NBDHE NBDHE Periodontal Assessment and Treatment 3 — Questions and Answers
Question 1: Which furcation classification indicates through-and-through involvement where a probe passes completely between the roots?
- Class I
- Class II
- Class III (Correct answer)
- Class IV
Correct answer: Class III
Class III furcation involvement means the furcation is open through-and-through, allowing a probe to pass completely from one side to the other.
Question 2: What is the primary rationale for performing a frenectomy as part of periodontal treatment?
- Increase keratinized gingiva width
- Eliminate a frenum pull that impedes oral hygiene or causes gingival recession (Correct answer)
- Correct a gummy smile
- Reduce pocket depth in anterior regions
Correct answer: Eliminate a frenum pull that impedes oral hygiene or causes gingival recession
A frenectomy is indicated when frenum attachment causes tissue pull that compromises oral hygiene access or contributes to gingival recession.
Question 3: Necrotizing ulcerative gingivitis (NUG) is characterized by which classic triad of findings?
- Bleeding, bone loss, and mobility
- Interdental papilla necrosis, pain, and fetid odor (Correct answer)
- Deep pocketing, furcation involvement, and recession
- Gingival enlargement, bleeding, and pseudopockets
Correct answer: Interdental papilla necrosis, pain, and fetid odor
NUG presents with the classic triad of punched-out interdental papillae (necrosis/ulceration), severe pain, and characteristic fetid breath (fetor ex ore).
Question 4: Which of the following local drug delivery agents is placed subgingivally to reduce pocket depth as an adjunct to SRP?
- Chlorhexidine gluconate 0.12% rinse
- Minocycline microspheres (Arestin) (Correct answer)
- Doxycycline hyclate systemic tablets
- Stannous fluoride gel
Correct answer: Minocycline microspheres (Arestin)
Minocycline microspheres (Arestin) are a subgingival local drug delivery system placed directly into periodontal pockets as an adjunct to scaling and root planing.
Question 5: A patient has 30% bone loss on the mesial of tooth #30 with a 6 mm probing depth. The tooth has a good prognosis. What is the most appropriate initial treatment?
- Extraction and implant placement
- Osseous surgery immediately
- Scaling and root planing followed by re-evaluation (Correct answer)
- Periodontal maintenance only
Correct answer: Scaling and root planing followed by re-evaluation
SRP (cause-related therapy) is always the first step in active periodontal treatment; surgical decisions are made only after evaluating the tissue response to nonsurgical therapy.
Question 6: Which radiograph provides the best detail for evaluating interproximal alveolar bone levels?
- Panoramic radiograph
- Periapical radiograph
- Bitewing radiograph (Correct answer)
- CBCT scan
Correct answer: Bitewing radiograph
Bitewing radiographs provide the best visualization of interproximal alveolar bone levels because they minimize distortion and show the crest of bone in relation to the CEJ.
Question 7: Smoking affects periodontal disease primarily by causing which of the following?
- Increased gingival bleeding and inflammation
- Vasoconstriction masking clinical signs and impairing neutrophil function (Correct answer)
- Accelerated bone regeneration after treatment
- Increased salivary flow reducing bacterial colonization
Correct answer: Vasoconstriction masking clinical signs and impairing neutrophil function
Nicotine causes vasoconstriction that masks bleeding on probing, while also impairing neutrophil chemotaxis and phagocytosis, reducing the host's ability to fight infection.
NBDHE NBDHE Periodontal Assessment and Treatment 3
Which furcation classification indicates through-and-through involvement where a probe passes completely between the roots?