Periodontics Ii Exam 1 Oucod Spring 2008

Front 1

what does SOAP format stand for

Back 1

subjective, objective, assessment, and plan

Front 2

what are the parts of the subjective portion of the SOAP format

Back 2

chief complaint, medical history, dental history, patient perception/attitude/experiences, and undocumented data

Front 3

what are the parts of the objective portion of SOAP

Back 3

general dental survey, periodontal survey, occlusal survey, deposits survey, radiographic survey, exudate

Front 4

what information is not obtained from x-rays

Back 4

presence or absence of pockets, morphology of bony deformities, tooth mobility, condition of structures on the labial and lingual aspects of teeth

Front 5

can you diagnose periodontal disease on the basis of radiographs alone

Back 5

no

Front 6

what is the time frame associated with short term vs long term prognosis

Back 6

short term: 3-5 years, long term: 7-10 years

Front 7

what are the phases of tx

Back 7

phase 1: initial, phase 2: surgical, phase 3: restorative, phase 4: maintenance (can be compromised maintenance)

Front 8

what are the goals of phase 1 therapy

Back 8

emergency tx and control of all etiologic factors

Front 9

what are the goals of phase 1 reevaluation

Back 9

to assure all etiologic factors have been controlled, to assess patient compliance, to evaluate tissue changes that have occurred as a result of controlling etiologic factors, and to determine/confirm further treatment needs

Front 10

when is phase 1 reeval performed

Back 10

4-6 weeks after completing all necessary steps of phase 1 therapy

Front 11

what things are assessed at phase 1 reeval

Back 11

plaque control level, tisue characteristics (contour, color, and consistency), probing depths, attachment level, recession, bleeding points, and maintenance requirements

Front 12

what is scaling

Back 12

instrumentation to remove plaque, calculus, debris, and stain

Front 13

what is the definitive procedure to remove cementum or surface dentin that is rough, impregnated with calculus, or contaminated with toxins or microorganisms

Back 13

root planing

Front 14

what is the biological objective for root planing

Back 14

root surface detox

Front 15

what are the different strokes involved in scaling and root planing

Back 15

exploratory, working, vertical, horizontal, and oblique

Front 16

an antimicrobial agnet that kills is said to be STATIC while one that suppresses is said to be cidal T/F

Back 16

false: kills is cidal, while supression of growth is static

Front 17

what are the broad uses of adjunctive chemical agents

Back 17

periodontal disease, periodontal emergencies, premedication, an control of gingivitis

Front 18

tetracyclines are bacteriostatic/bacteriocidal

Back 18

bacteriostatic

Front 19

what are the uses for tetracycline

Back 19

specific infections (aggressive periodontitis or Aa infections), regenerative therapy (systemic or mixed with bone graft material)

Front 20

what is the recommended regimen for tetracycline

Back 20

14-21 days

Front 21

what are the short term benefits for tetracycline

Back 21

reduce plaque, reduce inflammation, and inhibition of the activity of host collagenase

Front 22

what is the active ingrediaent in arestin

Back 22

minocycline HCl, 1 mg per unit dose cartridge

Front 23

what is the active ingredient in atridox

Back 23

doxycycline hyclate 10%

Front 24

what is the active ingredient in periochip

Back 24

chlorhexidine gluconate 2.5 mg

Front 25

which of the following is not a possible adjunct to root planing: arestin, atridox, periochip, or tetracyclin

Back 25

tetracycline

Front 26

what positive results occur from tetracycline/doxycycline

Back 26

increase CT attachement and inhibit growth of bacteria

Front 27

what positive resul comes from citric acid

Back 27

increase CT attachement

Front 28

what positive result comes form fibronectin

Back 28

decrease epithelial cell attachement and growth along the root surface

Front 29

what is the property which allows a medication to stick to hard and soft tissue and release beneficial effects over a prolonged period

