154 Periodotalogy- Prof. Sok Chea

New attachment refers to the process in which new periodontal ligament fibers are embedded into new cementum and new gingival epithelium attaches to a tooth surface that was previously denuded by disease. This process helps to restore the attachment between the tooth and the surrounding tissues, promoting the healing and regeneration of the periodontium.

Guided tissue regeneration is a technique used in periodontal therapy to promote the regeneration of periodontal tissues. It involves the use of a barrier membrane to prevent the migration of epithelial cells into the healing site, allowing for the growth of new connective tissue and bone. By preventing epithelial migration, guided tissue regeneration promotes the formation of a new attachment between the tooth and the surrounding tissues, improving periodontal health.

The most advantageous aspect of a full thickness flap compared to a partial thickness flap is that it exposes the cortical bone. This allows for better visualization and access to the underlying bone, which can be beneficial in certain surgical procedures or treatments. It also provides a more secure and stable flap, reducing the risk of flap laceration and making it easier to suture.

A positive knot has several advantages compared to a negative knot. Firstly, it does not have any memory, meaning it does not retain its shape or form after being untied. Secondly, it holds the knot better, providing a more secure hold. Thirdly, it can hold the knot for longer periods of time without slipping or coming undone. Lastly, it creates a better wound closer, ensuring a tighter and more secure closure. Therefore, all of the above advantages make a positive knot preferable over a negative knot.

The bacteria associated with ANUG (Acute Necrotizing Ulcerative Gingivitis) are the fff.fusospirochetal complex, which includes fusiform bacteria and spirochetes. These bacteria are known to cause the characteristic symptoms of ANUG, such as painful ulcers, bleeding gums, and bad breath. P. gingivalis, Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, and Prevotella intermedia are also commonly found in the oral cavity, but they are not specifically associated with ANUG.

The buccal mandibular premolar has the least amount of attached gingiva compared to the other options. The attached gingiva refers to the part of the gum that is firmly attached to the underlying bone. In the oral cavity, the amount of attached gingiva varies in different areas. The buccal mandibular premolar is located in the lower jaw and towards the back of the mouth. It is known to have the least amount of attached gingiva, making it more susceptible to gum recession and other oral health issues.

The primary symptom of root sensitivity is sensitivity to cold. This means that individuals with root sensitivity experience discomfort or pain when they consume cold foods or beverages. This symptom is often caused by exposed dentin, which is the layer beneath the tooth enamel that contains microscopic tubules leading to the nerve endings. When the dentin is exposed, cold temperatures can stimulate the nerve endings and cause sensitivity. Sensitivity to hot is not the primary symptom of root sensitivity, and neither is a combination of both hot and cold sensitivity.

The given statement "Flaps elevated after marginal incisions never need sutures" is not true for the marginal incision technique. This implies that sutures are sometimes required for flaps elevated after marginal incisions.

The mental nerve can frequently be found between the first and second premolar teeth. This is because the mental nerve is a branch of the inferior alveolar nerve, which runs along the mandible (lower jaw). It exits the mandible through the mental foramen, which is typically located between the first and second premolar teeth. Therefore, it is common to find the mental nerve in this area.

Blades 15 and 11 can be considered standard in dentistry.

The Lingual nerve can easily be injured when cutting too lingually in the molar area. This is because the Lingual nerve runs along the lingual aspect of the mandible and supplies sensation to the tongue. Cutting too lingually in the molar area can lead to accidental damage to the Lingual nerve, resulting in sensory deficits and potential complications.

Acellular dermal grafts are most effective when they are fully submerged beneath a mucoperiosteal flap during the healing process. This allows for optimal integration and healing of the graft with the surrounding tissues. By keeping the graft completely submerged, it is protected from external factors that may hinder its success. Therefore, the statement "Acellular dermal grafts work best when they are completely submerged beneath a mucoperiosteal flap during healing" is true.

