhibit osteoclast-mediated bone remodeling, increasing the risk of medication-related osteonecrosis of the jaw (MRONJ) following invasive procedures.
Question 3: In the 2017 AAP/EFP classification system, Grade reflects which aspect of periodontitis?
- The severity and extent of bone and attachment loss
- The rate of disease progression, risk factors, and systemic impact (Correct answer)
- The number of teeth affected
- The depth of periodontal pockets
Correct answer: The rate of disease progression, risk factors, and systemic impact
Grade (A, B, or C) describes the rate of periodontitis progression, evidence of direct and indirect risk factors, and the disease's potential systemic impact.
Question 4: Which systemic condition is associated with Papillon-Lefèvre syndrome, which causes severe early-onset periodontitis?
- Mutations in the cathepsin C gene causing neutrophil dysfunction (Correct answer)
- Hypophosphatasia causing abnormal cementum formation
- Chediak-Higashi syndrome affecting lysosomal trafficking
- Down syndrome causing altered immune response
Correct answer: Mutations in the cathepsin C gene causing neutrophil dysfunction
Papillon-Lefèvre syndrome is caused by mutations in the cathepsin C gene, leading to impaired neutrophil function and severe periodontitis beginning in primary dentition.
Question 5: Which periodontal parameter best predicts future attachment loss at a specific site?
- Probing depth alone
- BOP combined with suppuration and increased probing depth (Correct answer)
- Radiographic bone level
- Plaque index score
Correct answer: BOP combined with suppuration and increased probing depth
The combination of BOP, suppuration, and increased probing depth at the same site is the strongest clinical predictor of active disease and future attachment loss.
Question 6: During periodontal maintenance, what is the primary goal of deplaquing subgingival surfaces?
- Complete elimination of all periodontal bacteria
- Disruption of the subgingival biofilm to allow host defenses to control residual bacteria (Correct answer)
- Removal of all calculus to prevent pocket reformation
- Stimulation of cementum regeneration
Correct answer: Disruption of the subgingival biofilm to allow host defenses to control residual bacteria
The goal is biofilm disruption to shift the microbial environment toward health-compatible species, allowing the host immune system to manage remaining bacteria.
Question 7: Which of the following correctly describes the difference between gingivitis and periodontitis?
- Gingivitis involves bone loss; periodontitis involves only soft tissue inflammation
- Gingivitis is irreversible; periodontitis is reversible with treatment
- Gingivitis is limited to the gingiva with no attachment loss; periodontitis involves irreversible loss of the supporting apparatus (Correct answer)
- Both conditions involve the same histopathologic changes
Correct answer: Gingivitis is limited to the gingiva with no attachment loss; periodontitis involves irreversible loss of the supporting apparatus
Gingivitis is confined to the gingiva and is fully reversible, while periodontitis involves irreversible destruction of the PDL, alveolar bone, and cementum.
ADEX Periodontal Concepts 5
What is the significance of the mucogingival junction (MGJ) in periodontal assessment?