CPT Supportive Periodontal Therapy & Maintenance 2 — Questions and Answers
Question 1: What is the PRIMARY goal of supportive periodontal therapy (SPT)?
- To maintain the clinical results of active therapy and prevent disease recurrence (Correct answer)
- To reverse existing alveolar bone loss through repeated debridement alone
- To eliminate the need for future surgical intervention permanently
- To improve dental aesthetics and tooth whitening
Correct answer: To maintain the clinical results of active therapy and prevent disease recurrence
The primary goal of SPT is to preserve the clinical improvements achieved during active periodontal therapy and prevent reactivation of the disease.
Question 2: Which systemic condition most commonly necessitates more frequent SPT recall intervals?
- Poorly controlled diabetes mellitus (Correct answer)
- Well-controlled hypertension on stable antihypertensives
- Hypothyroidism managed with stable levothyroxine
- Iron deficiency anemia with normal oral findings
Correct answer: Poorly controlled diabetes mellitus
Poorly controlled diabetes impairs immune function and wound healing, significantly increasing susceptibility to periodontal recurrence and requiring shorter SPT recall intervals.
Question 3: During an SPT visit, bleeding on probing (BOP) is found at 30% of sites. This finding most likely indicates:
- Active gingival inflammation requiring reinforced oral hygiene instruction and possible interval adjustment (Correct answer)
- Complete periodontal health with no clinical intervention needed
- An immediate indication for systemic antibiotic therapy
- A normal finding in all SPT patients that requires no action
Correct answer: Active gingival inflammation requiring reinforced oral hygiene instruction and possible interval adjustment
BOP above 10% of sites indicates persistent gingival inflammation and signals the need for improved oral hygiene instruction and consideration of shorter recall intervals.
Question 4: Which bacteria are MOST strongly associated with recurrent periodontitis during SPT?
- Porphyromonas gingivalis and Tannerella forsythia (Correct answer)
- Streptococcus mutans and Lactobacillus acidophilus
- Actinomyces viscosus and Streptococcus sanguinis
- Candida albicans and Staphylococcus aureus
Correct answer: Porphyromonas gingivalis and Tannerella forsythia
P. gingivalis and T. forsythia are key members of the 'red complex' and are the primary pathogens driving periodontitis progression and recurrence during SPT.
Question 5: What is the MOST effective method to detect bone level changes over time during SPT?
- Sequential standardized periapical radiographs compared to post-treatment baseline images (Correct answer)
- Full-mouth probing depth measurements alone
- Cone beam CT (CBCT) performed at every 3-month visit
- Panoramic radiograph taken at each recall appointment
Correct answer: Sequential standardized periapical radiographs compared to post-treatment baseline images
Standardized periapical radiographs taken with the paralleling technique allow accurate comparison to baseline images to detect subtle interproximal bone changes over time.
Question 6: A compliant SPT patient with well-controlled type 2 diabetes has residual pocket depths of 4–5mm. What is the most appropriate recall interval?
- Every 3 months (Correct answer)
- Every 6 months
- Every 12 months
- Every 2 years
Correct answer: Every 3 months
Residual pocketing of 4–5mm combined with a systemic risk factor (diabetes) warrants the standard 3-month SPT interval to monitor for disease reactivation.
Question 7: Which factor is considered the STRONGEST site-specific predictor of future attachment loss during SPT?
- Presence of residual pockets ≥6mm after active therapy (Correct answer)
- Patient age greater than 50 years at initial diagnosis
- Use of a manual toothbrush instead of a powered toothbrush
- History of prior orthodontic treatment
Correct answer: Presence of residual pockets ≥6mm after active therapy
Residual pockets of 6mm or deeper are the strongest site-specific predictor of continued attachment loss because they harbor high levels of periodontal pathogens.
CPT Supportive Periodontal Therapy & Maintenance 2
What is the PRIMARY goal of supportive periodontal therapy (SPT)?