Back 29

substantivity

Front 30

first generation antimicrobial rinses have substantivity T/F

Back 30

false: lack substantivity

Front 31

listerine is what generation of antimicrobial rinse

Back 31

first generation

Front 32

what are the essential oils in listerine

Back 32

thymol, eucalyptus, menthol, and methyl salicylate

Front 33

what is the alcohol content in listerine

Back 33

26.9%

Front 34

what is the pH of listerine

Back 34

4.3

Front 35

daily use of listerine can reduce plaque and gingivitis by how much

Back 35

40-50%

Front 36

what is the result of substantivity of 2nd generation antimicrobial rinses

Back 36

therefore provide a prolonged antimicrobial effect

Front 37

2nd generation antimicrobial rinses can reduce plaque and gingivitis by how much

Back 37

70-90%

Front 38

chlorhexidine is what generation antimicrobial rinse

Back 38

2nd generation

Front 39

the primary effect of chlorhexidine is mediated how

Back 39

bacteriostatic by altering cell wall permeability

Front 40

chlorhexidine effects what targets

Back 40

non-specific effect against gram+, gram-, yeasts, and viruses

Front 41

what are the side effects and disadvantages of chlorhexidine

Back 41

stain, bitter taste, altered tase sensation, increased supragingival calculus, prescription medication, and cost

Front 42

what is the concentration of chlorhexidine gluconate in peridex/periogard

Back 42

.12% chlorhexidine digluconate

Front 43

how much alcohol is found in peridex/periogard

Back 43

11.6%

Front 44

what is the pH for peridex/periogard

Back 44

5.5

Front 45

what is a second generation antimicrobial agent with substantivity besides chlorhexidine

Back 45

1.64% stannous fluoride

Front 46

what concentration of saline rinse should be used after scaling and root planing

Back 46

1/2 teaspoon salt to 8 ounces of warm water

Front 47

what are the goals of periodontal surgery

Back 47

improve prognosis of teeth/implants, and improve esthetics

Front 48

does periodontal surgery cure periodontal disease

Back 48

no

Front 49

proper surgical flap design will provide a partially unobstructed access to the surgical site T/F

Back 49

False: completely unobstructed direct access to the surgical site

Front 50

what are the 5 common pre-prosthetic procedures

Back 50

crown lengthening, root resection, hemisection, implant placement, and soft/hard tissue augmentation

Front 51

which heals faster: long incision or short incision

Back 51

they heal at the same rate

Front 52

preservation of blood supply to the surgical area is accomplished by what

Back 52

correct flap design

Front 53

what are the reasons to consider using periodontal dressing

Back 53

protecting the wound, enhance patient comfort, and to hold flap in position

Front 54

what are possible postoperative complications

Back 54

pain, bleeding, infection, lost dressing or sutures, root sensitivity, increased mobility, and herpetic ulcers

Front 55

what blood dyscrasias may effect surgical or postoperative bleeding

Back 55

hemophilia or von willebrand's disease

Front 56

what medications can cause possible problems during perio surgery related to bleeding problems

Back 56

blood thinners (coumadin, plavix, or aspirin)

Front 57

how can age be a contraindication to periodontal surgery

Back 57

healing potential diminished and rate of attachment loss can be increased

Front 58

what are the 7 facial spaces

Back 58

mentalis, submental, sublingual, submandibular, buccal, pterygomandibular, and parapharyngeal

Front 59

what are the borders of the pterygomandibular fascial spaces

Back 59

mandibular ramus and medial pterygoid muscle

Front 60

what are the contents of pterygomandibular fascial space

Back 60

lingual nerve and inferior alveolar vessels and nerve

Front 61

what are the important arteries of note that can be involved in periodontal surgery

Back 61

greater palatine, facial, mental, and lingual

Front 62

what nerves can potentially involved in periodontal surgery

Back 62

greater palatine, nasopalatine, lingual, and mental

Front 63

what muscles are of note during periodontal surgery

Back 63

mylohyoid, mentalis, and buccinator

Front 64

what is dehiscence

Back 64

seperation of the layers of a surgical wound or bursting open or splitting along natural or sutured lines

