Perio_Quest_MCQS_and_Self_assessment

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Perio-Quest: MCQS and
Self-assessment Pictorial Tests in
Periodontics.
v
Dr.Syed Wali Peeran. B.D.S., M.D.S.,
Associate Professor,
Department of Periodontology and Oral Implantology,
Faculty of Dentistry, Sebha University, Sebha, Libya
II
Published by :
Manjunath S. Hegde
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Perio-Quest: MCQS and Self-assessment Pictorial Tests in
Periodontics.
Dr.Syed Wali Peeran. B.D.S., M.D.S.,
III
PrefacePrefacePrefacePrefacePreface
Periodontology is, like any other branch of dentistry, a dynamic,
ever evolving one. Research over the past decade has improved our
understanding of the periodontal disease process, and has certainly
added new dimensions to it. It has also disseminated and accumulated
large tomes of valuable material. However, the duration of the bachelor
degree course in dentistry remained the same over the period. The
capacity of a dental student is put to test to assimilate this growing
body of literature, to be an able dentist. He/she has to face the viva-
voce, deal with clinical examination, and answer the multiple-choice
questions in the various postgraduate entrance examinations.
Keeping this in mind and the developing countries scenario, where
the teaching and evaluating tools are primitive, I have made this sincere
attempt to write this book. This book consists of a section dedicated
to the multiple-choice questions and a Self-assessment pictorial test
section. The multiple-choice questions are written focusing a memory-
only pattern as this remains the dominant pattern of questioning both
in multiple-choice questions and in viva voce in developing countries.
Attempt has been done to stretch ourselves until the boundaries to
bring in the “All of the above”, “None of the above” and some negative
questioning to accommodate the memory only questions asked in
viva. The section on self-assessment pictorial tests has been added
to help the students in dealing with their clinical examination.
I, acknowledge the assistance of the learned contributors who
helped me in successfully completing this work. I thank Dr.Karthikeyan
Ramalingam for the great help he rendered in scientific editing of the
manuscript. My special thanks are for Dr.Mustafa Mubarak Pathan
and Dr. Nagamurali Eragam Reddy for English language editing. I
would like to inform the readers that while writing this book I did not
intend it to replace the standard textbooks on the subject it covers. In
addition, as no human effort is perfect, so is this one. There always
will remain options for improvement. I assure the readers-the students
that their valuable suggestions and healthy criticism will always be
welcomed. All the feedbacks, suggestions, comments can be sent
via mail to- doctorsyedwali@yahoo.in
Dr.Syed Wali Peeran,
Associate Professor,
Department of Periodontology and Oral Implantology,
Faculty of Dentistry,
Sebha University, Sebha, Libya.
IV
CONTRIBUTORS LIST:
1. Dr. Ahmed Taher ElHassan. B.D.S., M.Sc (Oral sciences-
Periodontics), Diplomate of American Board of Periodontics, NDBE,
WREB. Assistant Professor, Benghazi University, Benghazi, Libya
2. Dr. Fatma Mojtaba Al Said B.D.S., Faculty of Dentistry, Sebha
University, Sebha, Libya
3. Dr. Karthikeyan Ramalingam. MDS., (Oral Pathology and
Microbiology), Assistant Professor, Sebha University, Sebha, Libya
4. Dr. Khaled Awidat Abdulla, B.D.S., C.E.S., DuoDF (France),
Assistant Professor, Sebha University, Sebha, Libya.
5. Dr. Manohar Murugan M.Sc (Microbiology), Ph.D, Assistant
Professor, Sebha University, Sebha, Libya
6. Dr. Marei Hamad Al Mugrabi. B.D.S., M Dent.Sc (Periodontics-
Dublin), Ph.D, Professor and Head, Department of Periodontics,
Benghazi University, Libya.
7. Dr. R. Ganesh, B.D.S., M.D.S (Pedodontics), Reader, SRM
University, Tamil Nadu, India.
8. Dr. Syed Ali Peeran. B.Sc (Chem), B.D.S., M.D.S (Prostho).,
MBA(HA), M.Phill (H.A), Assistant Professor, Gezan University,
Gezan, KSA
9. Dr. Verdine Antony, B.D.S., M.D.S (Periodontics), PGDCR,
PGDHM, PGDFO. Assistant Professor, Sirte University, Sirte, Libya
V
CONTENTS
Sl No:
1.
2.
3.
4.
5.
Topic
Normal Periodontium
Etiology and Pathogenesis
of Periodontal diseases
Periodontal therapy
Oral Implantology
Self-Assessment Pictorial
tests
Page No
1
43
158
224
230
VI
1
NORMAL PERIODONTIUM
1. The periodontium consists of two mineralized and two
unmineralised tissues. They are as follows.
a. Cementum, alveolar bone, periodontal ligament and the
gingiva.
b. Dentine, alveolar bone, periodontal ligament and the gingiva.
c. Gingiva, enamel, dentine and alveolar mucosa.
d. Gingiva, cementum, junctional epithelium and periodontal
ligament.
