DAPE 721

Year II; Periodontics I

8:00 9:50 AM
Mid-Term Examination
9/04/2009

NAME _____________________________
SEAT NO _____________

Multiple Choice Questions: 50 Questions @ 2 Points Each

1.

The periodontal ligament is composed of 80 percent _________ collagen.

A)
B)
C)
D)
E)

2.

Type V
Type IV
Type III
Type II
Type I

The width of the attached gingiva is an important clinical parameter in evaluating

periodontal treatment outcome. The width of the attached gingiva primarily
corresponds to the width of the free marginal gingiva.
A)
B)
C)
D)

Both statements are true.

Both statements are false.
The first statement is true and the second statement false.
The first statement is false and the second statement is true.

3. Idiopathic gingival fibromatosis is primarily associated with:

A)
B)
C)
D)
E)
4.

Plaque
Genetics
Medications
A and B
A only

The Lamina densa within the epithelial attachment is primarily composed of

which collagen fiber type?
A)
B)
C)
D)

Type I
Type 11
Type III
Type IV

5.

The epithelial mitotic cell turnover rate is highest within __________.

A)
B)
C)
D)

Oral sulcular epithelium

Keratinized gingiva
Epidermis of skin
Junctional epithelium

6. The primary secretion by junction epithelial cells that provides

adherence to the tooth root surface is _____________.
A)
B)
C)
D)
E)

Hydroxyglycine
Laminin
Fibrinogen
Glycine
None of the above

7. Which of the following statements accurately inter-relates the tooth and

periodontium interface?
1. Junctional epithelial cells are oriented parallel to the root surface.
2. Periodontal ligament fibers insert in cementum and bone
biochemically through fibronectin.
3. The junctional epithelial cells are non-secreting cells.
4. The Lamina densa primarily contains hemidesmosomal plaques.
5. Polymorphonuclear leukocytes can pass between junctional
epithelium cells into the gingival sulcus/pocket.
A)
B)
C)
D)
8.

1, 2, 3, 4, 5
1, 3, 4
1, 2, 5
2, 3, 5

In the presence of abundant plaque formation, hyperplastic gingivitis can be

associated with which of the following?
1.
2.
3.
4.
5.
A)
B)
C)
D)
E)

1, 2, 3, 4, 5
2, 3, 4, 5
2, 3,5
2 and 5
4 and 5

Mouth breathing
Cyclosporine
Procardia
Pregnancy
Phenytoin

9.

In periodontal disease, loss of which of the following fiber bundles are primarily
associated in preventing the progressive downward proliferation of the junctional
epithelium into the periodontal ligament and alveolar bone?

A)
B)
C)
D)

10.

The looping within the vasculature of the free gingival margin is indicative of:
A)
B)
C)
D)

11.

Junctional cells
Internal basement membrane
Collagen fibers
External basement membrane
All of the above

In the (Stage IV) advanced periodontal lesion, collagen fiber lysis is advanced
permitting downward proliferation of the epithelial attachment on the root surface.
The marginal gingival lamina propria is heavily infiltrated by plasma cells.
A)
B)
C)
D)

13.

Connective tissue pull upon the vasculature

Capillary anastomosis within vasculature
Leukocyte margination within vasculature
Rapid collagen turnover within the connective tissue.

Glycosaminoglycans and/or glycoproteins are associated with which of the following

gingival / periodontal histologic structures?
A)
B)
C)
D)
E)

12.

Transseptal
Circular
Interradicular
Alveolar gingival

Both statements are true.

Both statements are false.
The first statement is true and the second statement false.
The first statement is false and the second statement is true.

Macrophages contained within the periodontium function as which of the following?

A)
B)
C)
D)
E)

Phagocytosis
Collagen destruction enzymes
Initiation of T-Cell production
B and C
All of the above

14.

The alveolar bone proper is also termed as which of the following?

1.
2.
3.
4.
5.
A)
B)
C)
D)
E)

15.

Synthesis of glycoproteins
Phagocytosis of collagen
Secretion of trophocollagen
Collagenase secretion
All of the above

The periodontal ligament fiber bundle that least protects the tooth and
alveolar bone during centric axial forces is which of the following?
A)
B)
C)
D)

17.

1, 2, 3, 4, 5
1, 3, 4
2, 4, 5
3, and 5
4 only

Depending upon its local periodontal environment, the fibroblast can function
in which of the following?
A)
B)
C)
D)
E)

16.

Cribriform plate
Sharpeys plate
Lamina dura
Bundle bone
Trabecular bone

Horizontal
Alveolar crestal
Obique
Apical

The predominant immune cell of Initial Lesion, (Stage I), gingivitis, is the:
A)
B)
C)
D)
E)

NK lymphocyte
Plasma cell
Polymorphonuclear leukocyte
T-lymphocyte
B-Lymphocyte

18.

A 27 year-old male presents to your office with the following signs: loss of
interdental and marginal stippling, blue-red tissue color, the junctional epithelium at
the CEJ, and bleeding upon gentle probing. Your diagnosis is __________________.
A)
B)
C)
D)
E)

19.

In gingivitis, (Stage II), the predominant cell is the plasma cell. Numerous plasma
cells become phagocytic causing destruction of the horizontal and oblique fibers of
the periodontal ligament.
A)
B)
C)
D)

20.

Free gingival margins

Interdental grooves
McCalls festoones
Stillman clefts

In periodontal health the gingival sulcus primarily contains the following contents
with the exception of:
A)
B)
C)
D)

22.

Both answers are true.

Both answers are false.
The first statement is true and the second is false.
The first statement is false and the second is true.

Linear-to-curved facial indentations that originate from the apex of the free gingival
margin and extend parallel to the root surface in an apical direction are termed:
A)
B)
C)
D)

21.

Gingival recession
Systemic infection
Advanced periodontal disease, (perodontitis)
Melanin pigmentation
Chronic gingivitis

Desquamated epithelial cells

PMNs
Transudate
RBCs

The oral mucous consists of which of the following?

A.
B.
C.
D.
E.

Attached gingival
Alveolar mucosa
Free gingival margin
Mucogingival junction
All of the above

23.

In health and good tooth alignment, the width of the keratinized gingiva is primarily
narrowest on the facial/ buccal of which of the following teeth?
A)
B)
C)
D)

24.

The space bounded by the tooth and free gingiva, and having the
Junctional epithelium at its base is termed:
A)
B)
C)
D)
E)

25.

Interdental groove
Mucogingival junction
Free gingival groove
Gingival sulcus
Interdental papillae

The basic function of the gingival fiber groups (apparatus) is to maintain the free
gingiva and junctional epithelium in close approximation to the tooth. The gingival
epithelium lamina propria is similar to other tissues of the body (i.e., consists of
fibroblasts, mesenchymal cells, mast cells, and macrophages).
A)
B)
C)
D)

26.

Maxillary lateral incisor

Mandibular second molar
Mandibular first premolar
Maxillary canine

Both answers are true.

Both answers are false.
The first statement is true and the second is false.
The first statement is false and the second is true.

Which of the following parameters are indicative of gingival health?

A)
B)
C)
D)

27.

Bleeding upon probing

Gingival enlargement
Inverted interdental gingival contours
Firm consistency of gingival margin

A stippled appearance is normal to the attached gingiva. This stippling is caused by

projections of elastic fiber bundles into the papillary layer of the lamina propria,
which elevate the epithelium into rounded prominences that alternate with
indentations of the epithelium.
A)
B)
C)
D)

Both answers are true.

Both answers are false.
The first statement is true and the second is false.
The first statement is false and the second is true.

28.

In the adult periodontium, the junctional epithelium:

A)
B)
C)
D)

29.

Recession of junctional cells apical from the CEJ, is related to which of the
ollowing?
A)
B)
C)
D)
E)

30.

Endosteal arterioles and capillaries

Periosteal arterioles and capillaries
Interdental artery
Crevicular plexus

The periodontal ligament is capable of transmitting tactile pressure and pain

sensations by the trigeminal nerve pathways. The sense of localization during closure
is imparted through the high elastic fiber content of the periodontal ligament.
A)
B)
C)
D)

32.

Position of the tooth in the arch

Infection associated with plaque
Calculus formation
Toothbrush trauma
All of the above

The blood vessels within the connective tissue adjacent the junctional epithelium are
named:
A)
B)
C)
D)

31.

have fewer hemidesmosomes

coronally the junctional cells are 1-2 cell thick
does not secrete glycoprpteins or glycoaminoglycans
during all stages of eruption, the junctional cell adhesion is limited to the
CEJ.

Both answers are true.

Both answers are false.
The first statement is true and the second is false.
The first statement is false and the second is true.

Bundle bone is named because of which of the following reasons?

A)
B)
C)
D)
E)

The formation of multiple lacunae within alveolar cortical bone.

The site of embedded Sharpeys fibers.
The incorporation of intrinsic fibers within the alveolar bone proper.
Collagen arrangement within trabecular spaces.
Remnents of cementum deposition in the alveolar bone proper.

33.

Generally, acellular cementum is not:

A)
B)
C)
D)
E)

34.

The dento-gingival unit is a dynamic structure. This refers to which of the

following?
A)
B)
C)
D)
E)

35.

Advancing periodontal disease

Position of the tooth in the arch
Mucogingival involvement caused by frenum pull
Occlusal traumatism
All of the above

Tooth # 24 has 3mm. of exposed lingual root as measured by a probe from the CEJ to
the free gingival margin. Your periodontal diagnosis is:
A)
B)
C)
D)
E)

37.

Remodels bone and cementum

Adapts to compensatory eruption
Permits mesial drift of the tooth
Performs a formative function
All of the above

Gingival recession may be associated with which of the following?

A)
B)
C)
D)
E)

36.

Is not replaced when root planed to dentin

Is associated with supragingival calculus
Primarily involved in root ankylosis
Is laid down in appositional layers
Is formed before the tooth erupts into the oral cavity

Gingivitis
Fenestration
Gingival enlargement
Gingival abscess
Recession

With recession, which of the following best describes ACTUAL POSITION?

A)
B)
C)
D)
E)

The level of the crest of the gingival margin on the tooth.

The level of the epithelial attachment on the tooth.
The depth of the gingival sulcus or periodontal pocket.
Measured by use of the periodontal probe
B and D

38.

Generalized diffuse gingivitis includes the following periodontal tissue:

A)
B)
C)
D)
E)

39.

During an acute gingival inflammatory response, which of the following cell types
can destroy virulent bacteria by phagocytosis and T-cell mediation?
A)
B)
C)
D)
E)

40.

Attached gingiva
Interdental gingiva
Marginal gingiva
Alveolar mucosa
All of the above

Plasma cell
Mast cell
B-Lymphocyte
Macrophage
Polymorphonuclear leukocyte

In health, mesial drift results in changes within periodontal alveolar bone; these
changes are best described as:
1. osteoclastic activity and loss of collagen on the pressure side.
2. necrosis and osteoclastic activity on the tension side.
3. Osteoblastic activity and collagen formation/mineralization on the
tension side.
4. cementoblastic and collagen mineralization on the pressure side.
5. apical osteoblastic ankylosis.
A)
B)
C)
D)
E)

41.

1, 2, 5
1 and 2
1 and 3
3 and 4
3, 4, 5

In health, the color of the attached gingiva is blue-red in color. This color of the
healthy attached gingiva is produced by the vascular supply, thickness of the
keratinized epithelium, and/or the presence of pigmentation.
A)
B)
C)
D)

Both answers are true.

Both answers are false.
The first statement is true and the second is false.
The first statement is false and the second is true.

42.

A fenestration primarily occurs:

1.
2.
3.
4.

A)
B)
C)
D)
E)
43.

5-10 %
30-50 %
60-65 %
over 65 %

Enamel projections can extend varying distances from the dentoenamel junction to
the mid-facial furcation areas. An epithelial attachment associated with these enamel
pearls is potentially weaker than a comparable epithelial attachment on cementum.
A)
B)
C)
D)

45.

1, 2, 3, 4
1 and 3
2 and 3
3 and 4
1 only

Clinical research reports that ____________of erupted teeth have a partial absence of
cervical cementum forming a space of exposed dentin. This exposed dentin space
may be associated with an increased incidence of caries and root sensitivity.
A)
B)
C)
D)

44.

In lingual bone rather than facial bone.

Where facial buttressing bone is heavy apically.
Where a root is facially prominent in the arch.
Where the denuded root area is located apical to the marginal
bone.

Both answers are true.

Both answers are false.
The first statement is true and the second is false.
The first statement is false and the second is true.

Gingival bleeding with gentle probing may be associated with which of the
following?
A)
B)
C)
D)
E)

Chronic gingivitis
Overzealous tooth brushing
Leukemias
Violation of the biologic width
All of the above

46.

In periodontal health, the distance between the epithelial attachment to the crest of the
alveolar bone remains relatively constant at 2.04 mm. As the epithelial attachment
moves apically in periodontal disease, the crest of the alveolar bone is resorbed in
attempt to re-establish this 2.04 mm distance.
A)
B)
C)
D)

47.

Which of the following histologic structures are generally absent within the
periodontal ligament?
A)
B)
C)
D)
E)

48.

angioblasts and undifferentiated cells

mylenated nerve fibers
interstitial spaces
fibronectin
mature elastic fibers

Remodeling of the periodontal ligament and bone by fibroblasts, cemenoblasts,

osteoblasts, and osteoclasts is an example of ______________ cellular function?
A)
B)
C)
D)
E)

49.

Both answers are true.

Both answers are false.
The first statement is true and the second is false.
The first statement is false and the second is true.

Physical
Formative
Sensory
Anatomical
None of the above

Tooth number 25 has a nonkeratinized gingival margin and probes 5 mm loss of

attachment from the CEJ. There is facial alveolar mucosal elastic pull associated the
pull of the mandibular labial frenum. These presented diagnostic findings are
consistent with a diagnosis of:
A)
B)
C)
D)

Hyperplatic gingivitis
Gingival recession
Mucogingival defect
None of the above

50.

Tooth number 14 has been without an antagonist for 18 months. You place a
mandibular bridge from teeth numbers 18 20, restoring occlusal function to
number 14. Histologic changes within the periodontium of tooth number 14 now
include:
1.
2.
3.
4.

A functional periodontal ligament space.

Decreased density within supporting bone.
Increased density of the alveolar bone proper.
Reorganization, formation, and orientation of periodontal
fiber groups.
5. Deposition of acellular cementum.
A)
B)
C)
D)
E)

1, 2, 3, 4, 5
1, 3, 4
2, 3, 4, 5
2 and 3
1 only