Front 65

what is fenestration

Back 65

making windowlike openings

Front 66

what is most likely located distal and apical to the mandibular first premolar

Back 66

mental foramen

Front 67

what is a disruption in the existing relationship of cells and tissues due to injury or surgery

Back 67

wound

Front 68

what is the phase of the inflammatory response whereby the body protects itself from further damage or infection and restores cells and tissues to a new anatomic and functional relationship

Back 68

healing

Front 69

what is the formation of a complete attachment apparatus, including new bone, pdl, cementum, CT, and junctional epithelium, at a more coronal level on a preivously diseased root surface

Back 69

regeneration

Front 70

the formation of new cementum, functionally oriented CT fibers, and junctional epithelium at a more coronal level on a previously diseased root surface

Back 70

new attachment

Front 71

the re-establishment of the soft tissue interface on a previously non-diseased root surface after surgical detachment. the CT and epithelial attachment levels are essentially unchanged after the surgery

Back 71

reattachment/repair

Front 72

what indicates a therapeutic failure

Back 72

recession/loss of keratinized gingive or net loss of supporting bone/attachment apparatus

Front 73

what are the causes for delayed wound healing

Back 73

nutritional deficiencies, uncontrolled diabetes, hormonal imbalance, tobacco, and infection

Front 74

what are the stages of wound healing associated with gingivectomy/gingivoplasty

Back 74

clot formation, graulation tissue dev't, epithelialization, collagen formation, regeneration of structural components, and maturation

Front 75

what are the healing stages associated with free soft tissue grafts

Back 75

plasmatic circulation (0-2 days), vascularization (2-7 days), CT organic union (4-10 days), epithelialization (7 days), clinically healed (14 days), and tissue maturation (10-16 weeks)

Front 76

what factors are associated with healing by primary intention

Back 76

simple incision, close approximation of wound edges, thin clot, rapid epithelial bridging and seal, more esthetic, and fewer symptoms

Front 77

what factors are associated with healing by secondary intention

Back 77

gaping wound edges, greater epithelial migration into wound, slower process, potentially less esthetic and more symptoms

Front 78

a periodontal flap is soft tissue elevated from the tooth/bone which retains an adequate blood supply T/F

Back 78

true

Front 79

what are the tissue sources during the healing of a flap

Back 79

marginal epithelium, gingival CT, bone marrow, periodontal ligament

Front 80

the specific type of wound healing, that takes place following periodontal flap surgery is highly dependant on what

Back 80

on which tissue reaches the root surface first and populates the surface

Front 81

when does epithelium begin to migrate cell by cell from wound margins

Back 81

12-24 hours

Front 82

what is the speed of migration of epithelium in wound healing

Back 82

.5 mm per day

Front 83

epithelium usually covers wound adn reaches tooth in how long (assuming a base of granulation tissue as a blood supply)

Back 83

7 days

Front 84

keratinization occurs after how long during wound healing

Back 84

14 days

Front 85

a functioning epithelial attachemnt and sulcus is formed in how many days

Back 85

28 days

Front 86

reattachment/repair of surgically severed CT fibers in how long

Back 86

14 days

Front 87

maturity of CT attachment is sufficient in how many days to withstand restorative procedures

Back 87

35 days

Front 88

initial cementoclastic and osteoclastic phase followed by cementoblastic and osteoblastic activity occurs over a variable period of how long

Back 88

2-6 week period

Front 89

final maturation can take how long

Back 89

up to 6 months or longer

Front 90

any surgical procedure effects the underlying bone to some extent. the outcome depends on what

Back 90

type (cortical or cancellous), thickness, manipulation, and covering

Front 91

whih is more friable thin bone or thick bone

Back 91

thin bone is more friable

Front 92

what is the periodontal surgery graduation requirements

Back 92

student must perform, or assist with, a minimum of two sextants of periodontal surgery for their own patients.

Front 93

what is the time limit for the 1st perio surgery case that must be completed ? 2nd surgery?