2. Which of the following cells synthesize collagen?
a. Fibroblasts. b. Osteoblasts.
c. Chondroblasts. d. Odontoblasts.
e. All of the above. f. None of the above.
3. The periodontal ligament is the soft specialized connective
tissue situated between the cementum covering the root
of the tooth and the bone forming the socket wall.
a. True. b. False.
4. The two mineralized tissues of the periodontium are
a. Cementum and periodontal ligament.
b. Cementum and alveolar bone. c.Enamel and gingiva.
d. Enamel and dentine.
5. The periodontal ligament was earlier called as
a. Desmodont, gomphosis and pericementum.
b. Dental periosteum, periodontal membrane and alveolo
 dentalligament.
c. All of the above.
d. None of the above.
Chapter - 1 : Normal Periodontium
2 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
6. The cell that synthesize the fibers and ground substances
of the periodontal ligament are:
a. Neutrophils. b. Eosinophils.
c. Fibroblasts. d. Foam cells.
7. The principal cells of the periodontal ligament are the
a. Neutrophils. b. Fibroblasts.
c. Osteoblasts. d. Ameloblasts.
8. Elaunin fibres are found in the
a. Cementum b. Periodontal ligament
c. Alveolar bone d. Gingiva
9. Cementum tears occurs in
a. Trauma b. Clenching
c. Root planning d. Deep bite
10. Cementum repair occurs in
a. Vital tooth b. Devitalised tooth
c. Both a and b d. None of the above
11. Which of the following can be described as coating of non-
developmental origin
a. Reduced enamel epithelium b. Dental plaque
c. Dental cuticle d. Coronal cementum
12. Which of the following are the most abundant cell of the
periodontium and have a central role in homeostasis,
pathogenesis and healing?
a. Dendritic cell. b. Epithelial cell.
c. Macrophage. d. Fibroblast.
13. The following statements about periodontal ligament
fibroblasts are true.
a. They are capable of synthesis and resorption.
b. They have migratory as well as contractile properties.
c. Both are true. d. Only a is true.
3
14. Which of the following is the depth ofclinically healthy
gingival sulcus?
a. 3-4 mm. b. 1-2 mm.
c. 2-3 mm. d. 2-4 mm.
15. Which of the following is the principal cell type of the
gingival epithelium?
a. Keratinocyte. b. Melanocyte.
c. Osteocyte. d. Fibrocyte.
16. The upper most cells of the stratum spinosum contain
numerous dense granules. What are they termed?
a. Keratinosomes. b. Odland bodies.
c. All of the above. d. None of the above.
17. Which of the following is an enzyme closely related to the
degree of keratinization?
a. Acid phosphatase. b. Alpha-glactosidase
c. Aminopeptidase. d. Alpha–chymotrypsin.
18. Tight junctions are also called as
a. Adhering junctions (zonula adherens).
b. Desmosomes (macula adherens)
c. Gap junctions.
d. Occluding junctions (zonula occludens).
19. Which of the following is not a cell type of gingival
epithelium?
a. Keratinocyte. b. Langerhan’s cells.
c. Lymphocyte. d. Melanocytes.
e. Merkel cells.
20. Melanocytes are dendritic cells of neuro-ectodermal
origin. They synthesize melanin in organelles called:
a. Premelanosomes. b. Melanosomes.
c. All of the above. d. None of the above.
Chapter - 1 : Normal Periodontium
4 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
21. Melanin granules are phagocytosed and are contained
within other cells of the epithelium and connective tissues.
What are they termed?
a. Melanophages. b. Melanophores.
c. All of the above. d. None of the above.
22. Which of the following is untrue? Gingival sulcus or crevice
is
a. Shallow crevice or space around the tooth
b. Lined by non-keratinized epithelium.
c. Approximately 2-3 mm in health.
d. Present in unerupted teeth.
23. Epithelial rests of malassez were first described by
______________ in 1884.
a. Pauster. b. King and tantum.
c. Miller. d. Malassez.
24. Epithelial rest cells of malassez are arranged parallel to
the root surface and are present as a strand or network of
cells. They are remnants of
a. Hertwigs epithelial root sheath. b. Tuberculum impar.
c. Both are true. d. Both are false.
25. ___________ helps in the formation and repair of collagen.
a. Vitamin A. b. Vitamin D.
c. Vitamin C. d. Vitamin E.
26. The principal fibers of the periodontal ligament are
a. Alveolar crest group and horizontal group.
b. Oblique, apical and inter-radicular group.
c. Both a and b. d. Only a is true.
27. Which of the following are predominately cancellous?
a. Interdental septum. b. Inter radicular spaces.
c. Maxilla. d. All of the above.
5
28. Oxytalan fibers were initially described by___________
and resemble preelastic fibers both histochemically and
ultrastructurally.
a. Malassez. b. Pauster.
c. King and Tantum. d. Fullmer.
29. Which of the following are the theories that explain the
resistance of the periodontal ligament to the impact of
occlusal forces?
a. Specific and non specific plaque theory.
b. Tensional viscoelastic and thixotropic theory.
c. Both a and b are true. d. Both are false.
