NDEB - National Dental Examining Board Periodontal Disease and Management Questions and Answers

Question 1

A 45-year-old male patient presents with generalized probing depths of 5-6 mm, radiographic evidence of bone loss extending to the middle third of the root on several teeth, and Class II furcation involvement on tooth #30. According to the 2017 AAP/EFP classification, what is the most appropriate Stage for this patient's periodontitis?

Accepted Answer

Stage III

Answer

The patient is classified as Stage III periodontitis. This stage is defined by severe periodontitis with the potential for additional tooth loss. Key indicators for Stage III include probing depths of ≥6 mm, radiographic bone loss extending to the mid-third of the root or beyond, and/or Class II or III furcation involvement. The presence of Class II furcation involvement and bone loss to the middle third of the root automatically places the patient in at least Stage III, regardless of clinical attachment loss.

Question 2

Which of the following is the primary goal of non-surgical periodontal therapy, such as scaling and root planing?

Accepted Answer

To remove biofilm and calculus to create a biologically acceptable root surface.

Answer

The primary objective of non-surgical periodontal therapy is to eliminate the etiologic factors of periodontal disease, which are bacterial plaque biofilm and calculus. By thoroughly debriding the root surfaces, a biologically acceptable environment is created, which promotes healing of the periodontal tissues, reduction in inflammation, and a decrease in probing depths. Regeneration of bone and new attachment are goals of surgical regenerative procedures, not initial non-surgical therapy.

Question 3

A patient diagnosed with Stage II, Grade B periodontitis is a smoker (15 cigarettes/day) and has poorly controlled Type 2 diabetes (HbA1c of 8.5%). According to the 2017 classification, how would these risk factors influence the patient's Grade?

Accepted Answer

The Grade would be shifted to C (rapid progression).

Answer

The grading system in the 2017 classification is designed to estimate the future risk of periodontitis progression. Grade B is the default moderate progression rate. However, specific risk factors can modify this grade. Smoking ≥10 cigarettes per day or having an HbA1c ≥7.0% are both indicators that shift the grade to C, signifying a high likelihood of rapid progression. Therefore, this patient's grade should be modified from B to C.

Question 4

Host modulation therapy (HMT) in periodontics, such as the use of sub-antimicrobial dose doxycycline (SDD), primarily aims to:

Accepted Answer

Inhibit the activity of matrix metalloproteinases (MMPs).

Answer

Host modulation therapy targets the host's destructive inflammatory response rather than the bacteria themselves. Sub-antimicrobial dose doxycycline (20mg twice daily) works primarily by inhibiting the activity of matrix metalloproteinases (MMPs), which are enzymes responsible for the breakdown of collagen and other connective tissues in the periodontium. It does not have a direct antibacterial effect at this low dose.

Question 5

Following successful non-surgical periodontal therapy, a patient is placed on a periodontal maintenance schedule. What is the most critical component of this long-term phase of treatment?

Accepted Answer

Ongoing professional debridement and monitoring of periodontal status.

Answer

Periodontal maintenance is crucial for preventing the recurrence and progression of periodontitis. The most critical component is the regular, ongoing monitoring of clinical parameters (probing depths, bleeding on probing, attachment levels) and professional debridement of both supra- and subgingival plaque and calculus to prevent the re-establishment of a pathogenic biofilm. This phase is key to long-term stability.

NDEB - National Dental Examining Board Practice Test

NDEB - National Dental Examining Board Practice Test

NDEB - National Dental Examining Board Periodontal Disease and Management Questions and Answers