Back 93

by the end of the spring semester of the junior year and then the end of the fall semester of the senior year

Front 94

what can be done in lieu of one of the required surgeries on your own patients

Back 94

assist the graduate periodontics residents with two of their surgeries. you must discuss each case at least one week ahead of the scheduled surgery appt with the resident

Front 95

which statement is true concerning the healing of free gingival grafts: vascularization occurs before plasmatic circulation can begin, thick clot favors more rapid vascularization, plasmatic circulation precedes epithelialization, or connective tissue maturation precedes epithelialization

Back 95

plasmatic circulation preceds epithelialization

Front 96

recognized benefits for using perio dressing after surgery include all of the following EXCEPT: protection of the wound, mask the bitter after taste of chlorhexidine rinses, help hld the flaps in position, and enhance patient comfort

Back 96

mask the bitter after taste of chlorhexidine rinses

Front 97

what is the biological objective of root planing

Back 97

root detoxification

Front 98

all of the following statements properly describe vertical incisions except: used to increase access and visibility, are required for displaced flaps, should be placed over the midfacial/radicular surface of roots, or should be used only with caution in the palate

Back 98

should be placed over the midfacial radicular surface of roots

Front 99

a long incision heals as quickly as

Back 99

a short incision

Front 100

according to the SOAP format for organizing your approach to patient management, under which category would you record the findings of the health history review

Back 100

subjective

Front 101

periodontal pocket is a space bounded by tooth on one side and what on the other

Back 101

ulcerated epithelium lining the soft tissue wall

Front 102

which artery is most likely to be severed by a vertical incision in the posterior palatal tissue during periodontal surgery

Back 102

greater palatine

Front 103

information obtained from dental x-rays would normally include all of the following except: tooth mobility, crown-root ratio, position of the maxillary sinus, or root morphology and length

Back 103

tooth mobility

Front 104

a partial thickness flap is composed of all of the following tissues except: mucosa, submucosa, gingiva, periosteum, or all the above

Back 104

periosteum

Front 105

any flap elevated beyond the mucogingival junction to involve both gingiva and alveolar mucosa would a

Back 105

mucogingival flap

Front 106

the external oblique ridge may complicate peridontal surgical procedures in which area

Back 106

buccal aspect of mandibular molars

Front 107

which of the following factors can worsen a tooth's prognosis: 1. fused roots, 2. end tx, 3. divergent roots, 5. root concavities or developmental defects, 5. root resoprtion

Back 107

1,4,5

Front 108

all of the following are disadvantages normally attributed to chlorhexidine rinses except: bitter taste, high toxicity, increased supragingival calculus, or tooth staining

Back 108

high toxicity

Front 109

indications for flap surgery would include all of the following except: when resective techniques are not adequate, to treat pockets beyond the mgj, to tx infrabony pockets, to tx dilantin hyperplasia, or all of the above

Back 109

to treat dilantin hyperplasia

Front 110

according to CLINICAL PERIODONTOLOGY, as a general rule, actual bone loss is _________ the amount as seen on radiographs

Back 110

always greater than

Front 111

a gingivectomy may be appropriate tx for all of the following conditions except: chronic inflammatory hyperplasia, gingival recession to the mgj, dilantin hyperplasia, hereditary fibromatosis, or all the above

Back 111

gingival recession to the mgj

Front 112

which muscle may prevent the surgeon from deepening the vestibule in the anterior facial region of the mandible:

Back 112

mentalis

Front 113

whe using tetracycline impregnated fibers (actisite) to tx localized pockets found to be non-responsive to root planing, how may days should the fibers be left in place in the pockets: 3, 10, 14, 21 days, or they are resorbable and do not have to be removed

Back 113

10 days

Front 114

healing by primary intention is characterized by all of the features listed below except: simple sharp incision, deep epithelial migration into the wound, close approximation of wound edges, or fewer postop problems

Back 114

deep epithelial migration into the wound

Front 115

the reestablishment of the soft tissue interface on a previousy non-diseased root surface after surgical detachment best describes: epithelial adaptation, soft tissue necrosis, reattachment/repair, new attachment, or regeneration

