NBDHE NBDHE Periodontal Assessment and Treatment 5 — Questions and Answers
Question 1: Following scaling and root planing, re-evaluation is typically performed after how many weeks?
- 1-2 weeks
- 2-4 weeks
- 4-6 weeks (Correct answer)
- 8-12 weeks
Correct answer: 4-6 weeks
Re-evaluation is typically scheduled 4-6 weeks after SRP to allow tissue healing and reassess pocket depths, bleeding, and need for additional treatment.
Question 2: A patient has generalized probing depths of 5-7 mm, Grade C periodontitis. Which systemic antibiotic regimen is most supported by evidence as an adjunct to SRP?
- Amoxicillin alone for 7 days
- Amoxicillin 500 mg + metronidazole 500 mg three times daily for 7 days (Correct answer)
- Doxycycline 100 mg once daily for 14 days
- Clindamycin 300 mg twice daily for 10 days
Correct answer: Amoxicillin 500 mg + metronidazole 500 mg three times daily for 7 days
The amoxicillin and metronidazole combination targets both aerobic and anaerobic periodontal pathogens and has the strongest evidence as a systemic adjunct to SRP in aggressive/Grade C periodontitis.
Question 3: What is the primary purpose of root planing during SRP?
- Remove enamel irregularities to prevent plaque retention
- Remove cementum containing endotoxins and create a smooth, hard surface to promote tissue reattachment (Correct answer)
- Polish the root surface to a mirror finish
- Open the sulcus to allow better subgingival irrigation
Correct answer: Remove cementum containing endotoxins and create a smooth, hard surface to promote tissue reattachment
Root planing removes contaminated cementum containing bacterial endotoxins and creates a clean, smooth root surface that promotes reattachment of connective tissue fibers.
Question 4: Which of the following best describes 'pseudopockets' (false pockets)?
- Pockets formed by apical migration of junctional epithelium with bone loss
- Increased sulcus depth caused by coronal enlargement of gingiva without apical migration of junctional epithelium (Correct answer)
- Pockets associated with furcation involvement
- Pockets created by gingival recession exposing root surfaces
Correct answer: Increased sulcus depth caused by coronal enlargement of gingiva without apical migration of junctional epithelium
Pseudopockets result from gingival enlargement (tissue swells coronally) rather than apical migration of attachment; they represent increased probing depth without true attachment loss.
Question 5: What is the recommended width of keratinized gingiva needed to maintain periodontal health around natural teeth?
- At least 1 mm of attached gingiva
- At least 2 mm of keratinized gingiva (1 mm attached) (Correct answer)
- A minimum of 5 mm of keratinized gingiva
- No minimum is required if the patient maintains excellent oral hygiene
Correct answer: At least 2 mm of keratinized gingiva (1 mm attached)
Most consensus statements recommend a minimum of 2 mm of keratinized gingiva (with at least 1 mm attached) to withstand masticatory forces and maintain health around natural teeth.
Question 6: A patient has Stage IV periodontitis with tooth mobility and bite collapse. Beyond periodontal treatment, which additional specialist referral is most appropriate?
- Orthodontist only
- Prosthodontist or restorative dentist for occlusal rehabilitation (Correct answer)
- Oral surgeon for extractions only
- Endodontist for root canal therapy on all mobile teeth
Correct answer: Prosthodontist or restorative dentist for occlusal rehabilitation
Stage IV periodontitis with bite collapse and tooth mobility requires an interdisciplinary approach including prosthodontic management to restore occlusal function and vertical dimension after periodontal stabilization.
Question 7: Which of the following bacteria is considered a keystone pathogen in the development of periodontitis due to its ability to subvert host immune responses?
- Streptococcus mutans
- Porphyromonas gingivalis (Correct answer)
- Actinomyces viscosus
- Fusobacterium nucleatum
Correct answer: Porphyromonas gingivalis
Porphyromonas gingivalis is considered the keystone pathogen of periodontitis because even in low abundance it can dysregulate the host immune response and reshape the entire subgingival microbiome.
NBDHE NBDHE Periodontal Assessment and Treatment 5
Following scaling and root planing, re-evaluation is typically performed after how many weeks?