AGD Periodontics and Gum Disease 3 — Questions and Answers
Question 1: A free gingival graft is harvested primarily from which intraoral donor site?
- Buccal mucosa adjacent to the defect
- Hard palate (Correct answer)
- Retromolar pad
- Maxillary tuberosity
Correct answer: Hard palate
The hard palate provides keratinized epithelium and connective tissue ideal for free gingival grafts to increase the zone of attached gingiva.
Question 2: Which radiographic bone loss pattern is most characteristic of localized aggressive periodontitis affecting first molars?
- Horizontal bone loss
- Arc-shaped (arcuate) vertical bone loss (Correct answer)
- Generalized horizontal crestal resorption
- Diffuse trabecular pattern loss
Correct answer: Arc-shaped (arcuate) vertical bone loss
Localized aggressive periodontitis classically shows an arc-shaped vertical bone loss pattern on the mesial and distal aspects of first molars.
Question 3: The biologic width is defined as the combined measurement of:
- Sulcus depth and junctional epithelium
- Junctional epithelium and supracrestal connective tissue attachment (Correct answer)
- Free gingival margin and alveolar crest distance
- Probing depth and attached gingiva width
Correct answer: Junctional epithelium and supracrestal connective tissue attachment
Biologic width consists of junctional epithelium (~0.97 mm) plus supracrestal connective tissue (~1.07 mm), totaling approximately 2 mm.
Question 4: Which antibiotic regimen is specifically recommended as an adjunct for treating aggressive periodontitis caused by A. actinomycetemcomitans?
- Doxycycline monotherapy
- Amoxicillin plus metronidazole (Correct answer)
- Clindamycin monotherapy
- Azithromycin monotherapy
Correct answer: Amoxicillin plus metronidazole
The combination of amoxicillin and metronidazole has strong evidence as an adjunct to scaling and root planing for aggressive periodontitis, particularly against A. actinomycetemcomitans.
Question 5: Guided tissue regeneration (GTR) uses a membrane to:
- Stimulate new bone formation through osteoinduction
- Exclude epithelium and gingival connective tissue from the healing wound (Correct answer)
- Deliver growth factors directly to the defect
- Protect the root surface from bacterial recolonization
Correct answer: Exclude epithelium and gingival connective tissue from the healing wound
GTR membranes act as physical barriers that exclude fast-growing epithelial and connective tissue cells, allowing slower-growing PDL and bone cells to repopulate the defect.
Question 6: Which condition is characterized by pronounced gingival inflammation with pseudopockets but no true attachment loss?
- Chronic periodontitis
- Aggressive periodontitis
- Gingivitis (Correct answer)
- Periodontitis as a manifestation of systemic disease
Correct answer: Gingivitis
Gingivitis features inflamed, edematous gingiva that may form pseudopockets due to tissue swelling, but there is no apical migration of the junctional epithelium or true attachment loss.
Question 7: The Papilla Preservation Technique (PPT) in periodontal surgery is primarily designed to:
- Improve access to subgingival calculus deposits
- Maintain interdental papilla for better esthetic outcomes and wound closure (Correct answer)
- Reduce postoperative bleeding by avoiding papilla incisions
- Enable osseous recontouring of interproximal defects
Correct answer: Maintain interdental papilla for better esthetic outcomes and wound closure
The PPT keeps the interdental papilla intact by redirecting incisions, preserving esthetics and achieving primary closure over interdental bone defects, especially important in the anterior region.
AGD Periodontics and Gum Disease 3
A free gingival graft is harvested primarily from which intraoral donor site?