All of the above options (Tetracycline, EDTA, and Citric Acid) can be used to treat the root surface during debridement for a soft tissue graft. Tetracycline is an antibiotic that can help in controlling bacterial infection, EDTA is a chelating agent that can remove mineral deposits and promote root surface demineralization, and Citric Acid can help in removing smear layer and promoting root surface conditioning. Using all of these options together can ensure optimal cleaning and preparation of the root surface for the grafting procedure.

Charter's method is the best brushing technique for patients with orthodontic appliances. This method involves using a circular motion to clean both the teeth and the brackets or wires of the appliance. It is effective in removing plaque and food debris from hard-to-reach areas and helps maintain good oral hygiene during orthodontic treatment.

The patient's presentation of loss of interdental marginal stippling, blue-red tissue color, and bleeding upon gentle probing is consistent with chronic gingivitis. Gingivitis is an inflammation of the gums caused by plaque buildup and poor oral hygiene. The symptoms described are characteristic of chronic gingivitis, which is a long-term and persistent form of the condition. Gingival recession, systemic diseases, and advanced periodontal diseases may also cause similar symptoms, but the given symptoms specifically point towards chronic gingivitis as the most likely diagnosis.

Acute pericoronitis is an infection that occurs around the crown of a partially erupted tooth. This infection can cause inflammation and swelling of the regional lymph nodes in the area. The other conditions listed, such as lichen planus, pemphigus vulgaris, pemphigoid, and chronic ulcerative stomatitis, do not typically cause regional lymph node enlargement. Therefore, the correct answer is acute pericoronitis.

The average human biologic width is 2mm. This refers to the distance between the base of the gum pocket and the bone level. It is important to consider this measurement in dental procedures to ensure that there is enough space for proper placement of restorations and to avoid damage to the surrounding tissues.

Plaque is the primary aetiologic factor in the development of furcation defects. Plaque is a sticky film that forms on teeth and contains bacteria. If plaque is not removed through proper oral hygiene practices, it can lead to gum inflammation and periodontal disease. Furcation defects occur when the bone supporting the tooth's roots is damaged, and plaque buildup can contribute to this damage. Therefore, plaque is the main cause of furcation defects.

During a hemisection or root section of a maxillary first molar, the distobuccal root is commonly removed. This is because the distobuccal root is usually the most accessible and easiest to remove, compared to the other roots. The palatal, mesiobuccal, and distobuccal roots are the three roots of a maxillary first molar, but in this procedure, it is the distobuccal root that is typically targeted for removal.

A provisional restoration is a temporary restoration that is placed on a tooth while the final restoration is being fabricated. It is not intended to act as a permanent restoration because it is not as durable or long-lasting as the final restoration. Its main functions are to communicate the desired gingival margin to the surgeon, allow the patient to evaluate esthetics and phonetics, and protect the tooth and surrounding tissues during the fabrication of the final restoration.

The correct answer is that subgingival plaque consists mostly of anaerobic bacteria (frequently gram-negative). This is because subgingival plaque forms below the gumline where there is limited oxygen availability, creating an anaerobic environment. Additionally, the presence of gram-negative bacteria is common in subgingival plaque and is associated with periodontal disease.

The correct answer is "Pressure with a moistened gauze". This is because applying pressure with a moistened gauze helps to control bleeding by promoting clot formation and reducing blood flow. The moisture in the gauze helps to enhance clotting and the pressure applied helps to compress the blood vessels, reducing the bleeding. This method is commonly used as a first step in controlling bleeding at the donor site.

Certain medications can affect salivary flow, including tricyclic antidepressants and antihypertension drugs. The correct answer is "Antihypertension drugs."

In the treatment of refractory periodontal disease, it is important to consider all of the options mentioned. Surgery may be necessary to remove deep pockets or correct gum recession. Antibiotics can be prescribed to control bacterial infection. Systemic health, such as managing underlying conditions like diabetes, can also impact periodontal health. Mechanical debridement, such as scaling and root planing, is a crucial part of removing plaque and tartar buildup. Therefore, considering all of these factors is essential for effectively treating refractory periodontal disease.

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The Original Widman flap technique involves making two releasing incisions to mark the area scheduled for surgical therapy. A scalloped reverse bevel incision is then made in the gingival margin to connect the two releasing incisions. This technique aims to remove the inflamed pocket lining and reshape the gingiva to promote healing and prevent further periodontal disease progression. The other options mentioned (Apical position flap, Modified Widman flap, Papilla preservation flap, and Kirdland flap) are different periodontal surgical techniques with their own specific indications and procedures.

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The periodontal ligament fibers insert in cementum and bone through a biochemical process involving fibronectin. This means that fibronectin plays a crucial role in the attachment of the periodontal ligament fibers to the cementum and bone. It is not the junctional epithelium cells that are oriented parallel to the root surface, nor are they non-secreting cells. The lamina densa does contain hemidesmosomal plaques, but this is not directly related to the interrelation between the tooth and periodontium interface.

Macrophages are a type of immune cell that can destroy virulent bacteria through phagocytosis, which is the process of engulfing and digesting foreign particles. They also play a role in T-cell mediation, which involves activating and coordinating other immune cells to mount an immune response against the bacteria. Plasma cells are responsible for producing antibodies, mast cells are involved in allergic reactions, polymorphonuclear cells are a type of white blood cell, and lymphocytes are a general term for various types of immune cells including T-cells and B-cells. Therefore, the correct answer is macrophage.

Root planning is the process of removing diseased cementum along with other root deposits. This procedure is often performed to treat periodontal disease, as the removal of these deposits helps to eliminate bacteria and promote healing of the gums. By removing the diseased cementum, the root surface can be smoothed, allowing for better attachment of the gums to the tooth and preventing further progression of the disease.

Greater occlusal pressure on the periodontium can cause injury to fibroblasts and other connective tissue cells, leading to necrosis of the area of the ligament. This occurs due to the excessive force exerted on the periodontal ligament, which can result in cellular damage and tissue death. This can further contribute to the development of periodontal disease and the breakdown of the periodontal ligament.

Based on the given information, the 16-year-old boy is presenting with attachment loss related to the first molars and incisors only. This pattern of attachment loss is characteristic of localized aggressive periodontitis.

The correct answer is Non Eugenol pack and Coe-Pack. These are the most commonly used periodontal packs. Non Eugenol pack is preferred when the patient is allergic to eugenol, while Coe-Pack is a versatile pack that can be used for various dental procedures. Both these packs are widely used in periodontal treatment to promote healing and protect the surgical site.

After scaling and root planning, the removal of plaque and tartar helps to reduce inflammation in the gums and allows the gum tissue to heal. This leads to a reduction in pocket depth, which is the space between the gum and the tooth. As the inflammation decreases and the gums heal, the pockets become shallower, making it easier to clean the area and maintain oral hygiene. Therefore, the correct answer is reduction in inflammation and pocket depth.

The major problem in scaling and root planing in interproximal areas of mandibular anterior teeth is the proximity of root surfaces. This means that the roots of these teeth are close together, making it difficult to access and clean the interproximal areas properly. This can lead to inadequate removal of plaque and calculus, which can contribute to the development of periodontal disease.

The removal of the epithelial lining of the pocket is critical for the success of a subgingival curettage procedure. This procedure involves removing the diseased tissue and bacteria from the periodontal pocket, which is the space between the gum and tooth. The epithelial lining of the pocket can harbor bacteria and prevent proper healing. By removing this lining, the pocket can be thoroughly cleaned and the healing process can begin. Removal of free gingiva, removal of cementoenamel junction, and placement of sutures are not specifically mentioned as critical steps in the success of a subgingival curettage procedure.

During the healing of gingival wounds, epithelial cells migrate at a rate of 0.5-1.0 mm/day. This means that the epithelial cells move and cover the wound area at a speed of 0.5-1.0 mm per day. This migration is an important part of the healing process as it helps to close the wound and restore the integrity of the gingival tissue.

Conventional gingivectomy is a surgical procedure used to remove excess gum tissue. It is performed to eliminate false pockets and improve the health of the gums. The healing process after gingivectomy occurs through secondary intention, where the wound is left open to heal naturally. However, conventional gingivectomy does not lead to a decrease in the width of attached gingiva. It actually helps to increase the width of attached gingiva by removing the excess gum tissue. It also does not provide direct accessibility to the alveolar bone, as it primarily focuses on removing the excess gum tissue.

After a gingivectomy, which is the surgical removal of gum tissue, complete repair of the connective tissue takes place within 5-7 weeks. This process involves the regeneration and remodeling of the gum tissue, as well as the reattachment of the connective tissue to the tooth structure. It is important to note that individual healing times may vary, but on average, it takes approximately 5-7 weeks for the connective tissue to fully repair after a gingivectomy procedure.

An apically positioned flap is a surgical technique used in periodontal procedures to increase the clinical crown length and preserve the width of attached gingiva. It involves the repositioning of the gum tissue to eliminate pockets and improve the overall health of the periodontium. However, it is not commonly done on the palatal side.

Insufficient width of attached gingiva to mucogingival line is a defined indication for mucogingival surgeries (periodontal plastic surgeries). This means that when there is not enough attached gingiva present in the area where the gums meet the teeth, it can lead to various problems such as gingival recession, root exposure, and increased risk of periodontal disease. Mucogingival surgeries aim to correct this issue by grafting gum tissue to increase the width of attached gingiva, improving the overall health and aesthetics of the gums.

Elevating a partial thickness flap is the best way to prevent exposure of dehiscence during a surgical procedure. By only lifting a portion of the flap, the underlying tissues and structures are better protected, reducing the risk of complications such as dehiscence, which is the separation of the wound edges. This technique allows for better blood supply to the flap and promotes proper healing.

A swedged suture needle is the correct answer because it is specifically designed for use in periodontal surgery. It has a rounded point, which is important for minimizing tissue trauma during suturing. Additionally, it has a double cutting edge, which allows for easier penetration through the periodontal tissues. Therefore, a swedged suture needle meets both requirements mentioned in the question and is the most appropriate choice for periodontal surgery.

The anchor suture is recommended for apical because it provides secure fixation and stability at the apex of the wound. This type of suture involves placing a deep stitch at the apex and then tying it off to anchor the tissue in place. This helps to prevent any tension or pulling on the wound edges, allowing for better healing and minimizing the risk of dehiscence or wound breakdown. The anchor suture technique is commonly used in surgeries where there is a need for strong and secure closure at the apex of the wound.

Surgical lengthening is indicated in cases of subgingival caries or fracture, inadequate clinical crown length for retention, and unequal or unesthetic gingival height. This means that if any of these conditions are present, surgical lengthening may be necessary to address the issue.

Fibronectin is used in periodontal therapy as a biomodification of the root surface. Biomodification involves the application of substances to the root surface to promote the attachment and growth of periodontal tissues. Fibronectin is a glycoprotein that plays a crucial role in cell adhesion and tissue repair. By applying fibronectin to the root surface, it can enhance the attachment of periodontal tissues, promote regeneration, and improve the overall health of the periodontium.

Following flap surgery or curettage, the most frequent formation at the tooth-tissue interface is long junctional epithelium. This occurs when the epithelial cells migrate along the root surface and establish attachment to the tooth. Scar formation may occur as a result of the healing process, but it is not the most frequent formation. Adhesion of collagen fibers and collagen fibers parallel to the root surface are not specific to the tooth-tissue interface following flap surgery or curettage.

Histologic analysis is the only valid method to assess periodontal regeneration. This involves examining tissue samples under a microscope to evaluate the extent and quality of regeneration. Radiographic analysis can provide information about bone levels, but it does not provide a direct assessment of regeneration. Clinical attachment level measures the depth of the gum tissue attachment to the tooth, but it does not provide information about the regeneration of supporting structures. Reentry operation involves surgically opening the area to assess regeneration, but it is an invasive procedure and may not provide a comprehensive evaluation. Histologic analysis, on the other hand, allows for a detailed examination of the regenerated tissue at a cellular level, providing the most accurate assessment of periodontal regeneration.

The mandibular first permanent molar is commonly involved with furcation involvement. Furcation involvement refers to the condition where the roots of a tooth have become exposed due to gum disease or other factors. The mandibular first permanent molar is particularly susceptible to furcation involvement because it has two roots that are close together, making it easier for bacteria and plaque to accumulate in the area. Additionally, the anatomy of the tooth and its position in the mouth make it more difficult to clean properly, further increasing the risk of furcation involvement.

The most common indication for Coronally Positioned Flap is root coverage. This surgical procedure involves repositioning the gum tissue to cover exposed tooth roots, which can occur due to gum recession. By covering the roots, it helps to protect them from sensitivity, root decay, and improves the aesthetic appearance of the smile.

The main indication for using a Sling Suture is when only the buccal flap is elevated. This suggests that the Sling Suture is specifically designed to be used in cases where the buccal flap needs to be elevated, but not the lingual or palatal flaps.

The first cellular line of defense against periopathogens is PMN (polymorphonuclear leukocytes). PMNs are a type of white blood cell that plays a crucial role in the immune response by engulfing and destroying pathogens. They are typically the first immune cells to arrive at the site of infection or inflammation and are highly effective in combating bacterial infections. T-cells, B-cells, and plasma cells are also involved in the immune response, but they are not the first line of defense against periopathogens.

The correct answer is 1:2 (for each tooth). The crown-to-root ratio refers to the proportion of the tooth that is visible above the gumline (the crown) compared to the portion that is embedded in the jawbone (the root). In a healthy dentition, the crown is typically twice the length of the root, resulting in a 1:2 ratio. This ratio is important for maintaining stability and support for the tooth, as well as for proper function and aesthetics.

Crown lengthening is a dental procedure that involves the removal of gum tissue and, in some cases, bone tissue to expose more of the tooth's surface. This procedure can be performed in different situations depending on the patient's needs. In cases of natural passive eruption, where the gum tissue covers too much of the tooth, crown lengthening can be done by gingival resection and harmonization with or without osseous resection. Similarly, in cases of delayed passive eruption, where the gum tissue fails to recede properly, the same technique can be used. Therefore, the correct answer is "All of the above" because crown lengthening can be performed in both natural and delayed passive eruption scenarios using the mentioned techniques.

The aspect that does not have to be considered in postsurgical wound infection protocol is "Wait and see". This means that waiting and observing the wound without taking any immediate action is not a recommended approach in preventing or treating postsurgical wound infections. Instead, aspects such as local cleaning and debridement, antibiotics, oral disinfectants, and short-term recall are important considerations in the protocol to prevent and manage wound infections.

The correct answer is "All of the above." Autogenous soft tissue grafting refers to the use of a patient's own tissue for grafting procedures. Free gingival graft, connective tissue onlay graft, and vascularized interposition connective graft are all techniques that involve using the patient's own soft tissue for grafting. Therefore, all of these techniques fall under the category of autogenous soft tissue grafting.

The height of the interproximal bone affects the % of root coverage following root coverage surgery the most. This is because the height of the interproximal bone determines the amount of support and stability that the surrounding tissues can provide to the root. If the interproximal bone is at a sufficient height, it allows for better attachment of the gingival tissues to the root surface, resulting in a higher percentage of root coverage. On the other hand, if the interproximal bone is too low, it can limit the success of the surgery and lead to less root coverage.

In cases where periodontal surgery is necessary for horizontal bone loss, the most appropriate procedure would be the papilla preservation flap. This procedure is specifically designed to preserve the interdental papilla, which is the triangular gum tissue between the teeth. By preserving the papilla, the surgery aims to maintain the aesthetic appearance of the gumline and prevent further bone loss. The other procedures mentioned, such as the Widman flap, coronally displaced flap, and gingivectomy, are not specifically focused on preserving the papilla and may not be as effective in addressing horizontal bone loss.

The correct answer is "Ultra thin recipient tissue." This is because all the other options mentioned (labile prominent roots, shallow vestibule, inadequate thickness of attached gingiva at donor site) are contraindications for lateral sliding graft. However, ultra thin recipient tissue is not a contraindication for this procedure.

A free gingival graft is typically placed on the periosteum. The periosteum is a layer of connective tissue that covers the bone, providing support and nourishment to the surrounding tissues. Placing the graft on the periosteum allows for proper integration and healing of the graft with the underlying bone.

The success of a free gingival graft depends on the proper immobilization of the graft at the recipient site. This is because the graft needs to be securely attached to the recipient bed in order to ensure proper healing and integration. Without proper immobilization, the graft may become dislodged or move around, which can lead to complications and failure of the graft. The thickness of the donor tissue and the presence of a blood clot on the recipient bed site may also be important factors, but they are not the primary determinant of the success of the graft.

After reflection of a full thickness graft, the post-surgical alveolar bone loss is greatest at the thin facial margin. This is because the thin facial margin is more susceptible to bone resorption and loss compared to other areas. The thick lingual margin and interproximal bone are less likely to experience significant bone loss, and there is no bone loss at all is an unrealistic scenario. Therefore, the thin facial margin is the most vulnerable to post-surgical alveolar bone loss.

The vestibular extension procedure is a surgical technique used to increase the width of the non-keratinized attached gingiva. This procedure involves making an incision in the gingiva and then extending it to create a wider band of attached gingiva. By increasing the width of the non-keratinized attached gingiva, this procedure helps to improve oral health and prevent gum recession.

The papilla preservation flap is a surgical technique used for teeth with wide interdental spaces. This flap procedure aims to maintain the height and contour of the interdental papilla, which is the triangular gum tissue between the teeth. By preserving the papilla, the dentist can achieve better aesthetic outcomes and prevent the formation of black triangles between the teeth. This technique involves creating a partial thickness flap, which means that only the outer layer of gum tissue is lifted, leaving the underlying tissue intact.

After root coverage surgery on a tooth, it is suggested to wait for 12 weeks before making the final impression for the final restoration. This healing period allows for proper tissue healing and stabilization, ensuring the best outcome for the final restoration. Waiting for this duration allows the tissues to fully heal and reduces the risk of complications or failure of the restoration.

The primary reason for the failure of a free gingival graft is infection. Infection can lead to the breakdown of the graft and prevent proper healing. It can also cause inflammation and tissue damage, compromising the success of the graft. Disruption of the vascular supply before engraftment, suturing techniques, or the thickness of the graft being too thick can also contribute to failure, but infection is the most significant factor.

Gingivoplasty is a surgical procedure that involves reshaping and contouring the gum tissue. It is typically used to treat conditions such as gum recession or uneven gum line. ANUG, or Acute Necrotizing Ulcerative Gingivitis, is a severe form of gum disease characterized by painful, bleeding gums and ulceration. Since ANUG involves significant damage to the gum tissue, gingivoplasty may be more likely to be useful in this condition to repair and restore the gum tissue to its normal shape and function. Therefore, ANUG is the most appropriate condition for which gingivoplasty would be useful.

An apical displaced flap is a type of flap that accomplishes the double objectives of pocket elimination and increasing the width of attached gingiva. This flap is designed to be moved in an apical direction, meaning it is displaced towards the root of the tooth. By doing so, it allows for better access to the underlying tissues, facilitates pocket elimination, and helps in creating a wider band of attached gingiva. This technique is commonly used in periodontal surgeries to improve the health and stability of the periodontal tissues.

The correct answer is 2-5 weeks. During the process of healing of a graft, vasculisation refers to the formation of new blood vessels within the graft. This is important for the graft to receive a sufficient blood supply and for it to integrate with the surrounding tissues. The process of vasculisation typically occurs within 2-5 weeks after the graft is placed.