Back 115

reattachment/repair

Front 116

wound healing may be delayed by: tobacco use, uncontrolled diabetes, hormonal imbalances, A and B, or all the above

Back 116

all the above

Front 117

root sensitivity following periodontal tx: occurs most often in furcations of mandibular molars, occurs most often in the cervical area where cementum is thin, occurs most often at the apex where the nerve enters the root, or is very rare

Back 117

occurs most often in the cervical area where cementum is thin

Front 118

the prognosis in perio patients whose teeth habe short, tapered roots and relatively large crowns is: the same as a pt with average roots/crowns, worse than a pt with average roots/crowns, better than a pt with average roots/crowns, prognosis is not related to the crown to root ratio

Back 118

worse than a pt with average roots/crowns

Front 119

obectives achieved by apically displaced flaps include: eliminating the pocket, increasing the width of attached gingiva, both, or neither

Back 119

both

Front 120

when compared to granulation tissue, granulomatous tissue has a higher proportion of: fibroblasts, rests of malassez, capillaries, plasma cells, or all the above

Back 120

plasma cells

Front 121

perio surgical procedures that may enhance planned prosthetic tx include: placement of implants, crown lengthening, augmenting soft tissue where deficient, or all the above

Back 121

all the above

Front 122

an example of a displaced flap is: modified ENAP, envelope flap, laterally positioned flap, or subgingival curettage

Back 122

laterally positioned flap

Front 123

when a flap is retracted after elevation during surgery, there will be less trauma if the flap retractor is held gently but firmly against: alveolar mucosa, the undersurface of the flap, alveolar bone, the soft palate

Back 123

alveolar bone (alveolar mucosa?)

Front 124

which antibiotic sometimes used in the tx of refractory periodontitis has an antibuse-like effect when alcohol is ingested

Back 124

metronidazole

Front 125

while administering an inferior alveolar nerve block the needle of your syringe passes through which space

Back 125

pterygomandibular

Front 126

which incision would most likely be used when performing an envelope flap

Back 126

internal bevel incision

Front 127

a potential benefit of the short term use of tetracycline in patients with periodontal disease is: dev't of resistant bacterial strains, tooth staining in young chidren, superinfections, inhibition of host collagenase activity, or dev't of photosensitivity

Back 127

inhibition of host collagenase activity

Front 128

the principle muscle which seperates the sublingual space from the submandibular space is the

Back 128

mylohyoid

Front 129

when force is applied buccolingually to a tooth, a total movement of about 1 mm is noted. this amount of movement represents what grade mobility

Back 129

grade 2

Front 130

ludwig's angina, a severe infection which may extend to other spaces and lead to asphyxiation, begins in which space

Back 130

submandibular

Front 131

chlorhexidine has an antimicrobial effect agianst: gram +, gram -, yeast, or all the above

Back 131

all the above

Front 132

which statement is not generally true as related to wound healing: thin bone is more friable than thick bone, thick clots are more desirable than thin clots, CT maturation may take several months, all soft tissue should be removed from within infrabony defects, or exposed bone should be covered by a thick layer of soft tissue

Back 132

thick clots are more desirable than thin clots

Front 133

tx provided during phase 1 therapy normally may include any of the below procedures except: caries control, gross occlusal adjustment, scaling and root planing, gingivectomy, or endo

Back 133

gingivectomy

Front 134

elements of informed consent that should be discussed with the pt and documented in the record prior to performing perio surgery include: explanation of surgical risks and benefits, explanation of possible surgical complications, discussion of alternative tx options, or all the above

Back 134

all the above

Front 135

in which area are you least likely to encounter an exostosis or torus

Back 135

buccal aspect of mandible adjacent to the incisors

Front 136

the single most important therapeutic periodontal procedures is: scaling, free gingival grafts, occlusal adjustment, root planing, or all procedures have equal therapeutic value

Back 136

root planing

Front 137

final, definitive restorations are most appropriately placed during which phase of tx

Back 137

phase 3