ADEX Periodontal Instrumentation and Care 5 — Questions and Answers
Question 1: A patient is in supportive periodontal therapy (SPT) with stable 4 mm pockets and no bleeding on probing. The recommended maintenance interval is MOST likely:
- Every 3–4 months (Correct answer)
- Every 6 months
- Every 12 months
- Every 2 months
Correct answer: Every 3–4 months
Patients in SPT typically require 3–4 month intervals to prevent re-colonization of pathogenic bacteria and disease recurrence.
Question 2: Which furcation classification indicates that a furcation can be completely negotiated by a probe through to the opposite side?
- Class I
- Class II
- Class III (Correct answer)
- Class IV
Correct answer: Class III
Class III furcation involvement means the probe passes completely through the furcation from one side to the other.
Question 3: When adapting a curette to the mesial surface of a maxillary first molar from the facial approach, the clinician should position the instrument so the:
- Face of the blade points away from the tooth surface
- Toe of the blade points toward the mesial contact area and adapts at 45–90 degrees (Correct answer)
- Heel of the blade leads the working stroke
- Blade is positioned at 0–30 degrees to the tooth surface
Correct answer: Toe of the blade points toward the mesial contact area and adapts at 45–90 degrees
Pointing the toe toward the mesial surface and maintaining proper angulation ensures the cutting edge engages calculus without tissue trauma.
Question 4: The primary reason for using a modified pen grasp during periodontal instrumentation is to:
- Increase grip strength for heavy calculus removal
- Provide tactile sensitivity and controlled lateral pressure (Correct answer)
- Prevent carpal tunnel syndrome by reducing wrist movement
- Allow use of both cutting edges of universal curettes simultaneously
Correct answer: Provide tactile sensitivity and controlled lateral pressure
The modified pen grasp distributes grip across three fingers, enhancing tactile feedback and precise control of lateral pressure.
Question 5: Which of the following statements about periodontal maintenance for a patient with a history of aggressive periodontitis is CORRECT?
- Maintenance is less critical because aggressive periodontitis resolves after initial therapy
- More frequent maintenance intervals and adjunctive antibiotics may be indicated (Correct answer)
- Only annual maintenance is required once pocket depths are stable
- Patients with aggressive periodontitis do not respond to non-surgical therapy
Correct answer: More frequent maintenance intervals and adjunctive antibiotics may be indicated
Aggressive periodontitis patients are at high risk for recurrence and may benefit from more frequent SPT and systemic antibiotic adjuncts.
Question 6: An ultrasonic insert tip designed for use in periodontal pockets is recognized by its:
- Large diameter and blunt end for safety
- Slender, elongated design allowing subgingival access to narrow pockets (Correct answer)
- Curved arc shape identical to a Gracey curette
- Textured surface to improve grip during scaling
Correct answer: Slender, elongated design allowing subgingival access to narrow pockets
Slim-profile periodontal insert tips are designed to access deep, narrow pockets while minimizing tissue trauma.
Question 7: During SRP, the clinician detects a 'catch' sensation during an exploratory stroke. This MOST likely indicates:
- The instrument is properly adapted on smooth root surface
- Presence of residual calculus or a root irregularity (Correct answer)
- The curette tip has fractured
- Normal resistance from the junctional epithelium
Correct answer: Presence of residual calculus or a root irregularity
A tactile 'catch' during an explorer or curette stroke typically signals residual calculus or a root surface irregularity requiring further instrumentation.
ADEX Periodontal Instrumentation and Care 5
A patient is in supportive periodontal therapy (SPT) with stable 4 mm pockets and no bleeding on probing.
The recommended maintenance interval is MOST likely: