x M C Q s in P e r io d o n tic s

22. Pericoronitis .................................................................................... 90

23. Chronic Desquamative Gingivitis and D erm atoses................. 92

24. Periodontal Pocket ........................................................................ 97

2 5. Bone Loss in Periodontal Diseases ...................................... 100

26. Periodontitis .............................................................................. 104

2 7 . General Considerations in the M anagement of

Periodontal Diseases ................................................................ 107

28. Nonsurgical M anagem ent ...................................................... 113

29. M iscellaneous ........................................................................... 122

 Anatomy o f Gingiva and
Dentogingival Junction

1. T he part (s) o f oral mucosa referred to as specialized

mucosa is/are:
A. G ingiva
B. C overing o f the hard palate
C. Both o f the above
1). D orsum o f the tongue
nal width of the marginal gingiva is:
B. 2 mm
C . 0.5 mm I). 3 mm
3. All o f the follow ing are true about m ucogingival
junction except:
A. It separates the gingiva from m ovable m ucosa
B. It m akes the apical extent o f attached gingiva
C . It is stable and rem ains stationary throughout the life
I). Its position may change in a pathological condition
o f gingiva
4. T he incorrect statement about width o f attached
gingiva is:
A. It is the distance between m ucogingival junction and
projection o f base o f sulcus on outer surface
B. It increases with age and supracruption o f teeth
C. It in c re a s e s w ith p a th o lo g ic a l e n la rg e m e n t o f
gingiva
1). It decreases with loss o f epithelial attachm ent
5. Col is:
A. A pathological enlargem ent o f gingiva
B. K eratinized portion o f interdental gingiva
C. Valley like depression o f interdental gingiva
D. An abnorm al overgrowth o f interdental bony
septum
2 M C Q s in P e r io d o n tic s

6. W hich o f the followings is not true about interdental

papilla:
A. It is part o f interdental gingiva
B. Its tip and lateral borders are formed by continuation
o f marginal gingiva
C . It is absent in diastem a
I). It is keratinized and less prone to infection
7. Probing depth of clinically healthy gingiva is:
A. 0-1 mm
B. 1-2 mm
C . 2-3 mm
I). M ore than 4 mm
8. T he principal cells o f gingival epithelium are:
A. Keratinocytes
B. Langerhans’ cells
C . M erkel cells
D. M elanocytes
9. T he main function(s) of gingival epithelium is/are:
A. Protection o f underlying structures
B. N utrition o f underlying structures
C . To allow selective interchange with oral environm ent
D. Both (A) and (C)
10. The width of attached gingiva:
A. Increases with age and supraeruption o f the teeth
B. D ecreases w ith pocket formation
C . Both o f the above
I). N one o f the above
11. Which o f the following is incorrect about Langerhans’
cells:
A. These are dendritic cells
H. These are modified monocytes
< I hcse are absent in junctional epithelium
I). I hcse arc present in basal cell layer o f oral epithe­
lium
I• I lit nuclei are absent in stratum corneum of:
\ i Irihokcratinized gingival epithelium
li PmJikctatinized gingival epithelium
 A n a to m y of G ingiva a n d D en to g in g iv al J u n c t i o n 3

C. None o f the above

D. Both o f the above
13. The stratum granulosum is absent in:
A. O rthokeratinized epithelium
B. Parakeratinized epithelium
C. Both o f the above
D. None o f the above
14. Merkel cells are:
A. Present in superficial layers o f gingival epithelium
B. Antigen presenting cells for lymphocytes
C. Tactile preceptors
D. All o f the above
15. Sulcular epithelium is:
A. Sem iperm eable in nature
B. Non keratinized
C. Can be keratinized when exposed to oral cavity
I). All o f the above
L6. The length o f junctional epithelium is:
A. 0.1 to 0.2 mm
B. 0.25 to 1.35 mm
C . 1.35 to 2.00 mm
D. 2 to 2.5 mm
17. Which o f the followings is not the function o f sulcular
fluid:
A. It helps in rem oving harm ful m aterials from the
sulcus
B. It provides plasm a proteins that help in adhesion o f
junctional epithelium o f the tooth
C. It carries antibodies to help in defence m echanism o f
gingiva
D. It h e lp s in p la q u e fo rm a tio n by p r o v id in g
glycoproteins which arc an important com ponent o f
dental pellicle
18. The gingival fibers are arranged into following groups
except:
A. Dentogingival group
B. D entoalveolar group
4 M C Q s in P c r io d o n tic s

C . Circular group
1). Trans-scptal group
19. The cells present in connective tissue o f gingiva in­
clude:
A. M ast cells, m acrophages, adipose cells
B. Histocytes, eosinophils, m ast cells
C. Macrophages, histocytes, melanocytes
D. Both (A) and (B)
20. Blood supply to the gingiva is provided by:
A. Supraperiosteal arterioles
B. Vessels o f periodontal ligament
C. Vessels em erging from the crest o f the interdental
septa
I). All o f the above
21. The coral pink color of the normal gingiva is produced
due to:
A. Vascular supply o f gingiva
B. T hickness o f gingival epithelium
C. Degree o f keratinization o f gingival epithelium
I). Presence o f pigm ent containing cells
• (i) and (iv)
• (i), (ii) and (iii)
• (i) and (iii)
• (i), (ii), (iii) and (iv)
22. Choose the incorrect statement:
A. Stippling is absent in marginal gingiva
B. Stippling is absent in infants and appears at about 5
years o f age
C. Stippling is more prom inent on facial surface than
on lingual surface
I). Stippling is lost permanently in gingivitis
23. T he earliest sign o f gingival inflammation is:
A. Increased gingival fluid production rate
B. C hange in color o f gingiva
C . Loss o f stippling o f gingiva
I). Bleeding on gentle probing
 A n a to m y of G ingiva a n d D cn to g in g iv a l J u n c t i o n 5

24. Passive eruption is divided into:

A. Two stages
B. Three stages
C. Four stages
D. N ot divided into stages
25. Mark the wrong statement(s):
A. A ctive eruption is a physiological process
B. Passive eruption is a physiological process
C . Passive eruption is divided into four stages
D. Both (B) and (C)
26. The attachment apparatus o f the tooth is composed
of:
A. Periodontal ligament and cem entum
B. Periodontal ligament and alveolar bone
C . Periodontal ligament alone
I). Periodontal ligament, cem entum and alveolar
bone
27. The group o f periodontal fibers not attached to the
bone includc(s):
A. Transseptal group
B. H orizontal group
C . Interradicular group
D. Both (A) and (C)
28. The principal fiber group that gets reconstructed even
after the destruction o f alveolar bone is:
A. Transseptal group
B. Horizontal group
C . Intcrradicular group
I). Oblique group
29. T he largest group of principal fibers is:
A. Transseptal group
B. H orizontal group
C . O blique group
D. Apical group
30. T he principal fiber group that prevents extrusion of
the tooth and resists lateral tooth movements is:
A. Transseptal group
B. A pical group
6 M C Q s in P c r io d o n tic s

C. A lveolar crest group

D. O blique group
T) T h e p r in c ip a l c o n n ectiv e tissue cells p resen t in
periodontal ligament are:
A. Fibroblasts
B. Cem entoblasts
C. O steoblasts
D. All o f the above
All o f the followings are true about fibroblasts except'.
A. Fibroblasts are principal connective tissue cells o f
periodontal ligament
B. Fibroblasts synthesize collagen
C . Fibroblasts have pscudopodia like processes
I). F ib ro b la sts are not capable o f p h ag o cy to sis for
collagen destruction
Epithelial rests:
A. Are rem nants o f Mertvvig’s root sheath
B. May calcify to form cem enticles
C . May proliferate under stim ulation to form a periapi­
cal cyst
D. All o f the above
34.) M y elin a ted fibers o f nerve bundles en tering the
^ periodontal ligament ultimately terminate into:
A. Free endings with treelike configuration
B. Ruffini-like corpuscles
C . Coiled forms
D. Any o f above structures
 A n a to m y of G ingiva a n d D e n to g in g iv a l J u n c t i o n 7

Answers
1.D. The part o f oral m ucosa referred to as specialized
mucous is dorsum o f tongue because it consists o f
specialized taste buds. Other parts o f oral m ucosa are
m asticatory m ucosa and oral mucous membrane.
2. A. The normal width o f marginal or unattached gingiva
is about 1 mm wide. It is the terminal edge or border
o f the gingiva surrounding the teeth in collar like fash­
ion.
3.D. M ucogingival ju nction separates the gingiva from
m ovable portion and remains stationary throughout
adult life. Changes in the width o f attached gingiva
are caused by modifications in the position o f its coro­
nal end.
4.C. Since the position o f mucogingival junction rem ain
stationary throughout the life.
5.C. Col is a valley like depression o f interdental gingiva
that connects a facial and a lingual papillae and con­
forms to the shape o f interproximal contact.
6.D. Interdental papilla is covered by a thin non-keratinized
epithelium .
l.C . Probing depth o f clinically healthy gingiva is 2 to 3
m m and need not to be exactly equal to the histologi­
cal depth o f the sulcus (i.e. 1.8 mm).
8.A. The principal cell type in gingival ep ith eliu m is
k e r a tin o c y te s w h ich c a n s y n th e s iz e k e ra tin .
K eratinocytes costitute 90 percent or m ore o f gingi­
val epithelium.
9.1). The m ain functions o f gingival epithelium are protec­
tion o f underlying structures and to allow selection
interchange with oral environm ent as it acts as a semi-
perm eable membrane.
10.C. S in ce the m ucogingival ju n c tio n rem ain s stable
throughout life .the increasing width o f the gingiva
w ith age may suggest that the teeth, as a result o f
occlusal wear, slowly erupt throughout the life.
8 M C Q s in P c r io d o n tic s ____________ ________________________

11.D. Langerhans’ cells are dendritic cells located am ong

kcratinocytcs at all suprabasal levels.
12. A. Orthokeratinized gingival epithelium shows com plete
keratinization process w ith absence o f nuclei where
as parakeratinized gingival epithelium shows pyknotic
nuclei.
13.B. O rthokeratinized epithelium shows well defined stra­
tum granulosum where as in parakeratinized epithe­
lium, keratohyalin granules are dispersed not giving
rise to stratum granulosum.
14.C. M erkel cell are lo cated in the d eep e r la y ers o f
epithelium , harbor nerve endings, and are connected
to adjacent cells by desmosomes.
15.D. Sulcular epithelium has the potential to keratinize if
it is reflected and exposed to the oral cavity or the
bacterial flora o f the sulcus is totally eliminated.
16.B. The length o f junctional epithelium ranges from 0.25
to 1.35 mm. It is 3 to 4 layers thick in early life, but
the num ber o f layers increases w ith age.
17.D. Sulcular fluid (a) cleanse material (b)provides plasm a
proteins (c) possess antim icrobial properties and (d)
exert antibody activity.
18.B. T he three p rin cip al types o f gingival fibers are:
gin g iv o d en tal, circu lar and transseptal w hich are
collagenous in nature.
19.D. The cells present in the connective tissue o f gingiva
include m ast cells, macrophages, adipose cell, histio­
cytes and eosinophils. Melanocytes are dendritic cells
loeated in the basal and spinous layers o f gingival epi­
thelium .
20.D. B lo o d s u p p ly to th e g in g iv a is p ro v id e d by
(a)Supraperiosteal arterioles along the facial and lin­
gual surfaces o f alveolar bone (b) Vessels ofperiodon-
tal ligam ent and (c) Vessels em erging from the crest
o f the interdental septa.
 A n a to m y of G ingiva a n d D en to g in g iv al J u n c t i o n 9

21 .D. The coral pink color o f the gingiva is produced by the

vascular supply, the thickness o f gingival epithelium ,
degree o f keratinization o f epithelium and the pres­
ence o f pigm ent containing cells.
22.D. Stippling is a form o f reinforcem ent for function. It is
a reversible phenom enon, i.e. it is lost or disappears
in disease but returns following successful treatm ent.
23. D. The earliest sign o f gingival inflam m ation is bleeding
on gentle probing, mainly due to proliferation o f cap­
illaries and increased formation o f capillary loops be­
tween rete pegs or ridges.
24.C. Passive eruption is divided in to 4 stages on the basis
o f the position o f the junctional epithelium and the
base o f the sulcus on the tooth.
25.B. Passive eruption is exposure o f teeth by apical m igra­
tion o f gingiva. Passive eruption is now considered a
pathologic process.
26. D. The attachm ent apparatus o f the tooth is com posed o f
periodontal ligament, cem entum and alveolar bone.
W here as periodontium com prises o f gingiva, perio­
dontal ligament, root cem entum and alveolar bone.
27.A. Transseptal fibers arc the only fibers w hich are not
em bedded in to bone.
28.A. Transseptal fibers extend interproxim ally over the
alveolar bone crest and arc em bedded in cem entum
o f abjacent teeth, they arc constant finding and gets
reconstructed even after destruction o f alveolar bone.
29.C. The largest group o f principal fibers is oblique group
w hich extend from the cementum in a coronal direc­
tion obliquely to the bone.
30.C. The principal fiber group that prevents extrusion o f
tooth and resist lateral tooth movements is alveolar
crest group which extends obliquely form the cem en­
tum ju st beneath junctional epithelium to the alveolar
crcst.
31 .A. Principal connective tissue cells present in periodon­
tal ligam ent are fibroblast. These cells synthesize col­
lagen and phagocytose old collagen fibers.
10 M ( <Jn In IV iio tlo n tlc s

J.U ). Fibroblasts possess pseudopodia like processes that

enzyme hydrolysis.
33.D. Epithelial rests o f M alassez are rem nants o f H erlw ig’s
root sheath, which disintegrates during root develop-
m e iit^ ,-
34.1). M y elin ated fibers o f nerve b u n d les en te rin g the
periodontal ligament ultim ately term inate into free
e n d in g w ith tree like co n fig u ratio n . R u ffin i-lik e
corpuscles and coiled forms.
 Inflammation o f
Periodontium and
Host Response
1. Cytoplasmic granules o f mas! cells contain:
A. H istam ine
B. Slow releasing substances o f anaphylaxis
C. Heparin
D. All o f the above
2. Principal cells of defense against injury and infection
are:
A. Plasm a cells B. M ast cells
C . Lymphocytes D. Neutrophils
3. Antibodies are produced mainly by:
A. H elper T-cells
B. Suppressor T-cells
C. B-cells
1). Plasm a cells
4. Suppressor T-cells:
A. Release interleukin-4 and interleukins
B. S tim ulate cytotoxic and m icrobicidal activ ity o f
im m une cells
C. Are CDS positive
D. All o f the above
5. Macrophages arc formed by differentiation of:
A. M onocytes
B. Plasm a cells
C . Lymphocytes
D. Basophils
6. Plasma cells are formed by differentiation of:
A. M onocytes
B. Neutrophils
12 M C Q s in P e r io d o n tic s

C. 13 Lymphocytes
I). T lymphocytes
7. Effector cell for local and systemic humoral immu­
nity is produced hv:
A. Plasm a cells
B. M acrophages
C . Neutrophils
I). All o f the above
8. Antibodies are:
A. M ucopolysaccharides
B. Proteins
C . Glycoproteins
I). None o f the above
9. Specificity o f every antibody with a particular anti­
gen is due to:
A. Its unique am ino acid sequence
B. Tertiary structure o f its antigen com bining sites
C . Both o f the above
D. N one o f the above
10. The number of antibody binding sites in the im muno­
globulin molecule is referred to as:
A. Potency o f im munoglobulin molecule
B. Valence o f im m unoglobulin molecule
C . Both o f the above
D. None o f the above
11. Most abundant immunoglobulin in the scrum is:
A. IgG
B. IgA
C. IgM
I). IgE
12. Which o f the followings is wrong about IgG:
A. It is m ost abundant o f serum im m unoglobulins
B. It is distributed equally between blood and extracel­
lular fluids
C. It enhances phagocytosis by binding to m icroorgan­
isms
D. It does not cross placental barrier
 I n f la m m a tio n of P e r io d o n tiu m a n d H o s t R e s p o n s e 13

13. Antibodies responsible for acute allergic reactions

belong to the class:
A. IgG
13. IgE
C . IgA
D. IgM
14. T h e p rin c ip a l im m u n o g lo b u lin in exocrine secretions
is:
A. IgA
B. IgD
C . IgE
D. IgM
15. Im m u n o g lo b u lin first to be fo rm ed in re sp o n se to
initial a tta c k of infections is:
A. IgA
B. IgE
C . IgG
1). IgM
16. T h e b a sis fo r c o m p le m e n t fix a tio n a ssa y (a n im ­
p o rta n t la b o ra to ry p ro ced u re) is:
A. Increased permeability o f small blood vessels
B. Phagocytic activity by leucocytes and m acrophages
C . Hemolysis
D. All o f the above
17. Type III hy p ersen sitiv ity reactions a re also kno w n as:
A. Cytotoxic reactions
B. Arthus reactions
C. Imm une com plex reactions
D. Both B and C
18. W h ich o f th e follow ings is cell m ed iated h y p ersen siti­
vity reactio n :
A. Type I
B. Type II
C. Type III
D. Type IV
19. Type I hy p ersen sitiv ity is also know n as:
A. Anaphylaxis
B. Cytotoxic reactions
14 M« (J n Iii I’o rlo d n n tic s

A rthus reactions
1). Delayed hypersensitivity
20. Pharmacological actiofis o f histamine include follow­
ing except:
A. Increased capillary permeability
B. C ontraction o f striated m uscles
C. Stim ulation o f exocrine glands
D. Increased venule dilation permeability
21. Examples o f cytotoxic reactions include:
A. Hemolytic transfusion reaction
B. H em olytic disease o f newborn
C . Autoallergic hemolytic anemia
I). All o f the above
22. Which o f the followings is not a cytokine:
A. Interleukin 1
B. Tum or necrosis factor
C . Transform ing growth factor
I). None o f the above
 I n f la m m a tio n of P e r io d o n tiu m a n d H o s t R e s p o n s e 15

Answers
I .D. C ytoplasm ic granules (also know n as lysosom es)
contain inflam m atory m ediators such as histam ine,
eosinophil chem otactic factor, neutrophil chem otac-
tic factor, heparin, slow reacting substances o f ana­
phylaxis, tum or necrosis factor-x, and leukotriene C4.
2.D. N eutrophils are the predom inant leukocyte in blood.
N eutrophils do not need to differentiate substantially
to function, hence best suited for rapid response.
3.D. As a result o f antigen exposure, B-cells differentiate
to form plasm a cell. Plasma cells result in the produc­
tion and secretion o f antibodies.
4.D. S uppresso r T -cells release interleukins, stim ulate
cytotoxic and m icrobicidal activity o f im m une cells
and are CD-8 positive.
5.A. M onocytes are referred as m acrophages when they
leave the blood.
6.C. M em ory B-cells give rise to plasm a cells upon sec­
ondary exposure to antigen and produce high-affinity
antibodies.
7.A. Plasma cells produce effector cells for local and sys­
temic hum oral immunity.
8.C. A ntibodies are glycoprotein in nature.
9.C. A ntibodies are highly specific and sensitive. Speci­
ficity o f every antibody with particular antigen is due
to its unique am ino acid sequence and tertiary struc­
ture o f its antibody-com bining sites.
10.B. IgG has a valence o f 2, secretory IgA has a valcnce o f
4 and IgM has a valence o f upto 10.
11.A. M ost abundant im m unoglobulin in the serum is IgG
and is distributed equally between blood and extravas-
cular f lu id s .
16 M C Q s in P e r io d o n tic s

12.D. IgG crosses placental barriers and provides newborn

w ith hum oral im munity o f mother.
13.B. Higher concentrations o f IgE are found in patients with
asthm a, hay fever, and drug and food allergies.
14.A. IgA is the principal im m unoglobulin in saliva, milk,
respiratory secretions, intestinal mucin and tears.
15.D. The levels o f IgM generally decreases during later
stages o f infection and become negligible in com pari­
son with those o f IgG.
16.C. Red blood cell lysis, i.e. hem olysis as a consequence
o f com plem ent activation when antibody has reacted
is the basis for com plem ent fixation assay .
17.D. Type III hypersensitivity reactions are also known as
A rthus reaction or immune com plex reaction.
18.D. Type IV hypersensitivity reactions are also known as
cell mediated or delayed hypersensitivity reaction.
19.A. Type I hypersensitivity is also known as anaphylaxis
which may be cutaneous or systemic.
20.B. Pharm acological actions o f histam ine include in ­
creased capillar)' permeability, stim ulation o f exocrine
glands, sm ooth m uscle contraction and increased
venule dilation permeability.
21.D. Cytotoxic reactions are seen in autoim m une disease
in w hich antibodies react w ith patient’s own tissue
com ponents.
22.D. Interleukin 1, tum or necrosis factor and transform ing
grow th factor are cytokines. They are low molecular
w eight protein.
 Anatomy o f Cementum
Acellular cementum is mainly found in:
A. Cervical third o f the root
B. Apical third o f the root
C . M iddle third o f root
I). None o f the above
Thickness o f acellular cementum is:
A. 10 n
B. 2\x
C . 100 n
I). It varies from 30 to 230
Increased function o f tooth causes:
A. Increase is num ber o f Sharpey’s fibers
B. Increase in size o f Sharpey’s libers
C . Both o f the above
I). None o f the above
In cem entu m , cem entocytes arc contained in the
individual spaces known as:
A. Lam ellae B. Canaliculi
C. Lacunae D. None o f the above
All o f the following are true about cellular cementum
except:
A. It contains cemcntocytes
B. It is form ed before the tooth reaches its occlusal
plane
C. It is less calcified than acellular cem entum
D. It has sm aller am ount o f Sharpey’s libers as com ­
pared to acellular cementum
T he hypercaleified lines that separate lamellae o f
cellular cementum from that o f acellular cementum
are know n as:
A. Incremental lines
B. Lines o f Ritzius
I M Mi 'Q* Iii P e r io d o n tic s

( '. Both o f the above

I). N one o f the above
7. T he incremental lines o f cemcntum represent:
A. A ctive periods o f cem entum formation
B. Rest periods o f cem entum formation
C . Both o f the above
I). N one o f the above
8. Total inorganic content o f cementum is:
A. 90 to 95 percent
B. 70 to 80 percent
C . 60 to 65 percent
I). 45 to 50 percent
9. Cementum is thickest at:
A. C ervical third o f the roots
B. M iddle third o f the roots
C . Apical third and furcation areas o f roots
1). Uniform all over the root
10. C em cntum overlaps the enamel at ccmentoenamel
junction in about:
A. 60 to 65 percent o f cases
B. 30 percent o f cases
^ * '’cases

11. T he prominent thickening o f cementum on root is

termed as:
A. 1lypercem entosis
B. Cem entum hyperplasia
C. Both o f the above
I). None o f the above
12. Fusion o f cementum with alveolar hone resulting into
obliteration o f periodontal ligament is known as:
A. Cem entum hyperplasia
B. Ankylosis
C . I lypercem entosis
D. None o f the above
13. Ankylosed tooth is often associated with:
A. Suprabony pockets
B. Deep infrabony pockets
 A n a to m y of C e m e n t u m 19

C. Both o f the above

D. A true pocket never form s in ankylosed tooth
14. Resorption of cementum may occur in:
A. Erupted tooth
B. Partially erupted tooth
C . U nerupted tooth
D. All o f the above
15. N e w ly fo rm ed c em e n tu m d u r in g the p erio d o f
cemental repair is demarcated from rest o f the cemen­
tum by a line known as:
A. Increm ental line
B. Reversal line
C. Both o f the above
I). N one o f the above
20 M C Q s in P erio d o n tic s

Answers
1.A. A cellular cem entum is formed first and covers cervi­
cal third or half o f the root.
2.D. A cellular cementum is formed before tooth reaches
occlusal plane and its width ranges from 30-230 m i­
cron.
3.C. S ize, num ber and distribution o f S harpey’s fibers
increases w ith function.
4.C. In cellular cem entum . cem entocytes are contained in
individual spaces known as lacunae. Lacunae com ­
m unicate with each other through a system o f anasto­
m osing canaliculi.
5.B. A cellular cem entum is formed before tooth reaches
occlusal plane.
6.A. Increm ental lines denotes rest periods in cem entum
form ation and are m ore m ineralized than adjacent
cem entum .
7.B. Increm ental line o f cem entum represent rest periods
o f cem entum .
8.D. Total inorganic content o f cem entum is 45 to 50
percent which is less than that o f bone, enam el and
dentin.
9.C. Cem entum is thick at apical third and furcation areas
o f roots (upto 150 to 200 micron). But the thickness
on coronal h alf is 16 to 60 micron.
10. A. In about 30 percent, an edge to butt jo in t exists, and
in 5 to 10 percent, the cem entum and enam el fails to
meet.
11 .C. The prom inent thickening o f cem entum on root is
termed as hypercementosis (Cem entum hyperplasia).
It may affect one tooth or entire dentition.
12.B. Ankylosis is fusion o f cem entum w ith alveolar bone
where as hypercem entosis is prom inent thickening o f
cementum.
13.1). A true pocket never forms in ankyloscd teeth because
 A n a to m y of C e m e n t u m 21

apical proliferation o f epithelium along root is not

possible due to ankylosis.
14.D. Resorbtion o f cemcntum may occur in erupted, par­
tially erupted tooth that may be o f m icroscopic pro­
portion .
15.B. N ew ly form ed cem en tu m d u rin g th e p e rio d o f
cem ental repair is demarcated from rest o f the cem en­
tum by a deeply stained irregular line, known as re­
versal line. Cemcntum repair can occur in devitalized
as well as in vital teeth.
 Anatomy o f
Alveolar Bone
( p W hich of the following parts o f alveolar bone gives
attachment to principal fibers of periodontal ligament:
A. Inner cortical plates B. A lveolar bone proper
C . Both o f the above I). None o f the above
( 2 ) Inner wall o f the tooth socket is formed by:
A. Cancellous trabeculae B. Inner cortical plates
C . A lveolar bone proper 1). All o f the above
3. Alveolar bone proper is formed of:
A. I Iaversian bone
B. Com pact bone lam ellae
C . Bundle bone
I). Partly o f lamcllated and partly o f bundle bone
4. Lamina dura is:
A. Thin lamella o f bone that forms the inner wall o f the
socket
B. D ense rad io p aq u e line around the roots seen in
radiographs
C . Both o f the above
I). None o f the above
5. Alveolar process is formed:
A. Before the eruption o f the tooth
B. At the tim e o f tooth eruption
C . A fter the eruption o f the tooth
I). None o f the above
6. Lacunae o f (he alveolar bone communicate with each
other through:
A. Cytoplasm ic cell processes o f osteocytes
B. Intercellular matrix
C . Canaliculi
D. All o f the above
 A n a to m y of A lv e o la r B o n e 23

7. Inorganic matter of alveolar bone consists of:

A. '/a o f the bone
B. 2/3rd o f the bone
C . Vali o f the bone
D. '/4th o f the bone
S. Type I collagen forms:
A. 60 to 65 percent o f organic m atrix o f alveolar bone
B. 65 to 70 percent o f organic matrix o f alveolar bone
C. 76 to 82 perccnt o f organic matrix o f alveolar bone
D. 88 to 89 perccnt o f organic matrix o f alveolar bone
9. Which of the followings is wrong about interdental
septum:
A. Cancellous bone is bounded from facial and lingual
sides by alveolar bone proper
B. Cancellous bone may be absent in case o f narrow
interdental space
C . Bone m ay be absent in som e area o f interdental
septum in ease the roots are too close to each other
1). Cancellous bone is bounded from mesial and distal
sides by alveolar bone proper
10. Phe outer layer of periosteum of alveolar bone:
A. Has cells that have potential to differentiate into
osteoblasts
B. Consists o f fibroblasts and collagen fibers and is rich
in nerves and blood vessels
C . Both o f the above
1). None o f the above
11. Osteoid is:
A. Freshly secreted bone matrix
B. Freshly mineralized bone matrix
C. Both o f the above
I). None o f the above
12. Mineralization:
A. Always precedes bone matrix formation
B. Always lags behind bone matrix formation
C. O ccurs sim ultaneously with bone matrix formation
D. None o f the above
24 M C Q s in P c r io d o n tic s

13. The ruffled border is the characteristic structural fea­

ture of:
A. Osteocytcs
B. O steoblasts
C . Osteoclasts
I). All o f the above
14. A c id /a c id s secreted by o s te o c la s ts at the ruffle
border is/are:
A. Citric acid
B. Lactic acid
C. Hydrochloric acid
I). Both (A) and (B)
15. Osteoclasts:
A. Are formed by fusion o f circulating monocytes
B. May differentiate from mesenchymal cells in sites
C’. Are irregularly oval or club shaped with many branch­
ing processes
I). All o f the above
16. C hoose the correct statement:
A. In fenestrations the denuded area extends through the
marginal bone
B. In dehisccnce the marginal bone is intact
C . Both o f the above
1). N one o f the above
17. M ost com m on cause(s) of p h ysiologic mesial mi­
gration is/are:
A. Failure to replace extracted 1st perm anent molar
B. Flattening o f proxim al contact area due to proximal
w ear o f teeth
C. Both o f the above
1). None o f the above
18. In response to increased occlusal demands:
A. Bony trabeculae realign perpendicular to root surface
B. Width o f periodontal ligament increases
C. There is increased diam eter and num ber o f Sharpey's
fibers
1). All o f the above
 A n a to m y of A lv e o la r B o n e 25

19. In response to reduced occlusal demand:

A. Thickness and num ber o f trabcculac rcducc
B. Periodontal ligament becom es thin and atrophied
C. P eriodontal fibers gel disoriented an d ultim ately
arranged parallel to the root surface
D. All o f the above
20. SoUrcc(s) o f blond supply to periodontal ligament is
(are):
A. Branches given o ff by apical vessels before entering
the dental pulp
B. Transalvcolar vessels that enter periodontal ligament
after perforating the lamina dura.
C. G ingival v essels anastom osing w ith p erio d o n tal
ligam ent vessels o f cervical region
I). All o f the above
26 M C Q s in Periodon tics

Answers
I .B. A lveolar bone proper w hich is seen as lam ina dura in
radiographs gives attachm ent to principal libers o f
periodontal ligament.
2.C. Inner wall o f tooth socket w hich is thin com pact bone
is formed by alveolar bone proper.
3.D. A lv eo lar bone p ro p er is form ed o f partly dense
lam ellated bone and partly o f bundle bone. Bundle
bone is the bone adjacent to periodontal ligament that
contains a great num ber o f Sharpey’s fibers.
4.B. Lam ina dura is dense radiopaque line around the roots
seen in radiograph. Alveolar bone proper when seen
in radiograph is called lam ina dura.
5.B. A lveolar proccss is formed at the tim e o f tooth erup­
tion and disappears gradually after the tooth is lost.
6.C. C analiculi form an anastom osing system through the
intercellular matrix o f the bone.
7.B. Bone consist o f 2/3 inorganic matrix and 1/3 organic
matrix.
8.D. Type I collagen forms 88 to 89 percent o f organic m a­
trix o f alveolar bone with small am ounts o f non-col-
lagenous proteins such as osteocalcin, bone m orpho­
genetic protein, phosphoproteins and protcoglycans.
9.A. Interdental septum consists o f cancellous bone bor­
dered by sockct wall cribriform plates o f approxim at­
ing teeth and facial and lingual cortical plates.
10.B. The inner layer o f periosteum o f alveolar bone has
osteo p ro g en ito r cells w hich have the potential to
differentiate into osteoblasts.
11.A. O steo id is fresh ly secreted bone m a trix th a t is
nonm ineralized.
12.B. M ineralization always lags behind bone matrix for­
mation. i.e. osteoid formation.
 A n a to m y of A lveo lar B o n e 27

13.C. O steoclasts possess elaborately developed ruffled

border from which hydrolytic enzym es are believed
to be secreted.
14.D. Acids secreted by osteoclasts at the ruffled border arc
citric acid and lactic acid.
15.D. O steo cla sts arc form ed by fusion o f c irc u la tin g
monocytes, may differentiate from mesenchymal cell
in sites and arc irregular oval or club shaped with
many branching process.
16.1). In dehiscence the denuded area extends through the
marginal bone, and in fenestrations, marginal bone is
intact.
17. A. M ost com m on cause o f physiologic mesial m igration
is failure to replace extracted 1st perm anent molar.
18.1). In response to increased occlusal dem ands, bony
trabeculae realign perpendicular to root surface, width
o f periodontal ligam ent increases and there is in­
creased diam eter and num ber o f Sharpey’s fibers.
19.D. In response to reduced occlusal demand, thickness and
num ber o f trabeculae reduce, periodontal ligament
becom es thin and atrophied and periodontal libers gets
disoriented and ultimately arranged parallel to the root
surface.
20.1). Sources o f blood supply to periodontal ligament are
apical vessels, transalveolar vessels and and gingival
vessels.
 Sulcular Fluid and Saliva
Defense Mechanisms o f
Gingiva
1. Sulcular epithelium can be penetrated by substances
with a molecular weight o f up to:
A. One m illion B. Two m illion
C . Three m illion I). Ten m illion
2. Sulcular fluid is:
A. An inflam m atory exudate
B. A normal transudate
C . Derived from saliva
D. N one o f the above
3. The amount o f fluid collected on a paper strip can be
evaluated by:
A. M easuring the wetted area
B. The help o f an electronic device
C . Both o f the above
I). None o f the above
4. T h e concentration o f carbohydrates in the sulcular
fluid is:
A. Less than that in the blood
B. 3 to 4 times m ore than that in the blood
C . Sam e as in the blood
D. None o f the above
5. Concentration o f proteins in the sulcular fluid is:
A. Less than that in the blood
B. M ore than that in the blood
C . Same as in the blood
D. None o f the above
 S u l c u l a r F lu id a n d S aliv a D e fe n se M e c h a n is m s of G ingiva 29

6. T he am ount of gingival fluid usually increases with:

A. Severity o f the inflamm ation
B. Vigorous tooth brushing
C . M astication o f coarse food
D. All o f the above
7. Smoking:
A. Increases the flow o f sulcular fluid
B. D ecreases the flow o f sulcular fluid
C . First increases then decreases the flow o f sulcular fluid
I). Does not have any effect on the How o f sulcular fluid
8. During ovulation, prcgnancy and use o f hormonal
contraceptives, the production o f gingival fluid:
A. Increases
B. Decreases
C. Rem ains unchanged
1). None o f the above
9. Saliva helps in maintaining the oral tissues in physio­
logical state by:
A. M echanically cleaning the exposed oral surface by
its flushing action
B. By buffering the acids produced by bacteria
C . By controlling the bacterial activity
I). All o f the above
10. The most dominant immunoglobulin found in saliva
is:
A. IgA
B. IgG
C. IgM
I). IgD
11. Proteolytic enzymes found in saliva are produced by:
A. Oral bacteria
B. Host tissue cells
C . Both (A) and (B)
D. None o f the above
12. Antiprotease (s) found in saliva is/arc:
A. Cathepsins
B. Tissue inhibitor o f matrix m ctalloproteinase (T1MP)
30 M C Q s in P erio d o n tic s

C . A ntilcucoproteases
I). All o f Ihe above
13. T he activity o f collagen degrading enzymes in the
saliva is inhibited by:
A. C athepsins
B. TIM P
C. Antilcucoproteases
I). All o f the above
14. Concentration of which o f the following enzyme (s)
increases in saliva in periodontal disease:
A. H valuronidase
B. Cnondroitin sulphatase
C. Peroxidase
I). All o f the above
15. Orogranulocytic migratory rate refers to:
A. T he rate o f m igration o f m onocytes into oral cavity
B. T h e ra te o f m ig ra tio n o f p o ly m o rp h o n u c le a r
leucocytes into the oral cavity
C . T he rate o f immigration o f lymphocytes into the oral
cavity
I). All o f the above
16. The most important buffer system in the saliva is:
A. Bicarbonate-carbonic acid buffers
B. Protein buffers
C . Phosphate buffers
I). All o f the above
17. The important coagulation factors present in saliva
include:
A. Factors VIII, IX, and X
B. Hageman factor
C . Plasma throm boplastin antecedent (PTA)
D. All o f the above
18. Besides its defensive role, the saliva also helps in the
production o f periodontal diseases due to its:
A. High m olecular weight glycoproteins
B. Proteolytic enzymes
C . Both (A) and (B)
D. N one o f the above
 S u lc u ln r F luid a n d S aliv a D e f e n s e M e c h a n is m s of G in g iv a 31

Answers
1.A. Substance that penetrate sulcular epithelium include
album in, endotoxin, thym idine, histam ine, phenytoin
and horseradish peroxidase..
2.A. Sulcular fluid is an inflam m atory exudates. Sulcular
fluid is present in normal sulci since gingiva that ap­
pears clinically normal invariably exhibits inflam m a­
tion when m icroscopically examined.
3.C. The am ount o f fluid collected on a paper strip can be
evaluated by m easuring the wetted area and w ith the
help o f electronic device. Wetted area can be made
m ore visible by staining with ninhydrin.
4.B. This is because o f metabolic activity o f adjacent tis­
sues and also as a function o f local m icrobial flora.
5.A. The total protein content o f sulcular fluid is m uch less
then that in serum.
6.D. Even m inor stimuli represented by intrasulcular place­
ment o f paper strips increases the production o f fluid.
7.A. Sm oking produces an im mediate transient but marked
increase in sulcular fluid flow.
8.A. Fem ale sex horm ones increases sulcular fluid as they
increase vascular permeability.
9.D. By m echanically cleaning the exposed oral surface by
flushing action, by buffering the acids produced by
bacteria and by controlling the bacterial activity, sa­
liva helps in maintaining the oral tissues in physiologi­
cal state.
10.A. A lthough IgG and IgM are present, the most dom i­
nant im munoglobulin found in saliva is IgA.
11.C. The enzym es normally found in saliva are derived
form salivary glands, bacteria, leukocytes, oral tissues
and ingested substances.
12.D. Cathepsins inhibit cysteine, protease, antileuco-pro-
teases inhibit elastase and TIM P inhibit the activity
o f collagen degrading enzymes.
32 M C Q s in P e r io d o n tic s

13.B. A ctivity o f collagen degrading enzym es in the saliva

is in h ib ited by tissue in h ib ito r o f m atrix m ctal-
loproteinase (TIMP).
14.D. H yaluronidase, lipase, B-glucuronidase, chondritin
sulfatase, am ino acid decarboxylases, catalase, pero­
xidase and collagenasc concentration increases in
saliva in periodontal disease.
15.B. Living polym orphonuclear leucocytes in saliva are
referred to as orogranulocytcs and their rate o f m igra­
tion into oral cavity is termed orogranulocytic m igra­
tory rate.
16. A. The m aintenance o f pH at the mucosal epithelial cell
surface and the tooth surface is an im portant function
o f salivary buffers.
17.1). C oagulation factors hasten blood coagulation and
protect w ounds from bacterial invasion.
18.C. Saliva helps in production o f periodontal diseases clue
to its high m olecular weight glycoproteins and pro­
teolytic enzymes.
 l/
------ 6 -------
Aging o f Periodontium
1. W hich o f the following changes in gingiva is not
identified with aging:
A. Decreased connective tissue cellularity
B. D im inished keratinization
C . Reduced or unchanged am ount o f stippling
D. Decreased w idth o f attached gingiva
2. T he keratinizing potential o f which o f the following
docs not change with age:
A. Lip B. Cheek
C. Hard palate I). Attached gingiva
3. In the periodontal ligament, aging results in:
A. Increase in the number o f elastic fibers
B. D ecrease in the num ber o f collagen libers
C . Both o f the above
1). N one o f the above
4. A reduction in the width of periodontal ligament with
aging is due to:
A. L ow er fu nctional dem and o w in g to d ecrease in
strength o f the masticatory musculature
B. Increased functional dem and ow ing to decrease in
strength o f the masticatory musculature
C. L ow er fu n ctio n al dem and o w in g to in crease in
strength o f the masticatory musculature
I). Increased functional dem and ow ing to increase in
strength o f the masticatory musculature
5. Change (s) in alveolar bone with aging is/are:
A. O steoporosis
B. Decreased vascularity
C . D ecreased healing capacity
I). All o f the above
34 M C Q s in P e r io d o n tic s

6. Occlusal w ear results in all, except:

A. Reduction in cusp height
B. Reduction in cusp inclination
C. Loss o f sluiceways
I). D ecrease in food table area
7. With age the anteroposterior length of the dental arch:
A. Reduccs by approxim ately 0.5 cm by age 40
B. Increases by approxim ately 0.5 cm by age 40
C . Rem ains the sam e by age 40
D. Rem ains the sam e by age 60
 Aging of P e r io d o n tiu m 35

Answers
1 .0 . Width o f attached gingiva increases w ith age.
2.C. K eratinizing potential o f hard palate does not change
w ith age.
3.C. In the periodontal ligament, aging results in decreased
num ber o f fibroblasts, organic matrix production and
epithelial cell rests and increased am ount o f elastic
fiber.
4 .A. The w idth o f the periodontal ligam ent space will
decrease if the tooth is unopposed or in hypofunction.
5.D. W ith aging bone is rarified, trabeculae are reduced in
n um ber, co rtical p la tes are th in n ed and lacu n ar
resorption is more prominent.
6.D. Occlusal wear results in increase in food table area.
7. A. Anteroposterior length o f dental arch reduces with age.
Proxim al w ear o f teeth reduces the anteroposterior
length o f dental arch.
 Microbiology o f
Periodontal Diseases
1. One gram o f plaque (wet weight) contains approxi­
mately:
A. I x \ O' bacteria B. 2 x 10" bacteria
C. 1 * 10" bacteria I). 2 * 1010 bacteria

2. The initial bacteria colonizing the pellicle coated tooth

surface are predominantly:
A. G ram -positive facultative m icroorganism s
B. Gram-negative facultative microorganisms
C . Both gram -positive facultative m icroorganism s and
gram -negative facultative m icroorganism s
1). G ram -positive aerobic microorganisms
3. Secondary colonizers of the dental plaque are all of
the following, except:
A. Prevotella intermedia
B. Streptococcus sanguis
C. Porphyromonas gingival is
I). Fusobacterium nucleatum
4. W hich o f the following microorganisms is identified
as predominant pathogen in localized juvenile perio­
dontitis:
A. Prevotella gingivalis
B. A ctinobaciilus actinomycetemcomitans
C. Streptococcus sanguis
I). Actinomyces viscosus
5. T h e c h a n g e in periodon tal m icrobiology from a
healthy periodontium to a diseased periodontium
includes:
A. Increase in gram -positive facultative rods and cocci
and gram -negative rods
 M icrobiology of P e r io d o n ta l D i s e a s e s 37

13. D ecrease in gram-positive facultative rods and cocci

and increase in gram-negative rods
C . Decrease in gram-positive facultative rods and cocci
and gram -negative rods
1). Increase in gram-positive facultative rods and cocci
and decrease in gram-negative rods
6. Pregnancy gingivitis is associated with increase in the
levels of:
A. Prevotella intermedia
B. Streptococcus mitis
C. Campylobacter species
I). Actinomyces naeslundii
7. M icroorga n ism s predom inantly found in A N U G
lesions are:
A. Prevotella gingivalis and Prevotella intermedia
B. Prevotella intermedia and Spirochetes
C . Porphyromonas gingivalis and Prevotella intermedia
I). Porphyromonas gingivalis and capnocytophaga
8. In chronic adult periodontitis the microorganisms
often cultivated at high levels include:
A. Porphyromonas gingivalis
B. Prevotella intermedia
C . Actinohacillus actinomycetemcomitans
I). All o f the above
9. T he m icroorganism s significantly associated with
rapidly progressive periodontitis are:
A. P. gingivalis and A. actinomycetemcomitans
B. P. gingivalis and capnocytophaga
C . A. actinomycetemcomitans and capnocytophaga
I). P. gingivalis only
10. According to Koch’s postulates, the causative agent
in human infections must:
A. Be routinely isolated from diseased individuals
B. Be grow n in pure culture in the laboratory
C. P roduce a sim ilar d isease w hen in o cu lated into
susceptible laboratory animals
I). All o f the above
38 M C Q s in P e r io d o n tic s

11. A ctin om y ces viscosus that initially colonizes the

periodontal environment most likely attaches to the
pellicle or saliva coated tooth surface through:
A. M em brane protein
B. Meat sensitive protein
C . Fimbriae
D. O uter membrane protein
12. B acteria m ay e n te r host tissues th ro u g h :
A. Ulcerations in the epithelium o f the gingival sulcus
or pocket
B. Direct penetration o f bacteria into host epithelial or
connective tissue cells
C . Both o f the above
I). None o f the above
13. Selected bacterial properties involved in evasion of
host defense mechanisms include:
A. Imm unoglobulin degrading proteases
B. Inhibition o f superoxidc production
C . Production o f leukotoxin
D. All o f the above
14. The virulence factors o f periodontal pathogens w ork
in which o f the following ways:
A. Bacterial adherence in the periodontal environm ent
—> Bacterial evasion o f host defense m echanism s
-» Host tissue invasion
B. Bacterial evasion o f host defense m echanism s->H ost
tissue Invasion-*Bacterial adherence in the periodon­
tal environm ent
C . H ost tissue Invasion—»B acterial adherence in the
periodontal environm ent—►Bacterial evasion o f host
defense mechanisms
1). B acterial A dherence in the P eriodontal en v iro n ­
m ent—>Host tissue lnvasion~>Bacterial evasion o f
host defense m echanism s
15. The bacterial products that inhibit the growth or
alter the metabolism o f host tissue cells include:
A. Ammonia
B. Volatile sulfur com pounds
 M icrobiology of P e r i o d o n t a l D i s e a s e s 39

C. Fatty acids, peptides and indole

D. All o f the above
16. Trypsin like enzyme capable o f degrading host tis­
sues is produced by all, except:
A. P. gingival is
B. Campylobacter rectus
C. A. actinomycetemcomitans
1). Treponema denticola
17. Bacterial enzymes may facilitate:
A. Tissue destruction
B. Invasion o f the bacteria into host tissues
C. Both o f the above
I). N one o f the above
18. The microorganisms colonizing the gingival pockets
utilize which o f the following as energy source:
A. Saliva and sugars
B. Saliva and am ino acids
C. A m ino acids and sugars
D. A m ino acids and simple peptides
19. Host defense mechanisms in the dentogingival area
include all o f the following, except:
A. Host parasite inter-relations
B. Defense by saliva
C . Microbial perturbation o f the local humoral defense
I). Defense by RB C ’s
40 M C Q s in P erio d o n tic s

Answers
1.13. More than 500 different m icrobial species are found
in dental plaque.
2. A. The initial bacteria colonizing the pellicle coated tooth
surface are predom inantely gram -positive facultative
m icroorganism s such as actinom yces viscous and
Streptococcus sanguis.
3.B. Streptococcus sanguis is the prim ary colonizer o f den­
tal plaque.
4.B. Microbiologic studies indicate that alm ost all U P sites
harbor. A. actinomycetemcomitans , which m ay co m ­
prise as much as 90 percent o f the total cultivable
microbiota.
5.B. In pcriodontally healthy sites, gram -positive faculta­
tive rods and cocci arc predom inant (app.75% ).Thcir
num ber decreases proportionally in gingivitis (44% )
and periodontitis (10 to 13%).
6.A. Pregnancy associated gingivitis is accom panied by-
increase in steroid hormones in crevicular fluid and
dram atic increase o f P. intermedia.
7.B. Spirochetes are found to penetrate necrotic tissue and
apparently unaffectcd connective tissue.
8.D. In chronic adult periodontitis, the m icroorganism s
often cultivated at high levels include P. gingival is,
B.forsythus , P .interm ediate.rectus , E n u clea tio n ,
A.actinomycetecomitans and Treponema.
9. A. P. gingivalis and A. actinomycetemcomitans have been
show n to invade host tissue cells, w hich m ay be
significant in rapidly progressive periodontitis.
10.D. K och’s postulates also include that the causative agent
m ust be recovered from lesions in a diseased labora­
tory animal.
I l.C . A. viscous possess fibrous protein structure called
fim briae that extends from bacterial cell surface and
bind to proline rich proteins that are found in dental
pellicle.
 M icrob io logy of P e r io d o n ta l D i s e a s e s 41

12.C. B acteria may enter host tissues through ulcerations in

the epithelium or direct penetration o f bacteria into
epithelial or connective tissue cells.
13.0. Selected bacterial properties involved in evasion o f
host defense mechanisms include IgA and IgG degrad­
ing proteases, inhibition o f supcroxidc production,
production o f leukotoxin, cytotoxin and inhibition o f
11.-8 production by epithelial cells.
I4.D. Virulence properties can be broadly categorized into
2 groups: Factor that enable bacterial species to colo­
nize and invade host tissues, and factors that enable a
bacterial specie to cause host tissue damage.
15.1). M etabolic by products that inhibit the grow th or
alter the m etabolism o f host tissue cclls include
am m onia, volatile sulfur com pounds, fatty acids,
peptide and indole.
16.B. Trypsin like enzym es capable o f degrading host tis­
su e is p ro d u c e d by P. g in g iv a l is, A. a c tin o ­
mycetemcomitans and T.denticola.
17.C. Bacterial enzymes may facilitate tissue destruction and
invasion o f bacteria into host tissues .
18.D. B a c te ria th at p red o m in ate in m atu re p laq u e are
anaerobic and use amino acids and sim ple peptides as
energy source.
19.1). Host defense m echanism s in the dentogingival area
in clu d e h ost parasite in ter-relatio n s, d efen se by
saliva and microbial perturbation o f local humoral
defense.
 Calculus and
Periodontal Diseases
1. A hard deposit that forms by mineralization of
dental plaque is:
A. Marginal plaque B. Calculus
C. M ateria alba 1). All o f the above
2. Calculus is generally covered by a layer of:
A. M ineralized plaque
B. U nm ineralized plaque
C . M ateria alba
D. N one o f the above
3. Supragingival calculus occurs most frequently and in
greatest quantity on the:
A. Buccal surfaces o f the m axillary m olars and lingual
surfaces o f the m andibular anterior teeth
B. Lingual surfaces o f the maxillary m olars and lingual
surfaces o f the m andibular anterior teeth
C . Buccal surfaces o f the m andibular m olar and lingual
surfaces o f the m axillary molars
I). Lingual surfaces o f the m axillary anterior teeth and
buccal surfaces o f m axillary molars
4. Which of the followings is not a property o f subgingi­
val calculus:
A. It is usually dark brown or greenishblack in color
B. It is not visible on routine clinical exam ination
C . It can be easily detached from the tooth surface
I). It is hard or flintlike in consistency
5. Which o f the followings is the main mineral source
for subgingival calculus:
A. Saliva
B. G ingival fluid which resembles serum
 C a lc u lu s a n d P e r io d o n ta l D i s e a s e s 43

C . G ingival fluid which resem bles plasma

D. N one o f the above
6. W hich o f the following crystal forms occur in greater
amounts in supragingival calculus:
A. Ilydroxyapatite and m agnesium w hitlockite
B. O ctacalcium phosphate and Brushite
C . I lydroxyapatite and octacalcium phosphate
I). B rushite and M agnesium whitlockite
7. W hich o f the following cry stal forms is more in sub­
gingival calculus compared to supragingival calculus:
A. I lydroxyapatitc
B. M agnesium whitlockitc
C . O ctacalcium phosphate
D. Brushite
8. The content o f the following increases with the depth
o f periodontal pockets:
A. Calcium
B. Phosphate
C. Sodium
I). Potassium
9. The mode(s) of attachment of dental calculus to the
tooth surface is/are:
A. By m eans o f an organic pellicle
B. By penetration o f calculus bacteria into cem entum
C. M echanical locking into surface irregularities such
as resorption lacunae and caries
D. All o f the above
10. W hich o f the following chromogenic bacteria is most
com m only responsible for black stains:
A. Flavobacterium
B. A ctinom yces
C . Prevotella melaninogenicus
D. A spergillus
11. Calcifying plaques may become 50 percent mineral­
ized in:
A. 1 day
B. 2 days
C. 12 days
I). 21 days
44 M C Q s in P e r io d o n tic s

12. In the supragingival plaque calcification begins along

(he:
A. O uter surface o f the supragingival plaque
B. Inner surface o f the supragingival plaque adjacent to
the tooth
C. Equally on both the outer and inner surfaces o f the
supragingival plaque
1). It never calcifies
13. The primary effect of calculus in periodontal disease
seems to be:
A. Its irritating nature
B. By initiating gingivitis
C . Its retention site role for plaque
I). Disruption o f the attachment o f junctional epithelium
w ith tooth
 C a lc u lu s a n d P e r io d o n ta l D i s e a s e s 45

Answers
1.B. Hard deposit that forms by m ineralization o f dental
plaque is calculus. Calculus forms on the surface of
natural teeth and dental prosthesis.
2.B. Calculus is a hard deposit that is formed by m inerali­
zation o f dental plaque and is generally covered by a
layer o f unm ineralized plaque.
3.A. Saliva from parotid gland flows over facial surfaces
o f upper molars via Stenson’s duct whereas W harton’s
duct and B ortholin’s duct empty near the lingual sur­
faces o f low er incisors.
4.C. Subgingival calculus is firmly attached to the tcoth
surface.
5.B. Saliva is source o f mineralization for supragingival
calculus w hereas serum transudate called gingival
crevicular fluid furnishes the minerals for subgingi­
val calculus.
6.C. In 97 to 100 percent o f all supragingival calculus, hy-
droxy-apetite and octacalcium phosphate crystal forms
occur.
7.B. Subgingival calculus has same hydroxyapctite con­
tent as supragingival calcu lu s, m ore m agnesium
w hitlockite and less brushite and octacalcium phos­
phate.
8.C. l'h e ra tio o f c a lc iu m to p h o s p h a te is h ig h e r
subgingivally and the sodium content increased with
the depth o f periodontal pockets.
9.D. A nother mode o f attachm ent o f dental calculus to the
tooth surfacc is by clo se ad ap tatio n o f calcu lu s
undersurfacc depressions to the gently sloping mounds
o f unaltered cementum surface.
10.B. Dental stains arc pigmented deposits on tooth surface
which are primarily an aesthetic problem and do not
cause inflam m ation o f gingiva.
46 M C Q s in P e r io d o n tic s

11 .D. C alcifying plaques may become 50 pcrcent m ineral­

ized in 2 days and 60 to 90 pcrcent mineralized in 12
days.
12.B. C alcification begins along the inner surface o f the
supragingival plaque and in the attached com ponent
o f subgingival plaque adjacent to the tooth.
13.C. C alculus dose not irritate the gingiva but provides a
fixed nidus for continued accum ulation o f plaque and
retains it in close proximity to the gingiva.
 9
---------------------
Public Health Aspect o f
------------------------

Periodontal Diseases
1. T h e follow ing gingival score o f the gingival index is
associated w ith m o d erate degree o f gingivitis:
A. 0.1 to 1.0 B. 1.1 to 2.0
C . 2.1 to 3.0 I). 3.1 to 4.0
2. All a re indices of gingival bleeding, except:
A. Sulcus bleeding index
B. Papillary bleeding index
C. G ingival bleeding index
D. Periodontal bleeding index
3. T h e highest prev alen ce of gingivitis occu rs d u rin g :
A. Age o f 5 years
B. Puberty
C . Adulthood
I). Old age
4. T h e p rev alen ce an d severity o f p erio d o n tal disease in
m ales as co m p ared to fem ales is:
A. Higher
B. Lower
C. Equal
1). C annot be estim ated
5. T h e p rim a ry etiologic ag en t of th e gingival an d p e ri­
o d o n ta l disease is:
A. Poor oral hygiene
B. Malnutrition
C . A dverse habits
I). Lack o f fluorides in diet
6. W hich of th e follow ing area o f m outh is m ost severely
affected by gingivitis:
A. Buccal surfaces o f gingiva
B. Lingual surfaces o f gingiva
48 M C Q s in P e r io d o n tic s

C. Interproxim al areas
I). Both (A) and (B)
7. W h ich o f th e follow ing p a rts of m o u th has a slightly
h ig h e r ten d en cy to w a rd s gingivitis:
A. Right h a lf o f the arch
B. Left h a lf o f the arch
C . Com plete upper arch
I). Com plete low er arch
8. T h e su b g in g iv al calculus is found in g re a te r am o u n t
in association w ith:
A. I .owcr fi rst m olars
B. Lower second molars
C. Low er centrals and laterals
I). Upper centrals and laterals
9. T h e teeth th a t a re m ost severely affected by p e rio ­
d o n ta l d isease a rc the:
A. Lower centrals and laterals
B. I .ower premolars
C . U pper centrals and laterals
D. U pper premolars
10. In th e gingivitis index, m ild to m o d erately severe gin­
givitis ex ten d in g all a ro u n d the tooth is given th e g in ­
gival sta tu s of:
A. 0
B. 1
C. 2
I). 3
11. If th e p erio d o n ta l index score is betw een 0.7 an d 1.9,
it m eans th a t th e p erio d o n tal d isease is:
A. A bsent
B. Reversible
C. Irreversible
I). Treated
12. In th e PM A index, P, M an d A sta n d for:
A. P-periodontium . M -mobility. A- attrition
B. P-dental papilla, M -migration o f teeth, A-attrition
 P u b lic H e a lth A s p e c t of P e r io d o n t a l D i s e a s e s 49

C. P-dental papilla. M -gingival m argin. A - attached

gingiva
I). P-plaque, M-gingival margin, A-attached gingiva
50 M C Q s in P e r io d o n tic s

Answers
1.B. 0.1 to 1.0 degree is mild gingivitis, 1.1 to 2.0 degree is
moderate gingivitis and 2.1 to 3.0° is severe gingivitis.
2.D. Periodontal bleeding index is not an index for gingival
bleeding.
3.B. Prevalence and severity o f gingivitis increases with
age, beginning at approxim ately 5 years at o f age,
reaching their highest point in puberty, and there gradu­
ally decreases.
4.A. M ales av erag e ap p ro x im ately 10 p ercen t h igher
attachm ent loss then females from 18 to 80 + years
age.
5. A. Bacterial plaque is a primary etiologic factor o f perio­
dontal diseases.
6.C. G ingivitis is more severe in the upper arch than in
low er arch for interproximal and buccal areas and is
m ore severe in the lower arch than in the upper arch
in the lingual area.
7.A. T his is because o f the difficulty that right handed
persons have in brushing the right h alf o f mouth.
8.C. For subgingival calculus, low er central and lateral
incisors have the m ost calculus, followed by upper
first molars.
9.A. Teeth that are most severely affected by periodontal
disease are the lower central and lateral incisors and
the upper m olars (first, second and third ).
10.C. M ild to moderate inflammatory gingival changes, not
extending around the tooth is given gingival status o f
1.
1 l.B. If periodontal index score is 0.7 to 1.9,it m eans that
periodontal disease is reversible and if periodontal
index score is 3.8 to 8.0 it m eans that periodontal
disease is irreversible.
 P u b lic H e a lth A sp e c t of P e r io d o n ta l D is e a s e s 51

12.C. In the PMA index. P stands for mesial dental papilla, M

stands for gingival margin and A stands for attached
gingiva.
s/
10
Treatment o f HIV
Infected Patients
1. The percentage o f AIDS patients having oral lesions
is:
A. 20 pcrcent B. 35 percent
C . 55 pcrcent I). 95 percent
2. HIV infection is strongly correlated with:
A. Oral candidiasis
B. Oral hairy leukoplakia
C . Oral K aposi's sarcoma
I). All o f the above
3. In IIIV infected patients oral hairy leukoplakia is
found almost exclusively on the:
A. Buccal mucosa
B. Soft palate
C . Hard palate
D. Lateral borders o f the tongue
4. The Kaposi’s sarcoma that occurs in HIV infected
patients presents different clinical features in that it
is:
A. Very slowly growing lesion
B. M uch more aggressive lesion
C. Frequently involves the oral mucosa, particularly the
palate and the gingiva
D. Both (B) and (C)
5. Which o f the following statements is wrong about oral
hairy leukoplakia and AIDS:
A. Oral hairy leukoplakia in AIDS patients is found
almost exclusively on the lateral borders o f the tongue
B. Oral hairy leukoplakia is caused by hum an papillom a
virus
 T r e a t m e n t of HIV In fe cte d P a t i e n t s 53

C . The num ber o f HIV infected patients w ith hairy

leukoplakia who eventually develop AIDS approaches
100 percent
I). Small lesions are as diagnostically significant as
extensive lesions
6. The most common oral lesion in HIVinfected patients
is:
A. Oral hairy leukoplakia
B. Oral candidiasis
C . Oral K aposi’s sarcoma
I). Oral hyperpigm entation
7. T he percentage of AIDS patients su fferin g from
candidiasis is approximately:
A. 50 percent
B. 60 percent
C . 90 percent
I). 100 percent
8. Ill V associated gingivitis is best described by the term:
A. Juvenile gingivitis
B. Acute necrotizing gingivitis
C . Linear gingival erythema
I). N ecrotizing ulcerative gingivitis
9. HIV positive individuals can anticipate reasonably
good periodontal health throughout the course of their
disease by:
A. Periodontal surgery
B. A ntibiotic treatment
C . Proper home care and appropriate periodontal treat­
ment and maintenance
D. Proper scaling and root planing
10. HIV infected patients are more susceptible to perio­
dontal infections as their immune system becomes
more compromised. I1IV infected patients are not the
potential candidates for procedures such as perio­
dontal surgery and implant placement:
A. Both the statem ents are wrong
B. Only first statem ent is wrong
C . Only second statement is wrong
1). Both the statements are correct
54 M C Q s in P e r io d o n tic s

Answers
1.C. M ore than 95 percent o f AIDS patients have head and
neck lesions and 55 percent o f AIDS and related com ­
plex patients have oral lesions.
2.D. HIV infection is strongly correlated with oral hairy
leu k o p lak ia, oral can d id iasis. K ap o si’s sarcom a,
bacillary angiomatosis, oral hyperpigmentation, atypi­
cal ulcers and delayed healing.
3.D. In HIV infected patients, oral hairy leukoplakia is
found alm ost exclusively on lateral borders o f tongue,
it frequently has a bilateral distrib u tio n and m ay
extend to the vcntrum.
4.D. The oral cavity may often be the first or only site o f
lesion.
5.B. Oral hairy leukoplakia is caused by Epstein-Barr vi­
rus.
6.B. C an d id iasis has been found in approxim ately 90
percent o f AIDS patients.
7.C. C andidiasis has one o f four clinical presentation:
pseudom em branous, erythem atous, hyperplastic or
angular cheilitis.
8.C. Linear gingival erythema is a persistent, linear, easily
bleeding, erythem atous gingivitis.
9.C. HIV infected patients are potential candidates for pro­
cedures such as periodontal surgery and implant place­
ment.
10.C. HIV infected patients arc more susceptible to peri­
odontal infections as their immune system becom es
more com prom ised. IIIV infected patients are poten­
tial candidates for procedures such as periodontal sur­
gery and im plant placement.
 Bacterial Interaction in
Periodontal Diseases
1. T h e cell co n stitu en t (s) o f v a rio u s b a c te ria th a t play a
role in p erio d o n tal disease is/are:
A. Endotoxins
B. Bacterial surface com plem ents
C . Capsular com ponents
I). All o f the above
2. E n d o to x in s a r c highly toxic s u b s ta n c e s , affectin g
p erio d o n tal tissues:
A. Directly
B. Through activation o f host responses
C . Both o f the above
I). None o f the above
3. A c e n tra l ch a ra c te ristic of p erio d o n ta l d estru ctio n is
th e d e g ra d a tio n of:
A. Collagen B. Elastin
C . Fibroblasts 1). M ucopolysaccharides
4. A significant im m u n e fin d in g in p reg n an cy gingivitis
is:
A. PMN chem otactic defect
B. Occurrence o f immune com plexes in tissues
C. No significant findings reported
I). Elevated antibody levels to Prevotella gingiva Iis
5. T h e p rim a ry source of collagenase in the p erio d o n tal
pocket is p ro b ab ly :
A. Host tissue cells
B. Bacteria
C. Diet
I). Blood
56 M C Q s in P e r io d o n tic s

6. Secreting im m une system affects the periodontal

disease by:
A. Decreasing bacterial colonization on surfaces exposed
to saliva
B. C ausing tissue destruction
C . Controlling im mune responses to bacteria
I). All o f the above
7. Which o f the following neutrophil disorder(s) is/are
associated with periodontal disease:
A. Diabetes m ellitus
B. D ow n’s syndrome
C . Papillon-Lefevre syndrome
I). All o f the above
8. W hich o f the following periodontal disease (s) is/are
associated with neutrophil disorders:
A. A cute necrotizing ulcerative gingivitis
B. Prepubertal periodontitis
C . Rapidly progressing periodontitis
I). All o f the above
9. Im m unoglobulins are inactivated or destroyed by
bacterial:
A. Collagenase
B. I lyaluronidase
C . C atalase
I). Protcasc
10. T h e im m u n ologic findings in adult p erio d o n titis
include all o f the following except:
A. Elevated antibody titer to Prevotella gingivalis and
other pcriodontopathogens
B. Cell mediated immunity to gingival bacteria
C . O ccurrence o f im mune com plexes in tissue
I). PMN and monocytic chem otactic defects
11. T he host factor (s) which is/are responsible for tissue
destruction in periodontal disease is/are:
A. Anti body mediated hypersensitivity
B. Cell mediated hypersensitivity
C . A ctivation o f tissue factor such as collagenase
I). All o f the above
 B a cterial I n te ra c tio n in P e r io d o n ta l D i s e a s e s 57

Answers
1.D. The cell constituents o f various bacteria that play a
role in periodontal disease are endotoxins, bacterial
surface com plements and capsular com ponents.
2.C. Endotoxins has the ability to produce leukopenia, ac­
tivate factor XII, activate com plem ent system , have
cytotoxis effects and induce bone resorption.
3.A. The prim ary source o f collagenase in the periodontal
pocket is probably host tissue cclls, but bacterial col-
lagenases may also contribute to collagen degrada­
tion.
4.C. In pregnancy gingivitis, no significant im m une re­
sponse is reported.
5.A. But bacterial collagenases may also contribute to col­
lagen degradation.
6.A. N eutrophil, antibody and com plem ent have bacteri­
cidal action: lymphocyte, macrophage and lymphok-
ine affect periodontal disease by tissue destruction.
7.D. D iabetes mellitus, Papillon-Lefevre syndrom e, syn­
drom e, Down Chcdiak-Higashi syndrom e, drug in­
duced agranulocytosis and cyclic n eutropenia are
neutrophil disorders that arc associated with periodon­
tal disease.
8.D. Localized juvenile periodontitis and refractory perio­
dontitis are also the periodontal diseases that are as­
sociated w ith neutrophil disorders.
9.D. Immunoglobulins are inactivated or destroyed by bac­
terial proteasc.
10.D. Immediate hypersensitivity to gingival bacteria is also
one o f the im munologic finding in adult periodonti­
tis.
11.1). The host factors which are responsible for tissue des­
truction in periodontal diseases are antibody mediated
hypersensitivity, cell m ediated hypersensitivity and
activation o f tissue factor such as collagenase.
------- 12-------
Functions o f Leukocytes in
Periodontal Diseases
1. T h e three prim ary leukocytes participating in the
immune response to periodontal diseases are:
A. N eutrophils, M onocytes and Eosinophils
B. Basophils. N eutrophils and Eosinophils
C. N eutrophils, M onocytes and Lymphocytes
I). N eutrophils, Basophils and Lymphocytes
2. Neutrophils virtually derive all their energy from:
A. Ferm entation o f stored glycogen
B. Oxidative phosphorylation
C. Both o f the above
I). N one o f the above
3. The chemoattractant for the neutrophils produced by
bacteria is:
A. Leukotriene B4 B. Interleukin 1
C . FM et peptides 0 . Endothelial IL8
4. N eu tro p h ils with m egab od ies is a ch a ra cteristic
feature of:
A. Neutropenia
B. Agranulocytosis
C . Leukocyte adhesion deficiency
D. Chediak-Higashi syndrome
5. Presence o f hyperproliferation o f peripheral blood
lymphocytes indicative of:
A. Less gingival inflammation
B. Normal gingiva
C . Less periodontal disease
D. Severe periodontitis
v/
F u n c tio n s of L e u k o c y te s in P e r io d o n ta l D i s e a s e s 59

6. C h ro n ic in flam m atio n begins w ith th e in filtra tio n of:

A. N eutrophils and M onocytes
B. M onocytes and Lymphocytes
C. Lymphocytes and Plasm a cells
I). Plasma cells and Neutrophils
7. M onocytes an d L ym phocytes p rim a rily in filtrate:
A. Connective tissue
B. Junctional epithelium
C. Gingival crevice
I). None o f the above
8. W hich o f th e follow ing serv es as o p so n in h elp in g
b in d in g of phagocytes to ta rg e t cells:
A. Com plem ent metabolite C3b
B. Com plem ent metabolite C3a
C. Com plem ent metabolite C5b
I). Com plem ent metabolite C5a
60 M C Q s in P c r io d o n tic s

Answers
1.C. N eutrophils are the initial leukocytes recruited into
the gingiva where as chronic inflammation begins with
the infiltration o f monocytes and lymphocytes.
2.A. T hus, neutrophils are well adopted to function in
hypoxic environm ent.
3.C. C 5a and formyl peptides are likely to play a m ajor
role in attracting neutrophils into the gingival crev­
ice.
4.1). A structural defect, the fusion o f azurophil and spe­
cific granules into giant granules called m egabodies
is characteristic feature o f Chediak-Higashi syndrome.
5.D. Presence o f hyperproliferation o f peripheral blood
lym phocytes to oral bacteria is indicative o f severe
periodontitis.
6.B. U nlike neutrophils, monocytes and lym phocytes pri­
m arily infiltrate connective tissue and develop into
tissue m acrophagcs and activates lym phocytes. In
acute inflammation neutrophils are main defense cells.
7.A. Lymphocytes and monocytes seldom follow the neu­
trophils into the crevicular arena.
8. A. C om plem ent m etabolite C 3b and im m unoglobulin G
serves as opsonins by helping binding o f phagocytes
to target cclls.
 13
Effect o f Local and
Iatrogenic Factors
1. Subgingivally located margins o f restorations are
associated with:
A. Increased plaque accumulation
B. Increased gingival inflammation
C. Increased rate o f gingival fluid flow
D. All o f the above
2. O v e r h a n g in g m argins con trib u te to p eriod o n tal
disease by:
A. P roviding ideal locations for the accum ulation o f
plaque
B. Changing the etiologic balance o f the gingival sul­
cus area to one that favors the growth o f disease as­
sociated organism s
C. Both o f the above
D. None o f the above
3. In general, restorative materials are not themselves
injurious to periodontal tissues, except:
A. G lass ionom er cement
B. S e lf curing acrylic
C. Light curingcom posites
D. Amalgam
4. Normally, the forceful wedging of food is prevented
by:
A. Integrity and location o f the proximal contacts
B. The contour o f marginal ridges
C . The contour o f facial and lingual surfaces
I). All o f the above
62 M C Q s in P e r io d o n tic s

5. Cusps that tend to forcibly wedge food interproxi-

mally are known as:
A. Wedging cusps
B. Traum a cusps
C. Plunger cusps
I). Sharp cusps
6. The common site of gingivitis associated with mouth
breathing is:
A. M axillary anterior region
B. M andibular anterior region
C . M axillary posterior region
I). M andibular posterior region
7. Sm oking causes gingival fluid flow to:
A. Decrease
B. Increase
C . First decrease then increase
I). No im pact on gingival iluid flow
8. W hen compared with non-smokers o f similar age and
oral hygiene status, the bone height in smokers is:
A. Reduced
B. Rem ains same
C. Increased
I). First reduces then increas
9. Chronic toothbrush trauma results in:
A. G ingival recession
B. Denudation o f the root surface
C. Linear grooves extending from the marginal to the
attached gingiva
I). All o f the above
10. Which o f the following is/are the causative factor (s)
for the development o f periodontal diseases:
A. O rthodontic therapy
B. Tongue thrusting habit
C. Radiation
D. All o f the above
 Effect of Local a n d Ia tr o g e n ic F a c t o r s 63

Answers
1.D. Subgingivally located margins o f restorations are as­
s o c ia te d w ith in c re a s e d p la q u e a c c u m u la tio n ,
increased gingival inflam m ation and increased rate
o f gingival fluid flow.
2.C. Removal o f overhangs permits m ore effective con­
trol o f plaque, resulting in the disappearance o f gingi­
val inflam m ation and increased alveolar bone support
3.13. Com position o f plaque formed on all types o f restor­
ative m aterials is similar, with the exception o f that
formed on silicate.
4.D. An intact, firm proxim al contact relationship prevent
the forceful w edging o f food interproximally.
5.C. Plunger cusp effect may occur with w ear or be the
result o f shift in tooth position after failure to rcplace
m issing teeth. Distolingual cusp o f m axillary molar
is plunger cusp.
6.A. G ingival changes in mouth breathing are erythema,
edem a, enlargem ent and diffuse surface shininess in
exposed areas.
7.B. Gingival fluid flow increases as a result o f blood flow
changes induced by nicotine.
8. A. Sm okers have about twice the chance o f having peri­
odontal disease or becom ing edentulous as do non-
smokers.
9.D. O ften the gingival margin is enlarged and appears to
be piled up as if it were molded in conform ity with
the strokes o f toothbrush.
10.L). O rthodontic therapy, tongue thrusting habit, radiation,
toothbrush trauma, use o f tobacco, m outh breathing
are som e o f the causative factors for developm ent o f
periodontal diseases.
 Effect o f Systemic Diseases
on the Periodontium
1. Which o f the following statement (s) is/are correct:
A. N utritional deficiencies initiate gingivitis and peri­
odontal pockets
B. Nutritional deficiencies aggravate the injurious ef­
fects o f local irritants on gingiva and periodontium
C. Both o f the above
D. N one o f the above
2. Which of the following types o f diet leads to accu­
mulation o f plaque and development o f gingivitis:
A. Soft diet
B. Hard diet
C. Fibrous diet
I). All o f the above
3. Glossitis, angular cheilitis, seborrheic dermatitis and
superficial vascularizing keratitis are due to deficiency
of:
A. Vitamin A B. Vitamin B
C. Vitamin C D. Vitamin D
4. Bleeding, swollen gingiva and loosened teeth are the
common features of:
A. Beri-beri
B. A riboflavinosis
C. Scurvy
I). Pellagra
5. Hormonal disturbances may affect the periodontal
tissues:
A. Directly, as periodontal m anifestations o f endocrine
disease
B. By m odifying the tissue response to plaque in gingi­
val and periodontal disease
 Effcct of S y ste m ic D is e a s e s o n th e P e r io d o n tiu m 65

C. By producing anatomic changes in the oral cavity that

favor plaque accumulation
I). All o f the above
6. Decreased skeletal growth leading to crowding and
malposition o f teeth is due to:
A. H ypothyroidism
B. 1lypopituitarism
C. Hyperpituitarism
D. Hyperthyroidism
7. Insulin dependent diabetic children tend to have more
destruction around the:
A. A nteriors
B. F irst m olars and incisors
C. Prem olars and canines
I). First m olars and canines
8. Frequent periodontal abscesses is an important
feature o f periodontal disease in:
A. I Iypothyroidism
B. I lypopituitarism
C . Diabetes
I). Starvation
9. The gingival fluid level of cyclic adenosine monophos­
phate (CAMP) in diabetics when compared with that
of nondiabetics is:
A. Lower
B. H igher
C . Sam e
D. No correlation o f CAMP level and diabetes
10. Which o f the following statement (s) is/are correct:
A. Pregnancy itself does not cause gingivitis
B. Pregnancy accentuates the gingival response to plaque
C. No notable changes occur in the gingiva
D. All o f the above
11. T he highest incidence o f leukemic gingival proli­
ferative lesions is in:
A. Acute monocytic leukemia
B. Chronic monocytic leukemia
66 M C Q s in P e rio d o n tic s

C . Acute lymphocytic leukemia

I). Chronic lymphocytic leukemia
12. Leukemic gingival enlargement is not found in:
A. Children
B. Edentulous patients
C . Patients w ith chronic leukemia
I). Both (B) and (C)
13. Which of the following is the early oral sign o f leu­
kemia:
A. Oral ulcerations
B. Gingival enlargement
C . Bleeding gingiva
I). Pain
14. A syndrome consisting o f glossitis and ulcerations o f
the oral mucosa and oropharynx, in clu d in g d ys­
phagia, has been described in patients with:
A. Pernicious anem ia
B. M egaloblastic anem ia
C . Sickle cell anem ia
I). Iron deficiency anemia
15. Bluish-black discoloration o f the gingival margin in
areas o f pre-existing gingival inflammation is due to:
A. Bismuth intoxication
B. Lead intoxication
C . M ercury intoxication
D. Arsenic intoxication
16. The absence of a notable gingival inflammatory reac­
tion to the local irritants is a striking feature of:
A. C hediak-H igashi syndrome
B. Arteriosclerosis
C . A granulocytosis
L). Throm bocytopenic purpura
 Effect of S y s te m ic D is e a s e s on th e P e r io d o n tiu m 67

Answers
1.B. There are no nutritional deficiencies that by themselves
can cause gingivitis or periodontal pockets.
2. A. I lard and fibrous foods provide surface cleansing ac­
tion and stim ulation, which result in less plaque and
gingivitis even if the diet is nutritionally inadequate.
3.B. G lossitis, angular cheilitis, seborrheic derm atitis and
superficial vascularizing keratitis are due to deficiency
o f riboflavin.
4.C. Other clinical findings in scurvy include hem orrhagic
lesions into the m uscles o f extrem ities, joints, pete­
chial hem orrhages;increased susceptibility to infec­
tion and im paired wound healing.
5.D. H orm onal disturbances may effect periodontal tissues
directly, by modifying the tissue response to plaque
in gingival and periodontal disease, by producing ana­
tom ic changes in the oral cavity that favor plaque ac­
cum ulation.
6.B. H yperpituitarism results in m arked overgrow th o f
alveolar process and consequently affect the spacing
o f the teeth.
7.B. But destruction becomes more generalized at older
ages.
8.C. Very severe gingival inflamm ation, deep periodontal
pockets, rapid bone loss and frequent periodontal
abscesses often occur in diabetic patients w ith poor
oral hygiene.
9.A. Since CA M P reduces inflamm ation, this could lead
to increased severity o f gingival inflam m ation in dia­
betics.
10.D. No notable changes occur in gingiva during preg­
nancy in the absence o f local irritants .
68 M C Q s in P e r io d o n tic s

II.A . H ighest incidence is in acutc m onocytic leukem ia,

followed by acute myelocytic- monocytic leukem ia
and acute myelocytic leukemia.
12.1). Leukem ic gingival enlargem ent con sists o f basic
infiltration o f gingival corium by leukem ic cells that
creates gingival pockcts.
13.C. It is due to thrombocytopenia that results from replace­
m ent o f bone m arrow cells by leukem ic cells.
14.D. A syndrome consisting o f glossitis and ulcerations o f
the oral mucosa and oropharynx, including dysphagia
(Plum m er-Vinson syndrome) has been described in
patients with iron deficiency anemia.
15.A. Such pigm entation results from precipitation o f par­
ticles o f bism uth sulfide associated w ith vascular
changes in inflamm ation.
16.C. Agranulocytosis is characterized by reduction in the
num ber o f circulating granulocytes.
 15
-------------------------
Occlusion and Periodontium
-------------------------

1. In (he p h ysiologic rest position, the m asticatory

muscles are in:
A. Mild state o f relaxation
B. Mild state o f contraction
C. Strong state o f relaxation
1). Strong state o f contraction
2. The space between (he mandibular and maxillary
teeth when the mandible is in postural position is
called the:
A. Vertical dim ension o f rest
B. Free way space
C . Both o f the above
I). None o f the above
3. Gradual physiologic attrition is characterized by:
A. Lack o f inflamm atory changes on the alveolar bone
surfaces
B. Severe inflamm atory changes on the alveolar bone
surfaces
C. Resorption o f the alveolar bone
I). None o f the above
4. Wear o f the non-occluding tooth surfaces with sharply
defined, wedge shaped depression in the facial cervi­
cal areas o f the tooth is termed as:
A. A ttrition B. Wear facets
C. Erosion I). Abrasion
5. Frictional ablation is considered to be caused by:
A. The action o f brush used against the dentition
B. The action o f dentifrices used against the dentition
C. The action o f hard food eaten
D. The action o f soft tissue and saliva against the
dentition
70 M C Q s in P e r io d o n tic s

6. The vertical dimension of occlusion is naturally main­

tained by:
A. Com pensatory rate o f both occlusal w ear and proxi­
mal w ear
B. Com pensatory rate o f both proxim al wear and m e­
sial drifting
C. Com pensatory rate o f both occlusal w ear and con­
tinuous tooth eruption
I). Com pensatory rate o f both continuous tooth eruption
and mesial drilling
7. No signs o f traumatic occlusion in healthy dental
arches appear if vertical dimension o f occlusion is
increased to a maximum upto:
A. 5 mm
B. 0.5 mm
C . .05 mm
I). 3 mm
8. Occlusal or incisal surfaces worn by attrition arc
called as:
A. Worn surfaces
B. Erosion
C . Facets
D. A blation
9. Bruxism and periodontal condition:
A. A ppear to be independent phenom ena
B. A ppear to be dependent phenom ena
C. Are proved to be independent phenom ena
I). A re proved to be dependent phenom ena
10. Facets generally represent:
A. O nly functional wear
B. Only parafunctional wear
C. Both functional and parafunctional wear
I). N either functional nor parafuctional wear
 O c c lu s io n a n d P e r io d o n tiu m 71

Answers
1.B. In order to support the mandible against the force o f
gravity, masticatory m uscles are in a mild state o f con­
traction during physiologic rest position.
2.C. Physiologic rest position and free way space are fairly
stable and reproducible but arc not necessarily con­
stant throughout life.
3.1). A certain am ount o f tooth wear is physiologic, but
accelerated wear may prevail with abnormal anatom ic
or unusual functional factors.
4.C. Erosion may occur due to digestive system regurgita­
tion, bulimia, medicinal therapy and dietary habits (e.g.
citrus fruits, carbonated drinks).
5.D. Frictional ablation is a process caused by ju x tap o si­
tion o f natural and artificial dental surfaces and hy­
perfunctional oral soft tissues.
6.C. Vertical dim ension o f occlusion is the distance be­
tween the maxilla and m andible when the teeth are in
intercuspal position.
7.D. In healthy dental arches increase in vertical dim en­
sion upto 3 mm is com pensated by or it com pensates
a. Variable thickness o f periodontal ligament.
b. Com pensatory rate o f both occlusal wear and
continuous tooth eruption.
8.C. W hen active tooth gnashing occurs, enam el rods are
fractured and become highly reflective to light result­
ing in shiny, smooth and curviplanar facets.
9.A. B m xism and periodontal condition are independent
phenom ena as 110 association has been shown between
bruxism and periodontitis or gingival inflamm ation.
10.C. F acets g en erally rep resen t fu n ctio n al and para-
functional wear as well as iatrogenic dental treatm ent
through coronoplasty.
 ----- 16-----
Diet and Nutrition in
Periodontium
1. The dietary effect on plaque is mostly due to:
A. Carbohydrates
U. Fats
C . Proteins
1). N ucleic acids
2. Large numbers o f lactobacilli in saliva are related to
a high consumption of:
A. Non fermentable carbohydrates
B. Ferm entable carbohydrates
C . Ferm entable fats
I). N onfcrm entable fats
3. T he plaque dry weight constituted by carbohydrates
is about:
A. 0.1 pcrcent B. 10 percent
C . 20 pcrcent D. 50 perccnt
4. T he extracellu lar polysaccharides synthesized in
plaque from dietary sucrose are:
A. Fructans and levans
B. Glycogen am ylopectin and glucose am ylopectin
C. Dextran and glucan
I). Fructans and glucans
5. Which o f the following functions primarily as struc­
tural stabilizer of intermicrobial matrix:
A. Levans
B. Fructans
C. D cxtrans
1). M utans
 D iet a n d N u tr itio n in periodonfjum 73

Answers
1.A. A m ount and type o f carbohydrates in diet and the
Frequency o f intake can influence b a c t e r i a l gj-owth.
2.B. Large num ber o f lactobacilli in saliva are rt|ated to
high consum ption o f ferm entable carbohy^^lcs
3.C. 20 percent o f plaque dry w eight is constitulC(j fry
carbohydrates.
4.1). Fructans and glucans are extracellular po^’^ ch arid e
synthesized in plaque from dietary s u c r o s e .
5.1). M utans by chem ical nature functions P structural
stablizer o f interm icrobial matrix.
 - 17
Gingivitis
-

1. The stage I gingivitis is termed as:

A. The early lesion
B. The initial lesion
C. The established lesion
I). The advanced lesion
2. Clinically in subclinical gingivitis, the initial response
of the gingiva to bacterial plaque is:
A. Not apparent
B. M anifested by reddened gingiva
C. M anifested by spontaneous bleeding o f gingiva
I). M anifested by bleeding o f gingiva on probing
3. The predominant immune cells infiltrating the con­
nective tissue and gingival sulcus in the initial lesions
of gingivitis are:
A. Eosinophils
B. Neutrophils
C. Lymphocytes
I). Plasm a cells
4. The percentage o f collagen destroyed around the
cellular infiltrate in the stage 11 gingivitis is:
A. 10 percent B. 25 perccnt
C. 50 percent D. 70 pcrcent
5. The changes in color, size and texture of gingiva are
seen in:
A. Stage 1 gingivitis
B. Stage II gingivitis
C. Stage III gingivitis
1). Stage IV gingivitis
6. The term chronic gingivitis is refers to the following
stage o f gingivitis:
A. Stage 1 gingivitis
B. Stage II gingivitis
 G in g iv itis 75

C. Stage III gingivitis

D. Stage IV gingivitis
7. All o f the following enzym e levels are found to be
elevated in chronically inflamed gingiva except:
A. Acid phosphatase
B. Alkaline phosphatase
C. Lactic dehydrogenase
1). Neutral m ucopolysaccharide
8. Advanced lesion is also termed as:
A. Chronic gingivitis
B. Phase o f intensive inflam m atory infiltration
C . Phase o f periodontal breakdow n
I). Phase o f collagenolytic activity
9. The sequence o f developing gingivitis is as follows:
A. The early lesion —>The initial lesion >The advanced
lesion -» The established lesion
B. The initial lesion -» The early lesion -> The estab­
lished lesion -» The advanced lesion
C . The early lesion -» The initial lesion -> The estab­
lished lesion —> The advanced lesion
I). The initial lesion -» The early lesion -> The advanced
lesion -» The established lesion
10. Erythema and bleeding on probing are initially
evident in:
A. The initial lesion
B. The early lesion
C . The established lesion
1). The advanced lesion
11. The main fiber groups affected in early gingivitis ap­
pear to be:
A. The circular and horizontal fibers
B. The circular and dentogingival fibers
C . The horizontal and alveolar crest fibers
I). The dentogingival and alveolar crest fibers
76 M C Q s in P e r io d o n tic s

Answers
1.B. Stage II gingivitis is termed as early lesion, stage III
as established lesion and stage IV as advanced lesion.
2.A. The first m anifestations o f gingival inflam m ation are
vascular changes consisting essentially o f dilation o f
capillaries and increased blood flow, w hich are not
clinical.
3.B. N eutrophils leave the capillaries by migrating through
the w alls(diapedesis. emigration).
4.D. I he main fiber groups affected appear to be circular
and dentogingival.
5.C. In stage III gingivitis, blood vessels becom e engorged
and congested, venous return is impaired, and blood
flow become sluggish.
6.C. C hronic gingivitis is stage III gingivitis.
7.1). Neutral m ucopolysaccharide levels arc decreased due
to degradation o f ground substance.
8.C. A davanced lesion is the extension o f lesion into al­
veolar bone.
9.B. One stage evolves into the next, w ith no clear cut d i­
viding lines.
10.B. Erythema appear due to proliferation o f capillaries and
increased form ation o f capillary loops between rete
pegs.
I l.B . T h ere is an in crease in the am o u n t o f co llag en
destruction.
--------18--------
Clinical Findings o f
Gingivitis
1. The earliest symptom of gingival inflammation which
precedes established gingivitis is:
A. Change in color o f gingiva
B. Change in texture o f gingiva
C. Bleeding from the gingival sulcus on gentle probing
I). Change in position o f gingiva
2. In most cases the cellular infiltrate of sites that bleed
on probing is predominantly:
A. N eutrophilic
B. Lymphocytic
C . Eosinophilic
I). Plasm a cclls
3. T he gingiva becomes more red than its normal color
w hen there is:
A. An increase in vascularization and decrease in de­
gree o f epithelial keratinization
B. An increase in vascularization and degree o f epithe­
lial keratini/ation
C. A dccrcasc in vascularization and degree o f epithe­
lial keratinizalion
I). A decrease in vascularization and increase in degree
o f epithelial keratini/.ation
4. Bluish red or deep blue linear pigmentation o f the gin­
gival margin is due to:
A. Bism uth B. Arsenic
C. M ercury D. Lead
5. Leathery texture o f the gingiva is due to:
A. A cute gingivitis
B. Chronic gingivitis
78 M C Q s in P e r io d o n tic s

C . Hyperkeratosis
I). Non-inflam m atory gingival hyperplasia
6. T h e sev erity o f recession is d eterm in e d by:
A. The actual position o f the gingiva
B. The apparent position o f the gingiva
C . Both o f the above
I). None o f the above
7. Gingival recession may be caused by:
A. Faulty toothbrushing technique
B. Tooth m alposition
C. I ligh frcnum attachm ent
I). All o f the above
8. Me C all’s festoons occur most frequently in:
A. Incisor areas on the facial surface
B. Canine and prem olar areas on the facial surface
C . Prem olar and m olar areas on the facial surface
1). Incisor and canine areas on the facial surface
9. T he severity o f the bleeding and the ease with which
it is provoked depend on the:
A. Duration o f the inflam m ation
B. Position o f the inflamm ation
C . Intensity o f the inflam m ation
D. All o f the above
10. Acute bleeding can occur:
A. Only in the absence o f gingival disease
B. Only in the presence o f gingival disease
C. Both in the presence and absence o f gingival disease
I). N either in the presence nor in the absence o f gingival
disease
 C lin ic a l F indin gs of G in g iv itis 79

Answers
1.C. Two earliest sym ptom s o f gingivitis are increased gin­
gival crcvicular fluid production rate and bleeding
from sulcus on gentle probing.
2.13. This is a characteristic o f stage II or early gingivitis.
3.A. W hen gingiva becom es red. capillaries are engorged
and closer to the surface. Epithelium is thinned and
degenerated.
4.1). T his results from perivascular precipitation o f m etal­
lic sulfides in the subepithelial connective tissue.
5.C. Peeling o f surface occurs in chronic desquam ative gin­
givitis and drug induced gingival overgrowth produces
nodular surface.
6.A. A ctual position is the level o f epithelial attachm ent
on tooth where as apparent position is level o f crest
o f gingival margin.
7.D. G ingival recession may also be due to friction from
soft tissues and gingival inflammation.
8.B. Me C all’s festoons are life preserver shaped enlarge­
ment o f the marginal gingival.
9.C. In moderate or advanced periodontitis, presence o f
bleeding on probing in considered a sign o f active
tissue destruction.
10.C. Laceration o f gingiva by tooth brush bristles during
aggressive tooth brushing or by sharp pieces o f hard
food can cause gingival bleeding even in absence o f
gingival disease.
 19
-------------------
Gingival Enlargement
------------------

1. Chronic inflammatory gingival enlargement origi­

nates as a slight ballooning o f the:
A. Attached gingiva
B. Free gingiva
C. Interdental papilla and/or marginal gingiva
I). Interdental papilla and attached gingiva
2. Gingival enlargement lesions that arc relatively firm,
resilient and pink have greater:
A. Vascular com ponent B. Inflammatory cells
C . Degenerative changes 1). Fibrotic com ponent
3. Chronic inflammatory gingival enlargement is caused
by:
A. Dental calculus
B. Genetic influences
C. Prolonged exposures to dental plaque
1). External physical traum a
4. The following is the most common site o f gingival en­
largement due to mouth breathing:
A. M axillary posterior region
B. M axillary anterior region
C . M andibular posterior region
D. M andibular anterior region
5. A localized, painful, rapidly expanding lesion that is
usually of sudden onset is termed as:
A. Gingival hyperplasia
B. Gingival hypertrophy
C. G ingival abscess
D. G ingival ulceration
6. Gingival abscess is generally limited to:
A. G ingival sulcus
B. Attached gingiva
 G ingival E n l a r g e m e n t 81

C. Marginal gingiva and interdental papilla

I). Marginal gingiva and attached gingiva
7. Phenytoin induced gingival hyperplasia is absent in:
A. Presence o f profuse local irritants
B. A bsence o f local irritants
C . Region where teeth are present
I). Edentulous spaccs
8. Which o f the following drugs induces gingival hyper­
plasia:
A. Phenytoin
B. Cyclosporine
C . Nifedipine
I). All o f the above
9. In combined gingival enlargement the primary com ­
ponent is:
A. H yperplasia o f connective tissue and epithelium
B. Inflam mation o f connective tissue
C. Both o f the above
I). None o f the above
10. In pregnancy the gingival enlargement tends to be
more prominent:
A. In interproxim al areas
B. On facial surfaces
C. On lingual surfaces
I). Equal enlargement on all surfaces
11. Tumor like gingival enlargement in pregnancy usu­
ally appears after the:
A. First m onth o f pregnancy
B. Third month o f pregnancy
C. Second trim ester o f pregnancy
1). First trim ester o f pregnancy
12. An exaggerated conditioned response to minor trauma
resulting in tumor like gingival enlargement is termed
as:
A. Atypical gingivitis
B. Gingivostom atitis
82 M C Q s In P e r io d o n tic s

G ranulom a pyogenicum
I). G ranulom atosis
13. True leukemic gingival enlargement occurs commonly
in:
A. A cute leukemia
B. Chronic leukemia
C . Both o f the above
1). N one o f the above
14. Most lesions referred to as epulis are:
A. N eoplastic gingival enlargements
B. M alignant gingival enlargements
C . Inflam m atory gingival enlargements
I). False gingival enlargements
15. W hich o f the following is the most common malig­
nant tumor o f the gingiva:
A. M alignant m elanoma
B. Fibrosarcom a
C . Squam ous cell carcinoma
1). Lymphosarcoma
16. Peripheral giant cell granulom a occurs most fre­
quently on the:
A. Interproximal areas
B. Labial surface
C . Lingual surface
1). Col area
 Gingival E n la r g e m e n t 83

Answers
1.C. In early stages, it produced life preserver shaped bulge
around the involved teeth.
2.L). I ,esions that are relatively firm, resilient, and pink have
greater fibrotic com ponent w ith an abundance o f
fibroblast and collagen fibers.
3.C. Factors that favor plaque accumulation include poor
oral hygiene, irritation by anatomic abnorm alities and
im proper restorative and orthodontic appliances.
4.B. In m outh breathing cases, gingiva appears red and
edem atous with diffuse surface shininess.
5.C. W ith in 24 to 48hours, lesion becomes fluctuant and
pointed with surface orifice from w hich a purulent
exudate may be expressed.
6.C. Adjacent teeth are often sensitive to percussion in gin­
gival abscess.
7.D. Drug induced gingival enlargement occurs in areas in
which teeth are present, not in edentulous spaces and
enlargem ent disappears in areas form which teeth are
extracted.
8.D. G ingival h y p erp lasia is produced by p h en y to in ,
cyclosporine and nifedipine.
9.A. There is an increase in the number o f fibroblasts and
new blood vessels. There is an abundance o f am or­
phous ground substance and secondary com ponent is
inflam m atory component.
10.A. Enlargement in pregnancy is usually generalized and
tends to be more prominent interproxim ally than on
facial and lingual surfaces.
11 .R. Tum or like gingival enlargement in pregnancy is not
a neoplasm but an inflammatory response to bacterial
plaque and is modified by patient condition.
84 M C Q s in P e r io d o n tic s

12.( Pyogcnic granuloma is also known as nonspecilie condi­

tioned enlargement. It is similar as in gingival enlargement
seen in pregnancy hence, differential diagnosis depends
upon the history o f the patient.
13.A. True leukem ic enlargement may also be seen in sub­
acute leukem ia but seldom occurs in chronic leuke­
mia.
14.C. M ost lesions referred to as epulis are inflam m atory
gingival enlargement.
15.C. Squam ous cell carcinoma may be exophytic, present­
ing as an irregular outgrowth, or ulcerative, which
appear as flat erosive lesion.
16.B. Peripheral giant cell granulom a arise interdentally or
from gingival margin and be sessile or pedunculated.
 — -2 0 -----
Acute Necrotizing
Ulcerative Gingivitis
1. P u n ch ed o u t, c r a te r like d ep ressio n s at th e crest of
in te rd e n ta l p ap illae a re found in:
A. A cute necrotizing ulcerative gingivitis
B. Trench mouth
C. V incent’s infection
I). All o f the above
2. W hich of th e follow ing is/are th e o ral sy m p to m s of
acu te n ecrotizin g u lcerativ e gingivitis:
A. M etallic foul taste
B. Crater like depression at interdental papillae
C . Pasty saliva
I). Both (A ) and (C)
3. System ic signs an d sym ptom s in severe case of acu te
necrotizing ulcerativ e gingivitis are:
A. Local lymphadenopathy
B. Slight elevation in temperature
C . Loss o f appetite
D. Increased salivation
4. W hich o f the following statem ents is/arc n o t tru e acute
n ecro tizin g ulcerativ e gingivitis (ANUG).
A. ANIJG m ay result in destruction o f periodontium
B. ANUG may result in pulmonary infections
C . A NU G may lead to periodontal pockct form ation
I). ANUG can be superimposed on periodontal pockct
5. N um erous leukocytes w ith b a c te ria in clu d in g sp iro ­
chetes a re found in w hich o f th e follow ing zones of
necrotic lesion o f ANUG:
A. ZONE 1 B. ZONK 2
C . ZONK 3 I). ZONK 4
86 M C Q s in P c rio d o n tic s

6. Diffuse erythema o f (he posterior areas of the oral

mucosa including the gingiva is the clinical feature
of:
A. Streptococcus gingivostomatitis
B. A granulocytosis
C. ANUG
I). Gonococcal stom atitis
7. The disease common in newborns characterized by
oral m ucosa covered with grayish m embrane that
sloughs off exposing bleeding surface is:
A. Acute herpetic gingivostomatitis
B. Gonococcal stomatitis
C. Vincent’s angina
I). ANUG
8. Painful membranous ulceration o f the throat with
edema and hypercmic patches is found in:
A. V incent’s infection
B. Vincent’s stom atitis
C . V incent's angina
I). All o f the above
9. Loss o f soft tissue and bone and formation of seques­
tra is found in:
A. ANUG in leukemia
B. ANUG in AIDS
C. N ecrotizing ulcerative periodontitis
D. Chronic destructive periodontal disease
10. Which o f the follow ing clinical features is not observed
in agranulocytosis, that distinguish it from ANIJC:
A. Ulceration o f the gingiva
B. Necrosis o f the gingiva
C. Severe inflammatory reaction
D. All o f the above
 A c u te N e c ro tiz in g U lc e ra tiv e G in g iv itis 87

Answers
1.D. Trench mouth or Vincent’s infection are another name
o f acute nccrotizing ulcerative gingivitis.
2.D. Crater like depression at interdental papilla is an oral
sign o f acute necrotizing ulcerative gingivitis.
3.C. Local lymphadenopathy and slight elevation in tem ­
perature are com m on features o f mild and moderate
stages o f disease.
4.C. ANUG does not lead to periodontal pockct formation
because necrotic changcs involve the junctional epi­
thelium and a viable junctional epithelium is needed
for pocket deepening.
5.B. Zone 2 is also known as neutrophil rich zone.
6. A. Necrosis o f the gingival margin is not the feature o f
streptococcal gingivostom atitis and there is no nota­
bly fetid odor as seen in ANUG patients.
7.B. G o n o co ccal sto m a titis is c h a ra c te riz e d by oral
m ucosa covered w ith grayish membrane that sloughs
o ff exposing bleeding surface.
8.C. Vincent’s angina is an infection o f oropharynx and
throat where as ANUG affects marginal gingiva.
9.B. AIDS in ANUG follows a very destructive course
leading to NUP.
10.C. A granulocytosis is characterized by marked decrease
in num ber o f circulating PMNs.
 \S

----21----
Acute Herpetic
Gingi vostomatitis
1. Acutc herpetic gingivostomatitis is caused by:
A. Herpes sim plex virus type I
B. Herpes sim plex virus type 2
C . I lerpes simplex virus type 6
I). Cytom egalovirus
2. Which of the following oral signs is/are found in acute
herpetic gingivostomatitis:
A. Edem a and gingival bleeding
B. Erythem atous and shiny gingiva
C . “ Soreness” o f the oral cavity
1). Both (A) and (B)
3. Painful small ulcers with red, elevated margin and
depressed yellowish central portion on the gingiva and
the adjacent oral mucosa are found in:
A. Chronic desquam ative gingivitis
B. Acute necrotizing ulcerative gingivitis
C. Streptococcal gingivostomatitis
I). A cutc herpetic gingivostomatitis
4. The oral symptom o f acute herpetic gingivostomati­
tis in infants is:
A. Soreness o f the oral cavity
B. Pain and sensitivity in ruptured vesicles
C . Refusal to take food
I). None o f the above
5. Diffuse involvement o f the gingiva with “ peeling” of
the epithelial surface is characteristic feature of:
A. Erythem a m ultiform e
B. D esquam ative gingivitis
C. ANUG
I). Acute herpetic gingivostomatitis
 A c u te H e r p e tic G in g iv o s t o m a t itis 89

Answers
1.A. It occurs most often in infants and children younger
than 6 years o f age.
2.D. Soreness o f the oral cavity is an oral symptom o f acute
herpetic gingivostomatitis.
3.D. These occur cither in widely separated areas or in
clusters.
4.C. In infants, disease is marked by irritability and refusal
to lake food.
5.B. Desquamative gingivitis is characterized by diffuse
involvement o f the gingiva, with varying degree o f
peeling o f epithelial surface and exposure o f underly­
ing tissue, it is a chronic condition.
 — 22
Pericoronitis
—

1. Pericoronitis occurs most frequently in the:

A. Maxillary third m olar area
B. M andibular third m olar area
C. M axillary first m olar area
1). M andibular second molar area
2. Red, swollen, suppurating lesion in third molar area
with radiating pain to ear, throat and floor o f mouth
is found in:
A. Periodontal abscess
B. Desquam ative gingivitis
C . Pericoronitis
1). N one o f the above
3. Abscess spreading posteriorly into the orophary ngeal
area and medially to the base of the tongue is:
A. Periodontal abscess B. Peritonsillar abscess
C. Pericoronal abscess D. Gingival abscess
4. Which o f the following is/are the clinical features of
pericoronitis:
A. Swelling o f the cheek
B. Lymphadenitis
C. Fever and malaise
I). All o f the above
5. Primary incubation zone in acute necrotizing ulcer­
ative gingivitis is:
A. Periodontal pockcts
B. Pericoronal flaps
C . Chronic gingival disease
I). Both (A) and (B)
 P e r ic o r o n itis 91

Answers
1.B. Pericoronitis is inflam m ation o f gingiva in relation to
crow n o f an incom pletely erupted tooth.
2.C. Patient is extrem ely uncom fortable because o f foul
taste and inability to elose the jaws.
3.C. This makes difficult for the patient to swallow. This
is associated w ith erupting third molor.
4.1). Sw elling o f the cheek in the region o f the angle o f the
jaw. Leukocytosis also occur.
5.D. Deep periodontal pockcts and pericoronal flaps are
particularly vulnerable areas because they offer favor­
able environm ent for proliferation o f anaerobic fusi­
form bacilli and spirochetes.
 ---------------------- 23 -----------------------
Chronic Desquamative
Gingivitis and Dermatoses
1. Which o f the following is the clinical feature o f the
moderate form o f desquamative gingivitis:
A. Diffuse erythem a o f the gingiva
B. Bright red and grey patches on the gingiva
C . Denuded and strikingly red gingiva
I). Burning sensation in the mouth
2. Speckled gingiva with dry and burning sensation
th ro u gh o u t the mouth is found in d esq u am a tive
gingivitis of:
A. Mild form B. M oderate form
C . Severe form I). None o f the above
3. Recommended dose o f prednisone for the treatment
of desquamative gingivitis is:
A. Daily dose o f 40 mg to 50 mg reduced to daily m ain­
tenance dose o f 5 to 10 mg
B. Daily dose o f 30 to 40 mg reduced to daily m ain­
tenance dose o f 5 to 10 mg
C . Daily dose o f 30 to 40 mg reduced to daily m ain­
tenance dose o f 10 to 20 mg
I). Daily dose o f 50 to 60 mg reduced to daily m ain­
tenance dose o f 10 to 20 mg
4. Grayish white, linear, lacelike elevations on the oral
mucosa in lichen planus are known as:
A. Vesicular lesions
B. B ullous lesions
C . D endritic lesions
I). None o f the above
5. Atrophic involvement of gingiva in lichen planus is
characterized by:
A. Raised w hite lesion
 C h r o n ic D e s q u a m a tiv e G ingivitis a n d D e r m a t o s e s 93

B. Thinning o f epithelium
C. Erosive gingivitis
I). Both (B) and (C)
6. Chronic desquamative gingivitis is the oral manifes­
tation o f which of the following disease:
A. Lichen planus
B. Bullous pem phigoid
C. M ucous membrane pemphigoid
I). All the above
7. Purplish red macules or papules with interspersed
bullous lesions on oral mucosa are found in:
A. Lupus erythematous
B. Pemphigus
C. Erythem a multiforme
I). Bullous pemphigoid
8. Swollen, bluish red and everted lips with adherent
scales and crusts arc the clinical feature of:
A. Erythem a multi forme
B. Chronic discoid type lupus erythematosus
C. Acute systemic type lupus erythematosus
I). Scleroderm a
9. The oral manifestations of the scleroderma are char­
acterized by:
A. Impaired mobility o f tongue
B. Thin and rigid lips
C. Restricted mouth opening
1). All the above
10. Local reaction from the use o f a medicamcnt in the
oral cavity is termed as:
A. Contact stom atitis
B. Stom atitis venenata
C. Stom atitis medicamentosa
I). Both (A) and (B)
11. The most common mycotic infection of the oral mu­
cosa is:
A. Acute candidiasis
B. Chronic candidiasis
94 M C Q s in P e r io d o n tic s

C . Actinomycosis
I). Histoplasm osis
12. The drug o f choice for the treatment o f chronic can­
didiasis is:
A. Clotrimazole
B. M ycostatin
C . A m photericin B
D. All o f the above
13. Large num bers o f hypliae and spores o f Candida
albicans are present at mucosal surface in:
A. Hyperplastic type oral candidiasis
B. Pseudom em branous type candidiasis
C. Atrophic type candidiasis
I). Perioral type candidiasis
14. Drug o f choice for the treatment o f oral pemphigus
is:
A. Diphenhydram ine hydrochloride
B. Methyl prednisolone
C . Acyclovir
D. Foscarnet
15. Increase in the width of the periodontal space, more
often in posterior teeth is found in:
A. Diffuse scleroderma
B. A crosclerosis
C . C ircum scribed scleroderma
1). Both (A ) and (B)
16. T he interdental gingiva o f the deciduous dentition is:
A. Broad mesiodistally and narrow faeiolingually
B. Broad faeiolingually and narrow m esiodistally
C . Same as in permanent dentition
D. N one o f the above
17. The mean gingival sulcus depth for the primary den­
tition is:
A. 2.1 mm ± 0.2 mm
B. 2.5 m m ± 0.2 mm
C . 2 .1 mm ± 0.4 mm
D. 2.5 mm ± 0.4 mm
 C h r o n ic D e s q u a m a tiv e G in g iv itis a n d D e r m a t o s e s 9 5

Answers
1.B. D iffuse erythem a o f gin g iv a occurs in m ild form
w hereas denuded and strikingly red gingiva occurs in
severe form.
2.C. Sincc the gingiva separating denuded and strikingly
red areas is grayish blue, in overall appearance, the
gingiva seem s to be speckled.
3.B. Prednisone can be used in a daily or every other day
dose o f 30 to 40 mg and gradually reduced to daily
m aintenance dose o f 5 to 10 mg or every other day
m aintenance dose o f 10 to 20 mg.
4.C. Dendritic or reticulate lesions consist o f grayish, white,
linear, lacc like elevations com posed o f large num ­
bers o f small, individual papules.
5.D. A trophic involvement o f dorsum o f tongue is charac­
terized by loss o f fillifom i and fungiform papillae.
6 .1). C hronic desquam ative gingivitis is the oral m anifes­
tation o f lichen planus, bullous pem phigoid and m u­
cous m em brane pemphigoid.
7.C. Lesions are so painful that chew ing and sw allow ing
are im paired.
8.B. The lip is tender and sensitive, and on removal o f ad­
herent scales, bleeding from raw surface is noted.
9.D. Oral m anifestation o f scleroderma are im paired mo­
bility o f tongue, thin and rigid lips and restricted
m outh opening.
10.D. E ruption in the oral cavity resulting from sensitivity
to drug that have been taken by m outh or parenterally
are term ed stom atitis medicamentosa.
11 .A. Acute candidiasis is seen in immunosuppressed adults,
in fa n ts, and adults who have been on an tib io tic
therapy.
96 M C Q s In P c r io d o n tic s

12.C. Drug o f choice for treatm ent o f chronic candidiasis is

systemic use o f am photericin B. a potent but relatively
toxic anti mycotic agent.
13.B. In pseudomem branous types, there are white, curd like
plaques overlying mucosal erythem a and ulceration.
14.B. Therapy for pem phigus involves the use o f systemic
corticosteroids, usually in a moderate to high dosage,
w hich can be gradually decreased.
15.D. Periodontal space in relation to the entire root is w id­
ened to an alm ost uniform thickness. Posterior teeth
are involved more often than anterior teeth.
16.B. I'lie width o f attached gingiva is greater in incisor area,
decreases over the cuspids and increases again, over
prem olars (prim ary molars) and perm anent molars.
17.A. The crest o f the interdental septa are flat.
 24
--------------
Periodontal Pocket
---------------

1. Which o f the following is/are the symptoms o f peri­

odontal pockct:
A. Gingival bleeding B. Tooth mobility
C . Localized pain I). Diastem a formation
2. Periodontal pocket is generally painful, when explored
with a probe because of:
A. Degeneration o f epithelium
B. U lceration on the inner aspect o f the pocket wall
C . Suppurative inflamm ation o f the inner wall
I). None o f the above
3. The soft tissue wall of the periodontal pocket show­
ing flat surface w ith minor depressions and shedding
o f cells is seen in:
A. Areas o f ulceration
B. A reas o f hemorrhage
C . Areas o f relative quiescence
1). A reas o f leukocytic bacterial interaction
4. Excessive pus formation occurs in:
A. D eep periodontal pockets
B. Shallow periodontal pockets
C . Both (A) and (B)
I). N one o f the above
5. The most dominant microorganisms in root surface
caries is:
A. Streptococcus sanguis
B. Fusobacterium nucleates
C . Staphylococcus
I). Actinomyces viscosus
6. The distance between the bottom o f the calculus and
the alveolar crest in periodontal pockets is constant,
having a mean length of:
98 M C Q s in P c r io d o n tic s

A. 2 mm -.fc 33.6 perccnt

B. 1.97 mm ^ 43.16 perccnt
C. 1.97 mm ± 33.16 perccnt
I). 2 mm ± 4 3 .1 6 pcrcent
7. Localized purulent inflammation in the periodontal
tissues is known as:
A. Lateral abscess
B. Periodontal abscess
C . Parietal abscess
D. All the above
8. The bone destructive pattern is angular in:
A. Infrabony pocket
B. Suprabony pockct
C . Both o f the above
D. None o f the above
9. T he periodontal cyst occurs most often in:
A. M axillary canine - premolar area
B. M axillary incisor canine area
C . M andibular canine -prem olar area
I). M axillary m olar area
10. In p erio d o n ta l pockct, bone an d connective tissue a t­
ta ch m en ts a re lost an d pocket d eep en s d u rin g :
A. Period o f quiescence
B. Period o f exacerbation
C . Period o f inactivity
D. None o f the above
 P e r io d o n ta l P o c k c t 99

Answers
1.C. Gingival bleeding and tooth mobility arc clinical signs
o f periodontal pocket.
2.B. Pain on tactile stim ulation with a probe is due to ul­
ceration o f the inner aspect o f the pocket w all.
3.C. Exposed connective tissue is seen in areas o f ulcer­
ation w hereas numerous ery throcytes are seen in area
o f hemorrhage.
4.C. Pus form ation is not an indication o f the depth o f the
pocket or severity o f destruction o f supporting tissues.
5.D. O ther bacterias such as Actinomyces naeslundii , Strep­
tococcus mu tans, Streptococcus salivarius , Strepto­
coccus sanguis are also involved.
6.C. The distance between apical end o f junctional epithe­
lium and alveolar bone is relatively constant. T he dis­
tance from attached plaque to bone is never less than
.5 mm and never m ore than 2.7 mm.
7.D. Periodontal abscess is also known as lateral or pari­
etal abscess.
8.A. Fibers extend from the cem entum beneath the base o f
pocket along the bone and over the crcst to join with
the outer periosteum. In suprobony pocket. Bone de­
struction is horizontal.
9.C. Periodontal cyst produces localized periodontal tis­
sues along the lateral tooth surface.
10.B. Period o f quiescence are characterized by reduced in­
flam m atory response and little or no loss o f bone and
conncctive tissue attachment.
 -25
-------------------
Bone Loss in Periodontal
---------------------

Diseases
1. The most common cause of hone destruction in perio­
dontal disease is:
A. Bone necrosis
B. Chronic inflammation
C . Traum a from occlusion
I). All the above
2. The three wall bone destruction pattern appearing
most frequently on second and third maxillary and
mandibular molars is known as:
A. Hemiseptum
B. Com bined osseous defect
C. A ngular defect
I). Intrabony defect
3. Defects produced by loss o f interdental bone, includ­
ing facial and/or lingual plates without concomitant
loss o f radicular bone are know n as:
A. Bulbous bone contours
B. Ledges
C. Reversed architecture
I). O sseous craters
4. The most common site o f furcation involvement is:
A. M andibular first molars
B. M axillary second molars
C . M andibular prem olar
D. M axillary first molar
5. T h e “cul-de-sac” feature appears in which o f the
following grades o f furcation involvement:
A. Grade i B. Grade II
C . Grade III D. Grade IV
 B o n e L oss in P e r io d o n ta l D i s e a s e s 101

6. T rau m a from occlu sion resulting from reduccd

ability of the tissues to resist the occlusal forces is
known as:
A. Primary traum a from occlusion
B. Secondary traum a from occlusion
C . Acute traum a from occlusion
1). Chronic traum a from occlusion
7. Thinning o f periodontal ligament, atrophy o f fibers
and osteoporosis o f alveolar bone occur in:
A. Traum a from occlusion
B. Excessive occlusal forces
C. Insufficient occlusal forces
1). None o f the above
8. During pathologic migration, premolars frequently
drift:
A. M esially
13. Distally
C . Labial ly
I). Lingually
9. A shift in the position of the tooth may occur due to:
A. Pathologic migration
B. Traum a from occlusion
C . Pressure from the tongue
1). All the above
10. Plateau like bone margins caused by resorption of
thickened bony plates are called as:
A. O sseous craters
B. Exostoses
C . Ledges
I). Reversed architecture
11. T he cells responsible for degradation o f organic
matrix during bone resorption are:
A. O steoclasts
B. Fibroblasts
C . M ononuclear cells
I). All the above
102 M C Q s in P c r io d o n tic s

12. The most common pattern o f bone loss in periodon­

tal disease is:
A. Vertical bone loss
B. Horizontal bone loss
C . O sseous defects
D. Osseous craters
13. The area o f the periodontium most susceptible to
injury from excessive occlusal forces is:
A. Cem entum
B. Inter-radicular bone
C . A lveolar bone
I), furcation
14. Which of the following statements is not true about
trauma from occlusion:
A. Trauma from occlusion is reversible
B. Traum a from occlusion d o esn ’t cause pockets or
gingivitis
C. Marginal gingiva is affected by traum a from occlu­
sion
I). Traum a from occlusion changes the shape o f alveo­
lar crest
15. The most common clinical sign of trauma to the perio­
dontium from occlusion is:
A. Tooth pain
B. Increased tooth mobility
C . Sensitivity to percussion
I). Tooth w ear
16. “Thickened periodontal ligament, w hich is funnel
shaped at the crest with angular defects in the bone”
is observed in which o f the following stages o f tissue
response to occlusal forces:
A. Stage I
B. Stage II
C . Stage III
I). Stage IV
 B o n e L oss in P e r io d o n ta l D i s e a s e s 103

Answers
I .B. The m ost com mon cause o f bone destruction in perio­
dontal disease is the extension o f inflam m ation from
marginal gingiva into supporting periodontal tissues.
2.D. Intrabony defect occurs m ost frequently on mesial
aspects o f second and third m axillary and m andibular
molars.
3.C. Reversed architecture is m ost com mon in maxilla.
4.A. M axillary premolars are least com m on site for furca­
tion involvement.
5.B. Cul-de-sac is partial bone loss seen in grade II furca­
tion involvement.
6.B. Trauma from occlusion resulting from alteration in
occlusal forces is called primary traum a from occlu­
sion.
7.C. Insufficient occlusal forccs can result from an opcn-
bite relationship, an absence o f functional antagonist,
or unilateral chewing habits that neglect one side o f
mouth.
8.B. W hile drifting distally, m andiblar prem olars lose their
intcrcuspating relationship with m axillary teeth.
9.D. Pressure from granulation tissue o f periodontal pock­
ets m ay also result in a shift in the position o f tooth.
I O.C. Ledges are one o f the bone destruction pattern in perio­
dontal disease.
1 l.C . The cells responsible for degradation o f organic m a­
trix during bone resorption are m ononuclear cells.
12.B. In horizontal bone loss, bone margin remain roughly
perpendicular to tooth surface.
13.D. Traum a from occlusion is a contributing etiologic fac­
tor in cases o f furcation involvement.
14.C. Traum a from occlusion occurs in supporting tissue
and does not affect the gingiva.
15.B. In traum a form occlusion, destruction o f periodontal
fibers occur, which increases mobility o f tooth.
16.C. In stage 111, there is adaptive remodeling o f the perio­
dontium .
 — 26 —
Periodontitis
1. Deep, crater like osseous lesions, mostly located in
interdental areas are found in:
A. Acule necrotizing ulcerative gingivitis
B. N ecrotizing ulcerative periodontitis
C. Refractory periodontitis
D. Localized juvenile periodontitis
2. Periodontitis that does not respond to therapy and
recurs soon after adequate treatment is referred to
as:
A. Juvenile periodontitis
B. N ecrotizing ulcerative periodontitis
C. Rapidly progressive periodontitis
I). Refractory periodontitis
3. Which o f the following diseases is/are associated with
prepubertal periodontitis:
A. Blood dyscrasias
B. Papillon-Lefcvre syndrome
C. 1Iypophosphatasia
I). All the above
4. Hypcrkeratotic skin lesions, severe destruction of the
periodontium with calcification o f dura are the char­
acteristic features of:
A. Blood dyscrasias
B. Papillon-Lcfevre syndrome
C. 1Iypophosphatasia
D. All the above
5. Periodontal disease in Down’s syndrome is most se­
vere in:
A. Lower anterior region
B. U pper anterior region
C . Lower posterior region
D. Upper posterior region
 P e r io d o n tit is 105

6. T he lesions o f localized juvenile periodontitis are

mostly found in:
A. Canines and first premolars
B. Second m olars and incisors
C. First m olars and incisors
1). Second molars and canines
7. The most common initial clinical symptom o f early
juvenile periodontitis are mostly found in:
A. Canines and first premolars
B. Second molars and incisors
C. First m olars and incisors
D. Second m olars and canines
8. The most common initial clinical symptom of early
juvenile periodontitis is:
A. Deep, dull radiating pain in teeth
B. Deep periodontal pockets
C . Denuded root surface sensitive to thermal and tactile
stimuli
1). M igration o f first molar and incisor
9. Bacteria considered to be pathogenic in juvenile perio­
dontitis is/are:
A. A. actinomycetemcomitans
B. Capnocytophaga
C. Pcptostreptococcus micros
1). Both (A) and (B)
10. Whitish-yellowish soft material that covers the areas
o f ulceration and necrosis of the gingival margin in
ANUG is referred to as:
A. Pyogenic membrane
B. Pseudom em brane
C‘. M ateria alba
I). None o f the above
11. P eriod on tal d estruction associated w ith D o w n ’s
syndrome is due to:
A. Defect in T-cell maturation
B. D efect in polym orphonuclear leukocyte chem otaxis
C. Reduced resistance to infection
1). All the above
106 M C Q s in P e r io d o n tic s

Answers
1.13. Inflam m ator infiltrate in lesions o f NIJG can extend
to underlying bone leading to necrotizing ulcerative
periodontitis.
2.D. In recurrent periodontitis, complete rem ission occurs
after therapy.
3.D. Prepubertal periodontitis has its onset before 11 years
o f age in the primary or mixed dentition.
4.B. H yperkeratotic skin lesions, severe destruction o f
periodontium w ith calcification o f dura are character­
istic featu re o f P apillo n -L cfev re sy n d ro m e. But
bacterial flora is sim ilar to adult periodontitis.
5.A. Periodontal disease in D own's syndrom e is charac­
terized by form ation o f deep periodontal pockets
associated with plaque accum ulation and moderate
gingivitis.
6.C. Localised juvenile periodontitis is characterized by
localized first m olar/incisor presentation with inter-
proxim al attachm ent loss on at least two permanent
teeth.
l.C . Explanation same as o f question No. 6
8.D. D isto lab ial m igration o f m axillary in ciso rs w ith
concom itant diastem a formation. M obility o f molars
are also increased.
9.D. Two types o f bacteria considered to be pathogens in
juvenile periodontitis are A.cictimycetecomitans and
capnocytophaga.
10.B. The ANUG lesions are painful and bleed often, giv­
ing rise to local lymphadenopathy and even fever and
malaise.
11. D. Reduccd resistance to infection occurs because o f poor
circulation especially in areas o f terminal vascular­
ization.
 27
----------------------
General Considerations in
-----------------------

the Management of
Periodontal Diseases
1. Curved N a hers probe is mainly used to:
A. Locate subgingival deposits
B. M easure depth o f periodontal pockets
C. Evaluate horizontal com ponent o f furcation areas
1). N one o f the above
2. Which of the following sickle scalers is used in mandi­
bular anterior area if there is little interproximal
space:
A. Jaquette scaler B. U 15/30 scaler
C. Bail scaler D. M orse scaler
3. Gracey curettes number 11-12 are used for:
A. A nterior teeth
B. Posterior teeth facial surface
C. Posterior teeth distal surface
D. Posterior teeth mesial surface
4. The tip action o f piezoelectric ultrasonic unit is:
A. Orbital
B. Linear
C . Elliptical
1). None o f the above
5. The proximal surfaces of the tooth can be polished
by:
A. R ubber cups
B. Bristle brushes
C. Dental tape
D. A irpow der polishing
108 M C Q s in P c r io d o n tic s

6. Knife/ves used for interdental areas during gingi-

vectomy is/are:
A. M errifield knife
B. Kirkland knife
C. Both (A) and (B)
D. N one o f the above
7. T he finger rest established on tooth surfaces adjacent
to the w orking areas is known as:
A. Finger on finger
B. C ross arch finger
C . C onventional finger rest
I). Palm up finger rest
8. Stroke used for the removal of both supragingival and
subgingival calculus should be:
A. Light to moderate pull stroke
B. Short, powerful pull stroke
C . Short, moderate push stroke
I). Powerful push stroke
9. T he distance between the apical edge o f the calculus
and the bottom of pocket usually ranges from:
A. 0.5 to 1.0 mm
B. 0.2 to 0.5 mm
C . 0.2 to 1.0 mm
D. 0.4 to 0.8 mm
10. S h a rp ly defined w edge shaped depression in the
cervical area o f the facial tooth surface is known as:
A. A brasion
B. Erosion
C . Cuneiform defect
1). N one o f the above
11. I.ess than adequate remaining bone support, some
tooth mobility, and grade I furcation involvement
establish one of the following prognosis:
A. E xcellent prognosis
B. Good prognosis
C . Fair prognosis
D. Poor prognosis
 M a n ag e m en t of Perio do ntal D iseases 109

12. Periodontal surgery, including placement o f implants,

is carried out in:
A. Phase I therapy
B. Phase II therapy
C . Phase III therapy
D. Phase IV therapy
13. Em bedding o f new periodontal ligament fibers into
new cementum and attachment o f gingival epithelium
to tooth surface is referred to as:
A. Epithelial adaptation
B. Repair
C . Reattachm ent
1). N ew attachm ent
14. Recommended prophylactic dose o f amoxicillin for
periodontal procedure in patients at risk for infective
endocarditis is:
A. 2 to3 gm orally 1 hour before procedure
B. 1 gm orally 1 hour before procedure
C. 3 gm IV 30 m inutes before procedure
I). 2 gm IM 30 m inutes before procedure
15. D rug o f choice for antibiotic prophylaxis for the
prevention o f infection during periodontal therapy in
diabetic patient is:
A. A m oxicillin
B. Erythromycin
C. Penicillin
D. A m picillin
16. W hich o f the following drugs shows development o f
loss o f alveolar bone in periodontitis:
A. A lendronate
B. Flurbiprofen
C . Ibuprofcn
I). All the above
110 M C Q s in P erio d o n tic s

17. A sinus opening onto the gingival mucosa along the

length o f root and covered by small, pink, bead like
mass o f granulation tissue is known as:
A. Acute periodontal abscess
B. Chronic periodontal abscess
C . Periapical abscess
I). Gingival absccss
 M a n a g e m e n t of P e r io d o n ta l D i s e a s e s 111

Answers
1.C\ Explorers are used to locate subgingival deposits.
2.D. Sicklcs with straight shanks are used for anterior teeth
w here as sickle scalers w ith contra-angled shanks
adapt to posterior teeth.
3.D. G raccy curettes num ber 13-14 are used lor distal sur­
faces.
4.B. Tip action o f magnetostrictive ultrasonic unit is ellip­
tical.
5.C. Tape is passed interproximally w hile being kept at
right angle to the long axis o f tooth and is activated
w ith firm labiolingual motion.
6.C. Kirkland knife is used in gingivectomy. M crrifield
knife is representative o f knives com m only used in
interdental areas.
l.C . Cross-arch finger rest is established on toOth surfaces
on the other side o f the sam e arch.
8.B. Scaling m otion should be initiated in the forearm and
transm itted form w rist to the hand with slight flexing
o f fingers.
9.C. D istance between apical edge o f calculus and bottom
o f pocket usually ranges from 0.2 to 1 mm.
10.C. Cuneiform defect is another name o f erosion.
11 .C. Acceptable patient cooperation, adequate maintenance
possible and presence o f limited system ic/environ­
mental factors also establishes fair prognosis.
12.B. Endodontic therapy is also included in phase II therapy.
13.D. It is not existing fibers that reattach but new fibers
that are formed and attach to new cem entum , there­
fore it is termed as new attachment.
14. A. Recom m ended prophylactic dose o f am oxicillin for
periodontal procedure in patients at risk for infective
112 M C Q s in P e r io d o n tic s

endocarditis is 2 to 3 gm orally lh o u r before proce­

dure.
15.C. Frequent re-evaluation after active therapy is needed
to assess treatm ent response and prevent recurrencc
o f periodontitis.
16.D. A lendronate, flubiprofen and Ibuprofen slow s devel­
opm ent o flo ss o f alveolar bone in periodontitis.
17.B. Acute periodontal abscess are painful, edem atous, red,
shiny, ovoid elevations o f the gingival m argin, the
attached gingiva, or both.
 ------ 28 ------
Nonsurgical Management
1. Diameters of bristles o f commonly used soft tooth
brushes is:
A. 0.007 inch B. 0.010 inch
C . 0.012 inch D. 0.014 inch
2. W hich o f the following statements is not true about
abrasion o f teeth:
A. A brasion is more prevalent on m axillary tcelh
B. Abrasion results in saucershaped indentations with
sm ooth shiny surface
C. Abrasion is more frequent on left h alf o f the dental
arch
I). Abrasion also occurs on incisal edges
3. W h ich o f the fo llo w in g b r u sh in g te c h n iq u e s is
recommended for cleaning in areas with progressive
gingival recession:
A. Bass method
B. Stillman method
C. M odified Stillman method
I). Charters method
4. The step 4 during the preparation o f tooth surface in
the initial phase of periodontal therapy is:
A. Supragingival removal o f calculus
B. Subgingival root treated
C. Plaque control instructions
1). Obturation o f carious lesions
5. Which of the following drugs is most frequently used
in treating rcfractory periodontitis, including local­
ized juvenile periodontitis:
A. M etronidazole +Amoxicillin
B. Tetracycline
C . Ciprofloxacin
D. Penicillin
114 M C Q s in P e r io d o n tic s

6. The recommended dose o f amoxicillin for the treat­

ment o f refractory or juvenile periodontitis is:
A. 250 mg tid
B. 500 m g bid
C . 500 mg tid
D. 250 mg qid
7. “ Keves technique” refers to:
A. A pplication o f various m edicam ents to root surfaces
B. A pplication o f slurry o f sodium bicarbonate and
hydrogen peroxide to tooth surface
C . Subgingival irrigation by oral m outhwashes
D. N one o f the above
8. T he recommended dose of doxycycline applied to root
surface for root bioinodifieation is:
A. 100 mg/ml
13. 50 mg/ml
C. 150 mg/ml
I). 25 mg/ml
9. The minimal daily dose o f chlorhexidine gluconate
required to be effective as a rinse in reducing gingivi­
tis may be as low as:
A. 10 ml o f a 0.1 percent solution
B. 20 ml o f a 0.16 perccnt solution
C. 50 ml o f a 0.1 percent solution
I). 50 ml o f a 0.2 pcrcent solution
10. C o n cen tration o f stann ou s fluoride required for
direct pocket lavage in advanced periodontitis is:
A. 0.64 percent
B. 1.64 percent
C . 2 percent
1). 2.64 percent
11. T he drug (s) o f choice for the treatment o f acute
necrotizing ulcerative gingivitis is/are:
A. A m oxicillin 250 or 500 mg every 6 hours
B. Erythrom ycin 250 or 500 mg every 6 hours
C. M etronidazole 250 to 500 mg every 8 hours
1). All o f the above
 N o n s u r g ic a l M a n a g e m e n t 115

12. Which of the following arc referred to as primary in­

c u b a tio n z o n e s in a cu te n e c r o tiz in g u lc e r a tiv e
gingivitis:
A. Pre-existing chronic gingival disease
B. Periodontal pockets
C. Pericoronal flaps
I). All the above
13. The drug o f choice for the treatment o f refractory
periodontitis in which associated micro flora prima­
rily c o n s is ts o f b la ck p ig m e n te d b a c te r ia an d
spirochetes is:
A. Tetracycline
B. M etronidazole
C. A zithrom ycin
I). Ciprofloxacin
14. Oral Kaposi’s sarcoma is treated by:
A. Laser excision
B. Radiation therapy
C . Intralesional injection with vinblastine
I). All o f the above
15. Reducing the supracontact while restoring the origi­
nal tooth con tou r d u rin g occlu sal adju stm en t is
referred to as:
A. Coronoplasty
B. G rooving
C. Spheroiding
I). Pointing
16. T h e flap tech n iq u e in v o lv in g an in tern al bevel
incision about 0.5 to 1 mm from the gingival margin
for surgical treatment o f periodontitis is known as:
A. Papilla preservation Hap
B. M odified widman flap
C. A pically displaced flap
1). None o f the above
17. The recommended dose of ibuprofen for presurgical
medication in periodontal patients is:
A. 400 mg 1 hour before the procedure
B. 200 mg Z2 hour before the procedure
116 M C Q s in P c r io d o n tic s

C . 800 m g 1 hour before the procedure

I). 400 mg 2 hour before the procedure
18. Restoration and cpithclialization o f sulcus after curet­
tage, takes place in:
A. 1 day
B. 2 to 7 days
C. 7 to 14 days
D. 21 days
19. Removal of inflamed soft tissue lateral to the gingival
pocket wall is known as:
A. Coronoplasty
B. Gingivectomy
C . G ingival curettage
I). Subgingival curettage
20. G ingivectom y is contrnindicated in w hich o f the
following conditions?
A. Elim ination o f suprabony periodontal abscesses
B. Elim ination o f gingival enlargements
C . Elim ination o f suprabony pockets
I). Elim ination o f pocket located apical to mucogingival
junction
21. Complete repair o f connective tissue after surgical
gingivectomy takes about:
A. 5 to 14 days
B. 4 weeks
C . 7 weeks
D. 10 wfccks
2 2 . The incision made from base of the pockct to the crest
o f the bone is known as:
A. Internal bevel incision
B. Reverse bevel incision
C. C revicular incision
D. Interdental incision
2 3 . Furcation involvement in which interradicular bone
is completely absent but the furcation involvement can
not be seen clinically, is classified under:
A. Grade I involvem ent
B. Grade II involvement
 N o n s u r g ic a l M a n a g e m e n t 117

C . Grade III involvement

1). Grade IV involvement
24. Which o f the following teeth have the most favourable
anatomic features for resectivc therapy?
A. M andibular first molar
B. M axillary first molar
C. Maxillary' second molar
1). M andibular second m olar
25. M arginal tissue recession that extends beyond the
mucogingival junction with no loss o f bone or soft
tissue in the interdental area is classified under:
A. Class I
B. Class 11
C . Class III
D. Class IV
26. Guided tissue regeneration technique for root cover­
age is indicated when the recession is more than:
A. 3.98 mm apicocoronally
B. 2.98 m m apicocoronally
C. 4.98 mm apicocoronally
I). 4.08 mm apicocoronally
27. The most widely used metal in the manufacturing of
the implants is:
A. Gold
B. Platinum
C. Chromium
I). Titanium
28. Screws shaped dental implant, made of commercially
pure titanium and applied in two stage surgical
procedure is known as:
A. Nobelpharm a system
B. ITI system
C . IM Z system
1). Integral system
29. The pontic design with the least affect on the perio­
dontium is the:
A. Ovate pontic
B. M odified ridgelap pontic
118 M C Q s in P erio d o n tic s

C . Sanitary pontic
D. Ridgelap pontic
30. Technique using mixture o f bone dust and blood for
autogenous hone grafts is known as:
A. Bone blend
B. Osseous coagulum
C . Bone blending
I). None o f the above
3 1. The suturing technique appropriate for the maxillary
arch is:
A. Horizontal suture
B. A nchor suture
C . Closed anchor suture
1). Continuous, independent sling suture
32. Which o f the following removable appliances is more
hygienic and can be used for patients with less than
ideal plaque control ?
A. The Hawley appliance
B. The Crozat appliance
C . Both o f the above
I). None o f the above
33. T he suture -n eed le and sutures most commonly used
in periodontal surgery are:
A. Z\ circle curved needle and 50 cotton sutures
B. 3/8 circle reverse cutting needle and 30 black braided
silk
C . Va circle curved needle and 60 absorbable suture
I). Straight needle and nylon suture
 N o n su rg ic a l M a n a g e m e n t 119

Answers
1 .A. Diam eters o f bristles for medium tooth brush is 0.012
inch and for hard tooth brush is 0.014 inch.
2.D. A ttrition occurs on incisal edges.
3.C. M odified Stillman method is recom m ended for clean­
ing in areas with progressive gingival recession and
root exposure to minimize abrasive tissue destruction.
4.1). Caries in the vicinity o f gingiva interferes with gingi­
val health, even in absence o f adjacent calculus or de­
fective restoration. Therefore, obturation o f carious
lesions is an integral part o f phase 1 therapy.
5. A. In refractory localized juvenile periodontitis, tetracy­
cline resistant actinobacillus species have been sus­
pected. therefore com bination o f amoxicillin and m et­
ronidazole is used.
6.A. Treatment o f refractory or juvenile periodontitis con­
sist o f 250 mg am oxicillin and 125 mg potassium
clavulanate three time daily for 14 days along with
scaling and root planing .
7.B. Keyes technique is one o f the local method o f deliv­
ery o f chem otherapeutic agents.
8.A. Root biom odification is the application o f various
m edicam ents to root surfaces during surgical treat­
ment.
9.C. D aily patient-applied home irrigation w ith 180 ml of
0.04 percent chlorhexidine gluconate reduces gingi­
val inflamm ation in periodontal maintenance patients.
C on sid erin g quantity and co n cen tratio n to g eth er
option 4e ’ is correct.
10.B. 1.64 percent stam ous fluoride is found to be effective
in reducing bleeding index scores and in delaying
rcpopulation o f the pocket by spirochetes and m otile
bacteria.
120 M C Q s in P erio d o n tic s

11. D. Antibiotics arc administered systemically only in patients

with toxic systemic complications or local adenopathy.
12.C. Elim ination o f pericoronal flap is one o f the many
m easures required to m inim ize the lik elih o o d o f
recurrent acute necrotizing ulcerative gingivitis.
13.13. Drug o f choice for refractor)' periodontitis in which
associated m icroflora prim arily co n sists o f black
pigm ented bactcria and spirochetes is metronidazole.
14.D. O ral K a p o s i’s s a rc o m a is tre a te d by u se o f
antiretroviral agents, laser excision, radiation therapy,
or intralesional injection with vinblastine.
15.C. Pointing consists o f restoring cusp pointed contours.
16.B. M odified Widman flap is also known as unre-posi-
tioned m ucoperiosteal flap.
17.C. The recom m ended dose o f ibuprofen for presurgical
medication in periodontal patients is 800 mg I hr be­
fore the procedure.
18.B. Restoration o f junctional epithelium occurs as early
as 5 days alter treatment.
19.C. Subgingival curettage is the procedure that is per­
formed apical to the epithelial attachm ent.
20.D. N eed for bone surgery and esthetic considerations are
also contraindications o f gingivectomy.
2 l.C . Com plete epithelial repair takes about I m onth and
connective tissue repair about 7wceks after gingivcc-
tomy.
22.C. Crevicular incision is carried out with the help o f beak
shaped if 12D blade.
23.C. In grade III furcation involvement, opening may be
filled with soft tissue and may not be visible.
24 .B. M axillary first m olar have the most favorable ana­
tom ic features for resectivc therapy am ong all m o­
lars.
 N o n su rg ic a l M a n a g e m e n t 121

25.13. This type o f recession can be subclassified in to wide and

narrow.
26.C. Guided tissue regeneration should result in recons-truction
o f attachment apparatus, along with coverage o f denuded
root surface.
27.D. M etallic biom aterials have been extensively used,
particularly titanium and alloys o f titanium, aluminium
and vanadium.
2 8 .D. Three main im plant designs are screw shaped implant
form, cylinder-shaped form and tapered screw shaped
form.
29.C. Pontic design with least effect on periodontium is sani­
tary pontic.
30.B. The technique uses small particles ground from corti­
cal bone.
31 .D. M axillary arch has palatal gingiva w hich is attached
and fibrous whereas facial tissue is thinner and m o­
bile.
32.B. C rozat appliance is m ore hygienic and can be used
for patients with less than ideal plaque control.
33.13. Considering the available working space and tissues
involved this is most suited in most o f the cases. In
som e cases 5-0 resorbable (catgut) suture is indicated.
 — 29
Miscellaneous
—

1. In a healthy gingival, the distance between gingival

margin and free gingiva groove is:
A. 0.1-0.5 mm B. 0.5-1 mm
C . 0.5-1.5 mm I). 1-2 mm
2. W hat is the difference between gingivitis and perio­
dontitis?
A. G ingival sulcus
B. Periodontal pocket
C . Loss o f epithelial attachm ent
I). M obility o f tooth
3. Which o f the following is true is case o f AIDS patient?
A. A cute pain
B. Diffuse red lesion o f the attached gingiva
C . G ingiva covered w ith pseudom em brane
I). G ingival itching
4. W hich of the following step should be most prefer­
ably taken in root planing procedure?
A. Rem oval o f root caries
B. Rem oval o f necrosed cem entum and calculus
C . Rem oval o f calculus
D. Rem oval o f dentine
5. If periodontal surgery in necessary in case o f hori­
zontal bone loss in upper anterior region. Which o f
the following procedure is the most appropriate?
A. Papilla preservation llap
B. W idman llap
C . Coronary displaced flap
D. Gingivcctom y
6. A y o u n g adult sh ow s n o n -flu ctu an t, ten d er and
redness swelling in the marginal gingival lesion:
A. Periodontal abscess
B. Periapical absccss
 M is c e l la n e o u s 123

C . G ingival abscess
D. Periapical sinus
7. Which o f the following periodontal diseases does not
have calculus:
A. ANUG
B. Chronic adult periodontitis
C . Juvenile periodontitis
1). Periodontal abscess
8. In w hich o f the following conditions gingivectomy is
contraindicated:
A. G ingival sulcus beyond mucogingival junction
B. Enlargem ent due to acute systemic disease
C . Papillary enlargement
I). Enlargem ent due to chromic systemic disease
9. What is the normal average distance between the crest
of the alveolar bone and the ceraentoenamel junction
in young adult?
A. 1.0 mm
B. 1.08 mm
C . 2.08 mm
D. 2.80 mm
10. In which percentage chlorhexidine is used as a mouth­
wash ?
A. 2 percent
B. 0.02 percent
C . 0.2 percent
D. 1.0 percent
11. Wh i c h probe is used to detect the furcation in ­
volvement:
A. Periodontal probe
B. Nabers probe
C. Florida probe
1). Probe No. 11
12. Which of the following areas of the oral cavity are
affected by inflammatory papillary hyperplasia?
A. Lips
B. Tongue
C . Palate
I). Gingiva
124 M C Q s in P erio d o n tic s

Answers
1.D. M arginal gingiva is dem arcated from adjacent, at­
tached gingiva by shallow linear depression called free
gingival groove.
2.C. In periodontitis epithelial attachm ent is affected.
3.B. Diffused red lesions o f attached gingival appear in
m ost o f the AIDS patients.
4.B. R oot planning is the procedure by w hich residual
em bedded calculus and portions o f cem entum are
removed from roots to produce smooth, hard and clean
surface.
5.A. The papilla preservation flap has the advantage o f
better postsurgical esthetics and more protection for
the interdental bone, hence preferred for upper ante­
rior region.
6. A. In periodontal abscess swelling is generalized and lo­
cated around the involved tooth and gingival margin,
seldom with a fistulous tract.
7.C. The plaque that is present forms a thin biofilm on the
teeth and rarely mineralizes to form calculus.
8.A. G ingivectom y is contraindicated when the bottom o f
th e p o c k e t is lo c a te d b ey o n d ( a p ic a l) to th e
m ucogingival junction becausc even alter gingivee-
tomy pathological pocket will exist hence, gingivec­
tomy will not som e any useful purpose.
9.B. I bis distance may be greater in older adults. As pas­
sive eruption takes place this distance increases.
10.C. Two daily rinses w ith 10 ml o f 0.2 percent aqueous
solution o f chlorhexidinc digluconate alm ost com ­
pletely inhibit the developm ent o f dental plaque, cal­
culus and gingivitis.
11 .B. N abcrs probe is used to detect furcation involvement.
12.D. G ingiva is affected by inflammatory papillary hyper­
plasia.
 All India P G D E E 2005

1. T h e n o rm a l d ep th of the gingival cervice in an ad u lt

does n o t exceed:
A. 0.5-1 mm
B. 1-2 mm .
C . 1.3 mm
D. 2-3 mm
2. T h e c h a ra c te ristic lesion of acu te n ecro tizin g gingi­
vitis is th e necrosis of th e gingiva m ainly o f the:
A. Interdental papilla
B. Marginal gingiva
C. A ttached gingiva
I). Free gingival
3. Ideologic d e te r m in a n ts o f p la q u e d e p e n d on a ll,
except:
A. Sugar content o f diet
B. Host resistance
C. Age and sex o f the patient
1). Status o f dentition
4. S aliv ary pellicle is com posed of the follow ing except:
A. Im m unoglobulin G
B. Im m unoglobulin A
C. Amylase
I). A lbumin
5. C o n d itio n a l gingival en larg em en t is u su ally not:
A. Hormonal
B. Leukemic
C. G ranulom a pyogcnicum
I). Drug induced
6. T h e oxvgen co n su m p tio n of no rm al gingiva is:
A. 1.6 ± 0 .3 7
B. 0.9 ± 0 .2 2
126 M C Q s in P erio d o n tic s

C. 2.7 ±0.41
D. 1.9 ± 0.21
7. Clucosc levels in gingival crcvicular fluid (GCF) are:
A. Equal to glucose level in serum
B. Zero
C. 3-4 tim es greater than serum levels
1). M ore than 10 tim es the scrum levels
8. Gracey Curette No. 11-12 are used for:
A. A nterior teeth
B. Posterior teeth mesial
C. Posterior teeth distal
I). Posterior teeth facial and lingual
9. The brushing technique recommended for patients
with periodontal disease is:
A. Scrub technique
B. Sulcular technique
C. Roll technique
I). Circular technique
 All India P G D E E 2 0 0 5 127

Answers
1.D. The space between the tooth and free gingiva which ex­
tends apically to the juctional epithelium is called gingival
sulcus. Its normal depth is 2 to 3 mm.
2. A. The lesions o f acute necrotizing ulcerative gingivitis
start as punched out crater like ulceration at the crest
o f interdental papillae. The surface o f ulcer is cov­
ered by grey pseudom em branous slough.
3.C. Plaque ecology depend upon
- Host defence factor as in im m unocom prom ised pa­
tient normal oral microbial flora m ay be pathogenic.
- Fermentable corbohydrate provide low pi 1 environ­
ment and favor growth o f acidogenic bacteria.
- Changes in diet texture and masticatory function which
depend on status o f dentition also influence plaque
ecology.
4.D. Deposition o f organic film on the tooth surface is the
first stage in plaque formation. This film is called pel­
licle and is formed by deposition o f salivary proteins
to the tooth surface. These salivary proteins arc am y­
lase, lysozym e, peroxidase, IgA. IgG and glucosyl
transferase.
5.D. Conditioned enlargmcnt is seen in a pregnancy , pu­
berty, vitam in C deficiency and plasm a cell gingivi­
tis. N on-specific condition enlargem ent is seen in
granulom a pyogenicum while the drug induced gin­
gival enlargment is o f fibrotic gingival enlargement.
6.A. The oxygen consumption o f normal gingiva is 1.6 ±
0.37.
7.C. The fluid secreted in gingival sulcus is called gingi­
val crevicular fluid. It is an inflam m atory exudates
and its flow increases with inflammation.
128 M C Q s in P e rio d o n tic s

8. B. Groccy Curette No. 11 -1 2 is used for mesial surface o f

tootli while 13-14 number is used for distal surfacc.
9. B. Bass method or sulcular method o f brushing concentrates
on the ccrvical and proxim al surfaces where plaque is
generally present since it cleans the gingival sulcus it is
recommended for patient with periodontal involement.
 All India P G D E E 2006

1. AH o f the following arc correct with regard to acute

necrotizing ulcerative gingivitis, except:
A. There is necrosis o f the interdental papillae
B. S lo u g h in g o f the n e c ro tic tis s u e p re s e n ts as a
pseudom em brane over the tissues
C. It is associated with decreased resistance to infection
I). It causes chronic inflam m ation o f the gingival
2. In which condition papilla preservation flap is indi­
cated ?
A. Infrabony defects
B. O ne walled defects
C . Horizontal bone loss in upper anterior teeth
I). Crater types o f bony defect
3. Which one o f the following is the role o f barrier mem­
brane in GTR?
A. To help overall healing
B. Prevention o f epithelial migration
C . To stop bleeding
D. fo prevent the underlying tissues from the infection
4. The Local Drug Delivery System “ELYZOL”contains:
A. M etronidazole
B. Penicillin
C. Sanguinarine
D. Tetracycline
5. The electronic probing system “Foster Miller ProbeM
detects:
A. Only the pocket depth
B. Only the CEJ
C . C E J and pocket depth
D. Furcation involvement
L30 M C Q s in P e r io d o n tic s

6. Purulent exudation from the gingival nulcii is an in­

dication of:
A. D eep pockets
B. Severe periodontal attachm ent loss
C. Nature o f the inflammatory changes in the pockct wall
I). Shallow pockets
7. An advanced diagnostic technique which has been
suggested as an alternative to culture methods is:
A. Phase contrast microscopy
B. D irect immunofluorescence
C. Latex agglutination
D. Indirect im m unofluorescent microscope assays
8. T he pocket epithelium shows a series o f histopatho-
logical changes. Which of the following is true in this
regard?
A. Necrotic changes
B. Proliferative changes
C. Degenerative changes
I). Proliferative and degenerative changes
9. T he consistency o f the subgingival calculus is d e­
scribed to be:
A. C lay like
B. Flint like
C. Brick like
1). Soft
10. Which type o f gingival enlargement is seen in pu­
berty?
A. Interdental papillae appear bulbous but facial gingi­
val is not affected
B. Interdental papillae and facial gingival both are en­
larged
C . Interdental gingival, marginal gingival and attached
gingival all are enlarged
I). Both marginal gingival and attached gingival are en ­
larged
 All In d ia P G P E E 2 0 0 6 131

11. How many osseous walls arc present in one walled

vertical defects?
A. One wall present
B. Tw'o wall present
C. Three wall present
I). Four wall present
12. What do you understand by Isograft?
A. Bone taken from same individual
B. Bone taken from genetically sim ilar individual
C. Bone taken from identical twin
I). Bone taken from the sam e individual
13. W hich percentage o f sodium fluoride is used in Ion­
tophoresis?
A. 1 percent
B. 2 perccnt
C. 3 perccnt
1). 4 percent
14. W hich microorganism has 90 percent presence in
localized aggressive periodontitis?
A. Spirochetes
B. P. Gingivalis
C. P. Intermedia
L). A. Actinomycetemcomitans
132 M C Q s in P e r io d o n tic s

Answers
1.D. Acute necrotizing ulcerative gingivitis most often oc­
cur as an acute disease o f the gingival. The lesions
involved are punched out crater like depression o f in­
terdental papillae. The crater is co v ered by gray
pseudom em branous slough.
2.C. Papilla preservation flap is used to preserve the entire
papilla. It is indicated for m axillary anterior region
where esthetics is required. Crevicular incision is made
around each tooth and papilla is generally incorpo­
rated into facial flap.
3.B. B arrier m em branes used in GTR are bio-inert m ateri­
als. It serve to protect the blood clot and prevent soft
tissue cells (epithelium and connective tissue) from
m igrating into the bone defect.
4.A. C ontrolled release antim icrobials are now available
w hich are placed in periodontal pocket after scaling
and root planing thus delivering the drugs locally.
T hese are -
- ATRIDOX-Contains doxycycline
- Periochip- contains chlorhexidine
- ELYZOL- contains m etronidazole
5.C. Foster M iller Probe is capable o f m easuring pocket
depth w ith the detection o f cem cntoenam el junction
from which the clinical attachm ent level is autom ati­
cally detected.
6.C. Pus is a com m on feature o f periodontal disease but it
is only a secondary sign presence o f pus merely re­
flects the nature o f the inflammatory change in the
pocket wall.
7.D. Dark field phase contrast microscopy has been sug­
gested as an alternative to culture method. The laxes
 All In d ia P G D F E 2 0 0 6 133

agglutination, direct and indirect innnunofluorcscent

microscopy recognize specific bacterial antigens.
8.D. The connective tissue o f pocket wall exhibits degen­
eration. In addition to exudative and degenerative
changes the connective tissue shows proliferation o f
the endothelial cells w ith newly formed capillaries fi­
broblasts and collagen fibers.
9.B. Subgingival calculus is dense Hint like in consistency
and is firmly attached to the tooth surface. Subgingi­
val calculus is usually dark brown in color and does
not grow much in size due to limitation o f space is the
subgingival area.
10.B. During puberty gingival enlargem ent is seen both in
m ales and fem ale. G ingival enlargem ent may be
present in marginal gingiva and the interdental papil­
lae. The interdental papillae appear bulbous. Facial
gingiva is mostly affected. After puberty it undergoes
spontaneous remission.
11 .A. In one walled defect only one osseous wall is present.
12.C. A ccording to source bone graft are classified as fol­
low s-
A utogenous graft bone taken from sam e individual.
A llograft Bone taken from sam e species but geneti­
cally dissimilar.
Isograft Bone taken from identical tw in
I Ieterograft /Xenograft— Bone taken from different
species.
A lloplastic graft— These are non-bone graft or bone
substitute.
13.B. Iontophoresis is used for treatm ent o f dentinal hyper­
sensitivity. It uses 2 pcrcent sodium fluoride. When
m ild current is passed sodium fluoride penetrate the
dentinal tubules to seal the tubules.