A mucogingival surgery is a procedure that aims to correct gum recession and improve the appearance of the gum line. Among the options given, only a free gingival graft involves the transfer of gum tissue from one area to another to cover exposed tooth roots or increase the width of the gum tissue. The other options, such as Widman flap, gingivectomy, and gingivoplasty, do not involve the grafting of gum tissue. Therefore, the correct answer is Free gingival graft.

Three-wall periodontal defects are most likely to repair or fill naturally after treatment. This is because three-wall defects have better blood supply and a more favorable architecture for regeneration compared to two-wall or one-wall defects. The presence of three walls in the defect allows for better stability and support for the regeneration process, leading to a higher chance of natural repair or filling after treatment.

NSAIDs are medications that are commonly used to reduce pain, inflammation, and fever. They work by blocking the cyclooxygenase (COX) enzymes, specifically COX-1 and COX-2, which are responsible for the metabolism of arachidonic acids. By inhibiting the COX enzymes, NSAIDs reduce the production of prostaglandins, which are inflammatory mediators. Blocking the cyclooxygenase metabolism of arachidonic acids is the correct answer because it accurately describes the mechanism of action of NSAIDs.

To maintain proper biologic width after crown lengthening, the crown preparation between the margin of the preparation and the crest of bone should be 3mm. This is because the biologic width, which includes the junctional epithelium and connective tissue attachment, needs to be maintained to ensure the health of the periodontium. Having a 3mm distance allows for adequate space for the biologic width, preventing any damage or disruption to the periodontal tissues.

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The correct answer is "Periodontitis as a manifestation of systemic disease." This is because the patient is a 40-year-old diabetic, and diabetes is a systemic disease that can contribute to periodontal attachment loss and periodontitis. The AAP 1999 classification recognizes periodontitis as a manifestation of systemic disease when there is a clear relationship between the periodontal condition and a systemic disease like diabetes.

Horizontal bone loss is a common characteristic of chronic periodontitis. This condition is characterized by the progressive loss of the bone that supports the teeth, resulting in a horizontal or even pattern of bone loss around the affected teeth. Unlike localized or generalized aggressive periodontitis, which typically involve vertical bone loss, chronic periodontitis is a slow and chronic inflammatory disease that affects the supporting structures of the teeth. Intrabony pockets and acute necrotizing ulcerative gingivitis may also be associated with bone loss, but they are not specific to horizontal bone loss as seen in chronic periodontitis.

The concept of one stage Full mouth disinfection aims to prevent the translocation of microorganisms. This means that it focuses on stopping the movement or spread of microorganisms from one area of the mouth to another. By disinfecting the entire mouth in one stage, the risk of microorganisms being transferred to different parts of the mouth is reduced, thereby preventing potential infections or complications.

The main aim of restoration of carious lesion in phase-I therapy is to reduce the microbial source. This is because carious lesions are caused by bacteria that break down the tooth structure, and restoring the tooth helps to eliminate or minimize the source of these bacteria. Restoring the function and form of the tooth are also important, but the primary goal is to reduce the microbial source to prevent further decay and damage.

Gingival curettage is indicated in the early stages of gum disease. It involves the removal of the diseased tissue from the gum pockets to promote healing and prevent further damage. Scaling and root planning is a deep cleaning procedure that is typically performed in the early to moderate stages of gum disease. Gingivectomy and flap surgery are more invasive procedures that are usually reserved for advanced cases of gum disease. Therefore, the correct answer in this case is gingival curettage.

After curettage, re-epithelialization of the sulcus occurs within 2-7 days. Curettage is a dental procedure in which the infected or inflamed tissue is removed from the gingival sulcus. After the procedure, the body initiates the healing process, and the sulcus starts to re-epithelialize. This means that new epithelial cells start to grow and cover the exposed area. The process usually takes around 2-7 days for the sulcus to be completely re-epithelialized.

Periodontal surgery is a procedure performed to treat periodontal disease, which affects the gums and supporting structures of the teeth. One of the main goals of this surgery is to eliminate pockets that have formed between the gums and teeth. These pockets can harbor harmful bacteria and contribute to the progression of the disease. By removing the pockets, the surgeon can help improve the health of the gums and prevent further damage to the teeth and surrounding structures. Regeneration of bone and cementum may also be achieved through certain periodontal surgical techniques, but the primary purpose is to eliminate the pocket.

The correct answer is internal bevel or first incision. During pocket elimination by reflecting flap, the incision that removes the pocket lining is the internal bevel or first incision. This incision is made to access the underlying pocket and remove the lining, allowing for thorough cleaning and treatment of the affected area. The second incisors and crevicular incision are not involved in removing the pocket lining.

The correct answer is "Reduce pocket depth by formation of long junctional epithelium." This procedure involves the reattachment of the periodontal connective tissue fibers to reduce the depth of the periodontal pocket. It is commonly used and usually heals by secondary intention. However, it is not indicated in cases where aesthetics is a prime consideration. The formation of long junctional epithelium helps in reducing the pocket depth and promoting healing.

A partial thickness flap should be composed of both epithelium and connective tissue. Epithelium is the outermost layer of tissue that covers the body's surfaces and lines its cavities. Connective tissue provides support and structure to the body and is found throughout the body, including in the skin. Together, these two types of tissue would make up a partial thickness flap.

The correct answer is polymorphonuclear neutrophils (PMNs), mast cells, and macrophages. These cells are typically found in the healthy periodontium, which refers to the tissues surrounding and supporting the teeth. Polymorphonuclear neutrophils are important for fighting off bacterial infections, while mast cells play a role in inflammation and immune response. Macrophages are responsible for engulfing and digesting cellular debris and pathogens. Together, these cells help maintain the health and integrity of the periodontium.

The bacteria associated with localized juvenile periodontitis are Actinobacillus actinomycetemcomitans.

Silk 3.0 is commonly used as a suture material in dentistry. It is a strong and durable material that is also biocompatible, meaning it is well-tolerated by the body. The size 3.0 is suitable for dental procedures as it provides sufficient strength for wound closure. Vicryl 1.0 and Vicryl 10.0 are also suture materials commonly used in dentistry, but they are not the correct answer in this case. Seralon 8.0 is not commonly used in dentistry as a suture material.

The common indications for Apically Positioned Flap are crown lengthening and pocket reduction. Root coverage is not a common indication for this procedure. Therefore, the correct answer is "a and b only".

The correct answer is 2mm. When using autogenous grafts utilizing the palatal connective tissue, the initial incision for graft harvesting should be made at a measurement of 2mm above the gingival margin of the maxillary teeth. This specific measurement is important to ensure proper graft harvesting and to minimize any potential damage to the surrounding tissues.

Apically Positioned Flap is a surgical procedure used in periodontics to treat various gum conditions. Crown lengthening involves removing gum tissue to expose more of the tooth's surface, usually done to prepare for a dental restoration. Pocket reduction aims to reduce the depth of periodontal pockets, which are spaces between the gums and teeth that can harbor bacteria and cause gum disease. Therefore, both crown lengthening and pocket reduction are common indications for Apically Positioned Flap. Root coverage, on the other hand, usually involves a different surgical technique and is not typically associated with Apically Positioned Flap.

ANUG stands for Acute Necrotizing Ulcerative Gingivitis, which is a severe form of gum disease. The bacteria associated with ANUG include P. gingivalis, Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, and Prevotella intermedia. However, the primary bacteria involved in ANUG are the fusospirochetal complex, which consists of fusiform bacteria and spirochetes. These bacteria contribute to the progression of ANUG and the formation of necrotic ulcers in the gums.

Planning of periodontal surgery is best accomplished after phase I therapy and during the re-evaluation visit because phase I therapy involves initial non-surgical treatment such as scaling and root planing, which helps to control the infection and inflammation in the gums. After this initial therapy, it is important to re-evaluate the patient's response to treatment and assess the effectiveness of phase I therapy. This evaluation will help determine if further surgical intervention is necessary and if so, what specific procedures are needed. Therefore, the correct answer is after phase I therapy and during the re-evaluation visit.