AGD Periodontics and Gum Health 4 — Questions and Answers
Question 1: Which parameter is used in the 2017 AAP/EFP staging and grading system to indicate rate of periodontitis progression?
- Stage (I–IV)
- Grade (A–C) (Correct answer)
- Extent (localized/generalized)
- Severity (mild/moderate/severe)
Correct answer: Grade (A–C)
Grade (A = slow, B = moderate, C = rapid) reflects the rate of periodontitis progression based on direct and indirect evidence.
Question 2: Enamel projections and enamel pearls are significant in periodontal disease because they:
- Increase root surface area for attachment
- Preclude connective tissue attachment, facilitating furcation involvement (Correct answer)
- Strengthen the cementoenamel junction
- Reduce bacterial colonization
Correct answer: Preclude connective tissue attachment, facilitating furcation involvement
Enamel projections extending toward furcations prevent normal periodontal fiber attachment, making those areas susceptible to furcation disease.
Question 3: A patient with well-controlled Type 1 diabetes and Stage III periodontitis is classified as Grade:
- Grade A
- Grade B (Correct answer)
- Grade C
- Cannot be determined without additional data
Correct answer: Grade B
Well-controlled diabetes is a grade modifier that upgrades the patient to at least Grade B due to the systemic risk factor.
Question 4: Which radiographic bone pattern is MOST favorable for periodontal regeneration?
- Horizontal bone loss
- Three-wall infrabony defect (Correct answer)
- One-wall infrabony defect
- Furcation Class III involvement
Correct answer: Three-wall infrabony defect
Three-wall infrabony defects provide three bony walls to support regenerative materials and act as a scaffold, yielding the best regenerative outcomes.
Question 5: Gingival hyperplasia is a known side effect of all of the following medications EXCEPT:
- Phenytoin
- Cyclosporine
- Nifedipine
- Metformin (Correct answer)
Correct answer: Metformin
Metformin (an antidiabetic drug) does not cause gingival enlargement; phenytoin, cyclosporine, and calcium channel blockers like nifedipine are the classic culprits.
Question 6: The modified Widman flap differs from an open flap debridement primarily because it:
- Uses vertical releasing incisions only
- Includes a reverse bevel incision and removes the inner epithelium and granulation tissue (Correct answer)
- Involves osseous resection
- Is used exclusively for furcation management
Correct answer: Includes a reverse bevel incision and removes the inner epithelium and granulation tissue
The modified Widman flap uses a reverse bevel (internal bevel) incision to excise the pocket epithelium and inflamed connective tissue while preserving the outer gingival tissue.
Question 7: Which measurement defines the width of attached gingiva?
- Distance from free gingival margin to mucogingival junction
- Distance from mucogingival junction to bottom of pocket subtracted from total gingival width (Correct answer)
- Probing depth alone
- Distance from CEJ to alveolar crest
Correct answer: Distance from mucogingival junction to bottom of pocket subtracted from total gingival width
Attached gingiva width = total keratinized tissue width (free gingival margin to MGJ) minus the probing depth.
AGD Periodontics and Gum Health 4
Which parameter is used in the 2017 AAP/EFP staging and grading system to indicate rate of periodontitis progression?