AGD Periodontics and Gum Disease 5 — Questions and Answers
Question 1: In the 2017 classification system, Grade C periodontitis (rapid progression) is indicated by evidence of:
- Probing depths greater than 6 mm on posterior teeth
- Bone loss exceeding 2% per year or heavy biofilm inconsistent with the destruction observed (Correct answer)
- Furcation Class III involvement on multiple teeth
- Tooth loss exceeding 4 teeth due to periodontitis
Correct answer: Bone loss exceeding 2% per year or heavy biofilm inconsistent with the destruction observed
Grade C uses primary criteria such as bone loss >2% per year or the presence of heavy risk factors (smoking ≥10 cigs/day, HbA1c ≥7%) and secondary criteria of destruction inconsistent with biofilm levels.
Question 2: Which of the following best describes the rationale for placing a resorbable membrane versus a non-resorbable membrane in GTR?
- Resorbable membranes provide better space maintenance due to their rigidity
- Non-resorbable membranes require a second surgery for removal but may offer superior space maintenance (Correct answer)
- Resorbable membranes are always preferred because they achieve higher bone fill
- Non-resorbable membranes degrade faster and cause less inflammation
Correct answer: Non-resorbable membranes require a second surgery for removal but may offer superior space maintenance
Non-resorbable membranes (e.g., expanded PTFE) require removal at a second surgery but can provide more predictable space maintenance; resorbable membranes eliminate the second surgery at the cost of variable resorption rates.
Question 3: Necrotizing ulcerative gingivitis (NUG) is distinguished from other forms of gingivitis by the presence of:
- Generalized horizontal bone loss
- Interproximal necrosis, pseudomembrane, and fetid odor without attachment loss (Correct answer)
- Deep periodontal pockets with suppuration
- Gingival hyperplasia with minimal bleeding
Correct answer: Interproximal necrosis, pseudomembrane, and fetid odor without attachment loss
NUG presents with punched-out interdental papillae covered by a gray pseudomembrane, spontaneous bleeding, fetid odor, and pain but no attachment loss (unlike necrotizing periodontitis).
Question 4: Platelet-rich fibrin (PRF) enhances periodontal wound healing primarily by:
- Acting as an antibiotic carrier reducing bacterial load
- Releasing autologous growth factors (PDGF, VEGF, TGF-β) that stimulate cell proliferation and angiogenesis (Correct answer)
- Providing a rigid scaffold for immediate bone regeneration
- Suppressing the inflammatory response through corticosteroid release
Correct answer: Releasing autologous growth factors (PDGF, VEGF, TGF-β) that stimulate cell proliferation and angiogenesis
PRF is an autologous fibrin matrix rich in platelets and leukocytes that releases growth factors promoting angiogenesis, cell migration, and tissue regeneration at the wound site.
Question 5: Which of the following best describes a one-wall intrabony defect?
- Three bony walls surround the defect with the root as the fourth wall
- Only one remaining bony wall exists adjacent to the defect (Correct answer)
- The defect involves only the cortical plate without trabecular involvement
- The root is the sole boundary of the defect with no remaining bony walls
Correct answer: Only one remaining bony wall exists adjacent to the defect
A one-wall defect has only one remaining bone wall (plus the root surface), making it the least favorable for regeneration because of the limited bony envelope.
Question 6: The primary goal of occlusal adjustment in periodontal therapy is to:
- Eliminate all non-working-side contacts
- Reduce traumatic occlusal forces that may accelerate bone loss in periodontally compromised teeth (Correct answer)
- Establish centric relation occlusion in all patients
- Prevent temporomandibular joint disorders
Correct answer: Reduce traumatic occlusal forces that may accelerate bone loss in periodontally compromised teeth
Occlusal adjustment in periodontics aims to eliminate excessive forces (primary or secondary occlusal trauma) on teeth with reduced periodontium to slow disease progression.
Question 7: Which index measures the percentage of tooth surfaces with plaque present, scored on a per-surface basis without distinguishing plaque thickness?
- Quigley-Hein Plaque Index
- O'Leary Plaque Control Record (Correct answer)
- Löe-Silness Gingival Index
- Russell Periodontal Index
Correct answer: O'Leary Plaque Control Record
The O'Leary Plaque Control Record scores four surfaces of each tooth as plaque-present or absent and calculates the percentage of surfaces with plaque, making it ideal for patient motivation and home care assessment.
AGD Periodontics and Gum Disease 5
In the 2017 classification system, Grade C periodontitis (rapid progression) is indicated by evidence of: