MCQs 303 Periodontology Prof. Lim Sokun 2019

The answer is explaining that for a treatment plan with code 3, it is necessary to perform supra and subgingival scaling, as well as improve home care. This means that the patient has pocketing of 4-5 mm, where the gingival margin is on the clear area of the probe. Code 3 indicates the severity of periodontal disease and the necessary treatment measures to address it, including professional scaling and improved oral hygiene practices at home.

Furcation involvement refers to the extent to which the roots of a tooth are affected by periodontal disease. It is measured using various probes, including Naber's probe. Naber's probe is specifically designed with a curved tip that allows for easy access to furcation areas, making it an effective tool for assessing the severity of furcation involvement. The other probes mentioned may be used for different purposes in periodontal examination, but Naber's probe is the most suitable for measuring furcation involvement.

The most efficient way to remove a heavy ledge of calculus is by using the lower third of the cutting edge. This part of the cutting edge would provide the best leverage and control, allowing for better removal of the calculus. Using the lower third would ensure that the force is applied effectively and minimize the risk of damaging the surrounding area.

The correct answer is "always, to ensure complete removal of the calculus." This means that regardless of the situation, it is important to follow scaling with the use of a curet in order to ensure that all calculus is completely removed. This is necessary for maintaining oral health and preventing further complications.

The palm grasp is the best way to hold an instrument to be sharpened because it provides a secure and stable grip. This grasp involves holding the instrument with the palm of the hand, allowing for better control and precision during the sharpening process. The pen grasp, modified pen grasp, and third-finger grasp may not provide the same level of stability and control, making them less ideal for sharpening instruments.

A separate initial appointment for gross scaling is necessary only for patients with extensive and extremely heavy deposits which interfere with oral hygiene procedures. This means that not all patients require a separate appointment for gross scaling, only those with significant deposits that make it difficult to perform regular oral hygiene procedures.

The correct answer is 50% because the question is asking for the percentage of cases that show a free gingival groove. Out of the given options, 50% is the only percentage that matches the question.

Parakeratinized gingiva is a type of oral mucosa that is found in certain areas of the mouth. It is characterized by the presence of a thick keratinized layer on the surface. The stratum granulosum is a layer of the epidermis that is responsible for the production of keratin. In parakeratinized gingiva, this layer is absent, which means that the cells in the gingiva do not produce keratin. This is why the correct answer is stratum granulosum.

During menstruation, hormonal changes can lead to an increase in blood flow to the gums, causing inflammation and exudate from inflamed gingiva. Additionally, hormonal changes can also affect the composition of saliva, leading to an increase in salivary bacterial count. Therefore, both the exudate from inflamed gingiva and salivary bacterial count can increase during menstruation.

Mineralized plaque refers to the hard deposits that form on teeth due to the accumulation of bacteria and food particles. This hardened plaque, also known as calculus, cannot be removed by regular brushing and flossing alone and requires professional dental cleaning. Materia alba, on the other hand, refers to the soft, white, cheesy material that can be easily removed by brushing and flossing. Food debris refers to small particles of food that may get stuck between teeth but can be removed by brushing and flossing. Dental stains, on the other hand, refer to discolorations on the teeth caused by various factors such as smoking, drinking coffee or tea, or poor oral hygiene.

The correct answer is Silness and Loe in 1964. The Plaque Index was developed by Silness and Loe in 1964.

The scaling process removes both calculus and plaque. Calculus refers to hardened plaque that forms on the teeth and cannot be removed by regular brushing. Plaque, on the other hand, is a sticky film of bacteria that forms on the teeth and can lead to tooth decay and gum disease if not removed. Scaling is a dental procedure that involves the removal of both calculus and plaque from the teeth, helping to maintain oral health.

A hoe is a dental instrument that has a two-point contact with the tooth. It is used for removing large or heavy deposits of calculus from the tooth surface. The two points of the hoe allow for effective and efficient removal of the deposits, ensuring thorough cleaning of the tooth.

Root planning is the process of removing diseased cementum, which is the outer layer of the tooth root, along with other root deposits. This procedure is typically done to treat periodontal disease and improve the health of the gums and supporting structures of the teeth. By removing the diseased cementum and other deposits, the root surface becomes smoother and allows for better reattachment of the gums to the tooth, reducing pocket depth and preventing further progression of the disease.

Polymorphonuclear leukocytes, also known as neutrophils, play a crucial role in the immune response against periodontal pathogens. They are the first line of defense and are responsible for combating these pathogens. Additionally, they contribute to the destruction of periodontal tissues during periodontitis, which is a chronic inflammatory condition affecting the gums and supporting structures of the teeth. Neutrophils are almost always found in the gingival tissues, highlighting their importance in the local immune response. However, they are not typically found in the gingival sulcus, which is the narrow space between the tooth and the gum.

Root planning is the process of removing diseased cementum along with other deposits on the root surface. This procedure is typically performed to treat periodontal disease and promote the healing and regeneration of the gums and surrounding tissues. By removing the diseased cementum and other deposits, the root surface becomes smoother and cleaner, allowing for better attachment of the gums to the tooth and reducing the risk of further infection and inflammation. This helps to restore the health and stability of the affected tooth and surrounding tissues.

Cyclosporine and Nifedipine are known to cause gingival overgrowth. Gingival overgrowth is a side effect of these drugs, characterized by an abnormal enlargement of the gum tissue. This condition can lead to discomfort, difficulty in maintaining oral hygiene, and aesthetic concerns. Insulin, Metronidazole, and Tetracycline are not associated with gingival overgrowth.

Dried calculus is easier to detect than wet calculus with the explorer because it is darker. When calculus dries, it becomes more visible due to its darker color, making it easier for the explorer to detect and identify. Wet calculus, on the other hand, may blend in with the surrounding teeth and be harder to distinguish. Therefore, the darker color of dried calculus makes it more noticeable and easier to detect during an examination.

The explorer is a dental instrument that is used to detect various dental conditions. It can be used to detect subgingival calculus, which is the buildup of plaque and tartar below the gumline. It can also be used to detect caries, which are cavities or decay in the teeth. Additionally, the explorer can be used to identify irregularities in the cemental surfaces, which are the outer layers of the tooth roots. Lastly, it can be used to detect furcations, which are areas where the roots of a tooth divide. Therefore, the correct answer is that the explorer is used to detect all of the above conditions.

Transillumination refers to the technique of shining a light through a body structure to examine the other side. In this case, the lingual aspect of the teeth is being examined from the buccal aspect by reflecting light through them. Therefore, transillumination is the correct term to describe this process.

A wire edge is produced when the last stroke of the stone is drawn away from the cutting edge. This means that when sharpening a blade, if the final stroke of the stone is pulled away from the edge, it can create a thin, weak edge known as a wire edge. This occurs regardless of whether a coarse artificial stone, a mounted ruby stone, or oil is used for lubrication. The key factor is the direction of the final stroke, which determines whether a wire edge is formed or not.

The correct answer is "all of the above." This means that the shape and extent of defects in the alveolar bone can be determined through direct inspection during periodontal surgery, sounding through the gingiva, and conventional probing methods.

Calculus is a hard, mineralized deposit that forms on the teeth. It provides a rough surface where bacteria can easily attach and multiply, leading to the formation of bacterial plaque. This plaque can cause inflammation and irritation of the surrounding tissues, contributing to the progression of periodontal disease. Therefore, if calculus is not detected and removed, it will continue to harbor bacterial plaque, perpetuating the periodontal disease process.

A good finger rest or hand rest must be located to allow wrist-forearm motion, parallelism of the handle or shank, optimal working angulation, and a "built-up" fulcrum. This means that the finger rest or hand rest should be positioned in a way that allows for comfortable and natural movement of the wrist and forearm, ensures that the handle or shank of the tool is aligned with the hand, allows for the best angle for effective work, and provides a stable base for leverage.

The lower third of the cutting edge is the most efficient part to engage with the edge of the ledge when removing a heavy ledge of calculus. This is because the lower third is closer to the handle of the cutting tool, allowing for better control and leverage. Additionally, the lower third is typically sharper and more effective at cutting through tough substances like calculus.

Pierre Fauchard was the first person to describe oral bacterial flora from a sample of material taken from his own gingival tissue. He was a French physician and is often referred to as the "father of modern dentistry." Fauchard made significant contributions to the field of dentistry, including the development of dental prosthetics and the understanding of oral health. His observations and documentation of oral bacterial flora helped pave the way for further research and understanding of oral hygiene and dental health.

Levi Spear Parmly is considered both the father of oral hygiene and the inventor of dental floss. He is credited with promoting the importance of oral hygiene and developing the concept of using silk thread as a means of cleaning between the teeth. Parmly's contributions to oral hygiene and the invention of dental floss have had a significant impact on dental care practices.

Trauma from occlusion does not increase the flow of crevicular fluid. Crevicular fluid is a fluid that is present in the gingival crevice or the space between the tooth and the gum. It is produced as a response to inflammation and acts as a protective mechanism for the periodontal tissues. Inflammation, smoking, and brushing can all cause an increase in the flow of crevicular fluid. However, trauma from occlusion refers to excessive force or pressure on the teeth during biting or chewing, which does not directly stimulate the production of crevicular fluid.

As a person ages, the thickness of cementum, which is the hard tissue that covers the root of a tooth, tends to increase. This increase in thickness is greater apically, meaning towards the apex or tip of the root. This can be attributed to the continuous deposition of cementum over time, which helps to protect and support the tooth. In contrast, the thickness of cementum tends to be less pronounced coronally, labially, or at the midroot level.

Hormonal imbalance can have multiple effects on periodontal tissue. It can lead to manifestations such as increased gingival inflammation and bleeding. It can also modify the tissue response to plaque, making the gums more susceptible to infection and inflammation. Additionally, hormonal imbalance can cause anatomic changes in the periodontal tissue that make it more prone to trauma from occlusion. Therefore, all of the given options are correct in describing the effects of hormonal imbalance on periodontal tissue.

During pregnancy, hormonal changes can lead to an increased risk of plaque accumulation and gingivitis. However, after parturition, the hormone levels return to normal, reducing the correlation between plaque accumulation and gingivitis. Therefore, the statement that the correlation between plaque accumulation and gingivitis is more during pregnancy than after parturition is incorrect.

Crater-like deformities are seen in NUG (necrotizing ulcerative gingivitis). This condition is characterized by the formation of deep, ulcerated craters in the gum tissue. NUG is an acute and severe form of gingivitis that is often associated with poor oral hygiene, stress, and a compromised immune system. It is typically accompanied by symptoms such as bleeding gums, bad breath, and pain. Prompt treatment is necessary to prevent further damage to the gums and underlying bone.

Implant surgery is done in Phase II. This phase typically involves the placement of the dental implant into the jawbone. It is the second phase of the implant procedure, following the initial evaluation and planning in Phase I. Phase III involves the healing and integration of the implant with the surrounding bone, while Phase IV includes the placement of the final crown or prosthesis. Therefore, Phase II is the correct phase for implant surgery.

In the presence of heavy function, the periodontal ligament undergoes certain changes. These changes include an increase in width and an increase in cellularity. This means that the ligament becomes wider and there is an increase in the number of cells present in the ligament. This could be due to the increased stress and load placed on the ligament during heavy function, leading to an adaptive response of increased tissue width and cellularity to support and stabilize the tooth.

The Hirsch field-file is the instrument used for crushing subgingival calculus. It is a dental tool specifically designed for removing calculus deposits from below the gumline. The file has a thin, pointed tip that can be inserted into the periodontal pocket to break down and crush the calculus deposits. This instrument is effective in removing subgingival calculus and promoting better oral hygiene.

Kirkland and Orban knives are specifically designed for gingivectomy procedures. A gingivectomy is a surgical procedure that involves the removal of diseased or excess gum tissue. These knives are commonly used by dentists and periodontists to precisely and effectively remove the targeted gum tissue during the gingivectomy procedure. They are sharp and have a specific shape that allows for accurate cutting and shaping of the gums. Therefore, the correct answer is gingivectomy.

Streptococci and Actinomyces spp. are early colonizing organisms in periodontal diseases. This means that they are among the first bacteria to colonize the periodontal tissues and initiate the disease process. Fusobacterium nudedum, on the other hand, is an anaerobic motile rod that is associated with chronic periodontitis. This means that it is commonly found in individuals with chronic periodontitis and is believed to play a role in the progression of the disease.

The dentogingival unit refers to the junctional epithelium and gingival fibers. The junctional epithelium is a specialized epithelial tissue that attaches the gingiva to the tooth surface, forming a seal between the oral cavity and the underlying periodontal tissues. The gingival fibers, on the other hand, are connective tissue fibers that provide support and stability to the gingiva. Together, the junctional epithelium and gingival fibers make up the dentogingival unit, which plays a crucial role in maintaining the health and integrity of the periodontium.

Vitamin B deficiency can lead to glossitis, which is the inflammation of the tongue. Glossodynia refers to the painful sensation in the tongue. Gingivitis is the inflammation of the gums. Inflammation of the entire oral mucosa refers to the inflammation of the lining of the mouth. These symptoms are commonly associated with a deficiency in vitamin B.

The Basic Periodontal Examination (BPE) is a screening tool that was specifically designed to assess the need for treatment. It is not intended to identify mobile teeth. Instead, it focuses on recording the maximum scores in each quadrant of the mouth. Additionally, the BPE does not identify furcation involvement, which refers to the separation or division of tooth roots.

The design feature of a curet with a convex back allows it to be used in the deepest area of the sulcus or pocket with the least tissue distention. The convex back helps to minimize tissue trauma and allows for better access and adaptation to the curved surfaces of the teeth and root surfaces. This design feature ensures that the curet can effectively remove plaque and calculus from the deepest areas of the sulcus or pocket without causing excessive tissue damage or discomfort to the patient.

Clefts are narrow "slit-like" areas of recession over the roots. They are characterized by a separation or splitting of the gingival tissue, exposing the root surface. This condition can lead to increased sensitivity, root decay, and potential loss of the tooth if left untreated.

To completely remove calculus on a proximal surface, the strokes should be extended at least halfway across the surface. This means that the scaling or cleaning should cover a significant portion of the proximal surface, ensuring that all calculus is effectively removed. Extending the strokes to the cementoenamel junction, just under the gingiva, or onto the lingual surface may not be necessary for complete removal of calculus on the proximal surface.

The correct answer is "short, oblique stroke." This is because when using an explorer, a short, oblique stroke is the most effective technique for detecting and removing dental plaque and calculus. This motion allows the explorer to gently glide along the tooth surface, feeling for irregularities and deposits. A vertical pushing motion or a short, pushing motion may not provide the same level of sensitivity and precision in detecting dental issues. A plunging vertical stroke, on the other hand, is not a recommended technique as it can be too aggressive and may cause damage to the tooth or gum tissue.

Periodontal disease is the most common disease found in the embalmed bodies of ancient Egyptians. This is because periodontal disease, also known as gum disease, is caused by the buildup of plaque and bacteria on the teeth and gums. Without proper dental hygiene, such as brushing and flossing, the bacteria can cause inflammation and infection in the gums, leading to periodontal disease. Given the ancient Egyptians' lack of modern dental care and hygiene practices, it is likely that they would have been susceptible to this disease.

The correct answer is Drug-induced gingival enlargement. Lobulated mulberry-shaped gingival enlargement is a characteristic feature of drug-induced gingival enlargement. This condition is caused by certain medications, such as anticonvulsants, immunosuppressants, and calcium channel blockers. These drugs can cause an overgrowth of the gum tissue, resulting in a lobulated appearance. Inflammatory gingival enlargement refers to gum enlargement caused by inflammation, while combined gingival enlargement refers to a combination of both drug-induced and inflammatory causes. However, the specific description of lobulated mulberry-shaped enlargement points towards drug-induced gingival enlargement as the most likely answer.

During pregnancy, hormonal changes can lead to an increased risk of gingivitis, which is inflammation of the gums. This is because the hormones can cause an exaggerated response to the bacteria in dental plaque, leading to swelling and bleeding of the gums. The severity of gingivitis tends to increase as pregnancy progresses, and typically peaks during the second trimester, which is around the 6th month. Therefore, the correct answer is the 6th month.

Osteoclasts are cells that are responsible for the breakdown and resorption of bone tissue. They play a crucial role in bone remodeling and maintenance. Inactive osteoblasts, on the other hand, are not involved in bone resorption. Osteoblasts are responsible for bone formation and the production of new bone tissue. Therefore, the correct answer is osteoclasts, as they are not involved in bone formation but rather in bone resorption.

In Stage II gingivitis (Early), the junctional epithelium shows the formation of rete pegs. Rete pegs are finger-like projections of the epithelium that extend into the connective tissue. They are a response to inflammation and are seen as a way for the epithelium to increase its surface area and attach more securely to the underlying tissue. This formation of rete pegs is characteristic of early gingivitis, indicating an inflammatory response in the gingival tissue.

Diabetes is not a direct cause of abnormal tooth mobility. However, it can contribute to periodontal disease, which can lead to tooth mobility. Hyperparathyroidism and resorption of alveolar bone are known causes of abnormal tooth mobility.

The distance between the apical edge of calculus and the bottom of the pocket is usually less than 1mm. This means that the calculus, which is a hard deposit of mineralized plaque, is typically located very close to the bottom of the periodontal pocket, which is the space between the tooth and the gum tissue. This close proximity makes it difficult to remove the calculus completely without professional dental intervention.

The correct answer is "Is associated clinically with increased flow of gingival crevicular fluid (GCF)." This is because gingivitis is characterized by inflammation of the gums, which leads to an increased flow of gingival crevicular fluid. This fluid is a serum exudate that is released from the inflamed gingival tissues and can be measured clinically as a sign of inflammation. The increased flow of GCF is a diagnostic feature of gingivitis and can help differentiate it from healthy gums.

If the mobility of the teeth is graded 3, it means that the teeth are mobile in the apicoocclusal direction and the mobility in the labio-lingual direction is more than 2mm. This indicates that the teeth have significant movement in both the vertical and horizontal directions, with the horizontal movement being more than 2mm. This level of mobility suggests a severe periodontal condition and may require immediate intervention or treatment.

False gingival enlargement refers to an increase in the size of the gums that is not caused by inflammation or disease. Instead, it is caused by factors such as underlying dental and osseous structures. This means that the enlargement is not a result of inflammation of the periodontal ligament, drug-induced gingival enlargement, epulis, or sarcoidosis. Instead, it is likely due to factors such as excessive bone or tooth structure, which can cause the gums to appear enlarged.

Subclinical gingivitis refers to a mild form of gingivitis that does not show obvious signs or symptoms. The correct answer explains that subclinical gingivitis is characterized by increased crevicular fluid flow and infiltration of sulcular and junctional epithelium by polymorphonuclear leukocytes. This means that there is an increase in the fluid that accumulates in the crevices around the teeth, and there is also an infiltration of a type of white blood cells called polymorphonuclear leukocytes into the gum tissue. This infiltration indicates an inflammatory response, even though there may not be visible signs such as redness or bleeding.

The correct answer is "Interproximally over the alveolar crest and are embedded in cementum of adjacent teeth." This means that the transseptal fibers extend between the teeth, specifically over the alveolar crest, and are embedded in the cementum, which is the hard tissue that covers the root of the tooth. These fibers help to support the teeth and maintain their position in the dental arch.

A forcibly embedded toothbrush bristle can cause a gingival abscess. When a bristle becomes embedded in the gingival tissue, it can cause irritation and inflammation. This can lead to the development of an abscess, which is a localized collection of pus. The abscess can cause pain, swelling, and redness in the affected area. If left untreated, it can lead to further complications such as the spread of infection or damage to the surrounding tissues.

The average human biologic width is 2mm. This refers to the distance between the bottom of the gum pocket and the bone level. It is important to maintain this width for healthy gum tissue and to prevent gum disease.

Root planing is a dental procedure that involves the thorough removal of calculus deposits and necrotic cementum from the root surface of teeth. This helps to eliminate the bacteria and toxins that contribute to gum disease. Additionally, root planing aims to facilitate healing by promoting the formation of a long junctional epithelium, which is a type of tissue that helps to create a seal between the tooth and the gum tissue. This new tissue attachment helps to prevent further bacterial invasion and promotes the overall health of the gums.

The correct answer is "When there is recession and/or true pocket." Periodontal attachment loss can be detected clinically when there is recession, which refers to the exposure of the root surface due to the loss of gum tissue. It can also be detected when there is a true pocket, which is a deepening of the space between the gum and the tooth caused by the destruction of the supporting structures. Therefore, the presence of either recession or a true pocket indicates periodontal attachment loss.

Using short jets of warm air is the correct answer because it helps to alleviate the discomfort caused by hypersensitive teeth or caries. Warm air can help to desensitize the teeth and reduce sensitivity. Using short jets ensures that the air is not too forceful, which could potentially cause further discomfort or damage to the teeth. The warmth of the air also provides a soothing effect, helping to ease any pain or discomfort experienced by the patient.

The correct answer is palm grasp. The air syringe is held with a palm grasp, where the syringe is held between the palm of the hand and the fingers. This grip allows for better control and stability while using the syringe to deliver air or water into the oral cavity during dental procedures. The palm grasp provides a comfortable and secure hold, enabling the dentist or dental assistant to manipulate the syringe effectively.

Rolling the handle of the explorer between the thumb and fingers is important because it allows the dental professional to manipulate the working end of the explorer to adapt it to line angles and depressions in the teeth. This technique helps in detecting any irregularities or abnormalities in the tooth surface, which is crucial for accurate diagnosis and treatment planning. By rolling the handle, the dental professional can effectively navigate the explorer to explore all areas of the tooth, ensuring a thorough examination.

Charaka Samhita is an ancient medical book that recommended cleaning the teeth twice a day with an astringent stick that has been chewed into a brush form. This book is one of the earliest texts on Ayurveda, the traditional Indian system of medicine, and it provides detailed information on various medical practices, including dental hygiene. The recommendation to clean the teeth with a chewed stick shows the importance given to oral health in ancient times.

Cyclosporin-induced gingival enlargement is more frequent in children compared to adolescents, adults, and older people. This may be due to the fact that children have a higher susceptibility to the side effects of medications, including cyclosporin. Additionally, the developing gingival tissues in children may be more responsive to the effects of cyclosporin, leading to an increased likelihood of gingival enlargement.

The correct answer is Hydroxyapatite and octacalcium phosphate. Supragingival calculus is the hardened plaque that forms on the teeth above the gumline. It mainly consists of hydroxyapatite, which is a crystalline form of calcium phosphate. Octacalcium phosphate is another common crystalline form found in supragingival calculus. Both hydroxyapatite and octacalcium phosphate contribute to the formation and structure of supragingival calculus.

The facial and cervical areas of the tooth are considered to be the most sensitive to various stimuli. This is because these areas are closer to the surface of the tooth and have a thinner layer of enamel, making them more susceptible to sensitivity. Additionally, these areas are more exposed to external factors such as hot or cold foods and drinks, which can trigger sensitivity.

Macrophages are a type of immune cell that can destroy virulent bacteria through phagocytosis, which involves engulfing and digesting the bacteria. They can also mediate the immune response by activating T-cells, which play a crucial role in coordinating and regulating the immune system. Therefore, during an acute gingival inflammatory response, macrophages are capable of both phagocytosis and T-cell mediation, making them the correct answer.

The average width of the periodontal ligament around a functional permanent tooth is 0.2 - 0.3 mm.

Ameloblasts are unable to undergo mitosis because they are fully differentiated cells that are responsible for enamel formation during tooth development. Once they have completed their function, they do not divide or replicate like other cells. Instead, they undergo apoptosis (programmed cell death) and are eventually replaced by other cells. This lack of ability to undergo mitosis is essential for the proper formation and maintenance of enamel in teeth.

Gingival inflammation refers to the inflammation of the gums. One of the best diagnostic signs of gingival inflammation is the texture of the gums. Inflamed gums tend to have a swollen and puffy texture, often appearing shiny and smooth. This is in contrast to healthy gums, which have a firm and stippled texture. Therefore, by observing the texture of the gums, a dentist or healthcare professional can identify the presence of gingival inflammation.

A universal curet is called that because it adapts to all surfaces of the teeth. This means that it can be used on both the outer and inner surfaces of the teeth, as well as the surfaces in between. The design of the curet allows it to effectively remove plaque and calculus from all areas of the teeth, making it a versatile tool in dental hygiene.

Infrabony pockets are pockets that extend into areas of vertical bone loss. This means that the bone surrounding the tooth has been lost in a vertical direction, creating a pocket-like space. Infrabony pockets are typically associated with advanced periodontal disease, where the supporting structures of the tooth, including the bone, are damaged. These pockets can contribute to further bone loss and tooth mobility if left untreated.

To make a complete s that will adapt to all tooth surfaces, four working ends of a hoe are needed. This suggests that each working end of the hoe is designed to adapt to a specific tooth surface, and all four working ends together can cover all tooth surfaces effectively.

The ultrasonic sealer only dislodges calculus that is in direct contact with the tip because the ultrasonic vibrations created by the sealer are transmitted through the tip. This means that the calculus must be in direct contact with the vibrating tip in order for the vibrations to effectively break it up and dislodge it. Calculus that is not in direct contact with the tip may not be affected by the vibrations and therefore will not be dislodged.

During the initial preparation stage of treatment, it is important to reevaluate the response to the removal of local etiologic factors. This is because the initial preparation stage involves identifying and addressing any local factors that may be contributing to the problem, such as plaque buildup or faulty restorations. By continually reassessing the response to these interventions, the dentist can ensure that the treatment plan is effective and make any necessary adjustments as needed. Reevaluation at the end of the initial therapy phase or only during the maintenance phase would not provide timely feedback for adjusting the treatment plan, and reevaluation only when the patient requests it may lead to delays in addressing any unresolved local factors.

The correct answer is "All of the above." This means that before establishing a treatment plan for scaling and root planing, it is essential to determine the location and depth of pockets, presence of furcations, condition of the tissue, and location, nature, and extent of the calculus deposits. All of these factors are important in determining the appropriate treatment approach for scaling and root planing.

During a sequence of scaling appointments, it is most advantageous to thoroughly scale and root plane a designated segment to completion. This approach allows for focused and thorough treatment of a specific area, ensuring that all plaque and calculus are removed. Scaling the entire mouth at each appointment may not allow for enough time to adequately clean each area. Only giving anesthesia for areas of depth over 6 mm may result in incomplete treatment of other areas. Anesthetizing the entire mouth may not be necessary and could lead to unnecessary discomfort for the patient.

A "heavy" set of curets should be reserved for patients with heavy calculus and retractable tissue because heavy calculus requires more force to remove, and retractable tissue allows for better access and visibility during the scaling procedure. This combination of factors ensures that the curets can effectively remove the heavy calculus without causing discomfort or damage to the patient's tissues.

To open the angulation of a curet blade in relation to the tooth surface, the shank must be moved away from the tooth. This means that the angle between the shank and the tooth surface needs to increase. By moving the shank away from the tooth, the curet blade will be positioned at a greater angle to the tooth surface, allowing for better access and improved efficiency in removing plaque and calculus.

John W Riggs is the correct answer because he is widely recognized as the first dentist to focus primarily on periodontics, which is the branch of dentistry that deals with the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth. Riggs made significant contributions to the field, including the development of the first periodontal probe, which is still used today to measure the depth of periodontal pockets. His work laid the foundation for modern periodontics and he is considered a pioneer in the field.

The depth of the gingival sulcus refers to the space between the tooth and the surrounding gum tissue. Under normal conditions, the depth of the gingival sulcus is 0mm, meaning there is no space between the tooth and the gum tissue. This indicates healthy gums and proper oral hygiene.

The width of attached gingiva refers to the distance between the bottom of the gingival sulcus and the mucogingival junction (MG junction). It can also be measured as the distance between the bottom of the periodontal pocket and the MG junction. Therefore, both options are correct as they describe the same measurement.

The cementoenamel junction of the teeth is used as a fixed landmark for measuring the level of periodontal attachment loss in the Periodontal Disease Index (PDI). This index is a tool used to assess the severity of periodontal disease by measuring various parameters, including attachment loss. The cementoenamel junction is a stable reference point that helps in accurately measuring the level of attachment loss, which is an important indicator of periodontal disease progression. The other options mentioned, Papillary Bleeding Index (PBI) and Russell's Periodontal Index (PI), do not specifically use the cementoenamel junction as a reference point for measuring attachment loss.

Extraction of hopeless teeth is done in the emergency phase because this phase involves immediate treatment for urgent dental issues. Hopeless teeth are those that cannot be saved or restored and may be causing severe pain or infection. In the emergency phase, the priority is to alleviate pain, control infection, and remove the source of the problem, which in this case is the hopeless teeth. This ensures that the patient's overall oral health is not compromised and allows for further treatment planning and restoration in subsequent phases.

The stratum intermedium is the primary source of the junctional epithelium in the tooth germ. The junctional epithelium is a specialized epithelial tissue that forms the attachment between the tooth and the surrounding gum tissue. It is responsible for maintaining the integrity of the tooth-gum interface and plays a crucial role in preventing bacterial invasion and infection. The stratum intermedium is located between the inner enamel epithelium and the outer enamel epithelium in the tooth germ and is involved in the development of the enamel organ.

After the completion of amelogenesis in humans, the anatomic crown is lined with a layer of reduced enamel epithelium. This layer is primarily derived from the stratum intermedium and ameloblast layer. The stratum intermedium is a layer of cells located between the ameloblasts and the outer enamel epithelium. The ameloblast layer is responsible for the formation of enamel during tooth development. Therefore, the stratum intermedium and ameloblast layer contribute to the formation of the reduced enamel epithelium that lines the anatomic crown.

The portion of tooth covered by calculus or altered cementum is referred to as the instrumentation zone. This term is used to describe the area that requires dental instruments to remove the calculus buildup or treat the altered cementum. The other options, such as pathologic zone, toxic zone, and deposit zone, do not accurately describe this specific area of the tooth.

Ciprofloxacin is the correct answer because it is an antibiotic that is effective against all strains of Actinobacillus. This means that it can effectively kill or inhibit the growth of this bacteria, making it a suitable treatment option for infections caused by Actinobacillus. Tetracycline, Amoxicillin, and Metronidazole may also be effective against Actinobacillus, but they are not universally susceptible to all strains of this bacteria like Ciprofloxacin is.

A Schwartz periotrievers is a magnetized instrument used in periodontal surgery. It is designed to aid in the removal of calculus and plaque from the root surfaces of teeth. The magnetization of the instrument helps to attract and hold onto metal objects, making it easier to manipulate and control during the procedure. This feature allows for more efficient and effective cleaning of the teeth and gums, resulting in improved oral health.

Periodontal diseases are mainly caused by dental plaque, which is a sticky film of bacteria that forms on the teeth. When plaque is not properly removed through regular brushing and flossing, it can harden and turn into calculus (tartar), which further contributes to periodontal disease. Malocclusion (misalignment of teeth) and faulty restorations can potentially contribute to periodontal disease, but they are not the primary cause. Therefore, the correct answer is dental plaque.

Necrotising ulcerative gingivitis (NUG) is a painful condition that is likely to recur if long-term maintenance is not carried out. This means that without proper ongoing care and treatment, the condition is likely to come back. It is not a viral infection, but rather a condition characterized by the formation of ulcers with a red 'halo' of inflammation. The statement does not mention metronidazole as the first line of treatment, so it cannot be concluded that it should always be used.

The most commonly used periodontal pack is the Non Eugenol pack. This pack does not contain eugenol, which is a substance that can cause irritation and allergic reactions in some patients. Non Eugenol packs are often used in periodontal procedures to protect the surgical site and promote healing. They provide a barrier that helps to prevent infection and control bleeding. Additionally, Non Eugenol packs are easy to handle and remove, making them a popular choice among dental professionals.

Probing is considered the most reliable means of detecting periodontal pockets. This involves using a periodontal probe, a thin instrument, to measure the depth of the pockets around the teeth. By gently inserting the probe into the space between the gum and tooth, the dentist or hygienist can determine if there is any loss of attachment or gum recession. Probing helps assess the health of the gums, identify the severity of periodontal disease, and plan appropriate treatment. Visual examination, radiographic examination, and testing for tooth mobility may provide additional information, but probing remains the gold standard for detecting periodontal pockets.

The best way to examine the dorsum of the tongue is to extend the tongue fully by grasping with a dry gauze square and use direct vision. This method allows for a clear and unobstructed view of the tongue's surface, enabling the examiner to observe any abnormalities or changes in color or texture. Using a dry gauze square helps to improve grip and prevent slippage during the examination. Direct vision ensures accurate observation without the need for additional instruments or techniques.