30. Which of the following theories that explain the resistance
of the periodontal ligament to the impact of occlusal forces
is considered the most apt?
a. Tensional theory. b. Thixotropic theory.
c. Viscoelastic theory.
31. Cementum is a hard avascular connective tissue that covers
the roots of the teeth.
a. True. b. False.
32. Which of the following statements about cementum are
true?
a. Cementum is pale yellow with dull surface.
b. Cementum is more permeable than other dental tissues.
c. Cementum is the hardest tissue in the human body.
d. Only statements a and b are true.
e. All the statements are true.
f. None of the statement is true.
33. Which of the following is composed entirely of densely
packed bundles of sharpey’s fibers and lacks cells?
a. Acellular afibrillar cementum.
b. Acellular extrinsic fiber cementum.
c. Cellular mixed stratified cementum.
Chapter - 1 : Normal Periodontium
6 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
d. Cellular intrinsic fiber cementum.
e. Intermediate cementum.
34. Which of the following cells produce acellular afibrillar
cementum and cellular intrinsic fiber cementum?
a. Cementoblasts. b. Epithelial rest cells of Malessez.
c. Fibroblasts. d. Cementocytes.
35. Which of the following cells produce acellular extrinsic
fiber cementum and cellular mixed stratified cementum?
a. Cementoblasts & fibroblasts.
b. Epithelial rest cells of Malessez.
c. Fibroblasts. d. Cementoblasts.
36. Which of the following contains cellular remnants of
hertwig’s root sheath?
a. Acellular afibrillar cementum.
b. Acellular extrinsic fiber cementum.
c. Cellular mixed stratified cementum.
d. Cellular intrinsic fiber cementum.
e. Intermediate cementum.
37. Which of the following describes the correct distribution
of the various types of cementum?
a. Acellular afibrillar cementum- coronal cementum:
Acellular extrinsic fiber cementum-cervical third:
Cellular mixed stratified cementum-apical third,
Cellular intrinsic fiber cementum-resorption lacunae -
furcation areas
Intermediate cementum-cementodentinal junction.
b. Acellular afibrillar cementum- cementodentinal junction:
Acellular extrinsic fiber cementum-cervical third:
Cellular mixed stratified cementum-apical third,
Furcation areas: Cellular intrinsic fiber cementum-
resorption lacunae; Intermediate cementum- coronal
cementum.
7
c. Acellular afibrillar cementum- coronal cementum:
Acellular extrinsic fiber cementum-cervical third:
Cellular mixed stratified cementum- resorption lacunae:
Cellular intrinsic fiber cementum- apical third, furcation
areas;
Intermediate cementum-cementodentinal junction.
d. Acellular afibrillar cementum- cervical third:
Acellular extrinsic fiber cementum- coronal cementum:
Cellular mixed stratified cementum- cementodentinal
junction:
Cellular intrinsic fiber cementum-resorption lacunae;
Intermediate cementum- apical third, furcation areas.
38. Which is the tissue rich in fluoride?
a. Bone. b. Cartilage.
c. Cementum. d. Hair.
39. ________________ are the principal fibers of the
periodontal ligament that are embedded in the cementum.
a. Gingival fibers. b. Muscle fibers.
c. Oxytalan fibers. d. Sharpey”s fibers.
40. The periodontal ligament is that soft specialized
____________________ situated between the root of the
tooth and the bone forming the socket wall.
a. Connective tissue. b. Epithelial issue.
c. Lymphoid tissue. d. Neural tissue.
41. What is the average distance between the cemento-enamel
junction and the crest of the alveolar bone in a healthy
young adult?
a. 1.08 mm b. 1.8 mm
c. 2 mm d. 2.08 mm.
Chapter - 1 : Normal Periodontium
8 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
42. The principal fibers of periodontal ligament are bundles
of collagen fibers. They are grouped according to the
direction they extend between the alveolar bone and
cementum. Which among the following does not belong to
the principal fibers of the periodontal ligament?
a. Apical fibers and interradicular fibers.
b. Dentogingival fibers.
c. Horizontal fibers and alveolar crest fibers.
d. Oblique fibers and transseptal fibers.
43. The principal fibers of the PDL are arranged in groups
that develop sequentially in the developing root. The apical
group of the principal fibers of the PDL are present at the
apical region of the socket. These fibers are absent in-
a. Dilacerated roots. b. Incompletely formed roots.
c. Multi rooted tooth roots. d. Single rooted tooth roots.
44. The principal fibers of the PDL are arranged in groups
that develop sequentially in the developing root. Inter-
radicular group of the principal fibers of PDL are present
in,
a. Single rooted tooth roots. b. Roots of multi-rooted teeth.
c. Both a & b d. None of the above
45. A number of small collagen fibers are associated with the
larger principal collagen fibers of the PDL. These fibers
run in all directions and form a plexus. What is this plexus
termed?
a. Elastin fiber plexus. b. Eluanin fiber plexus.
c. Indifferent fiber plexus.d. Oxytalan fiber plexus.
46. Which of the following statements about sharpey fibers
are true?
a. Sharpey’s fibers are extrinsic fibers.
b. They are formed by the fibroblasts.
c. They help in anchoring the tooth.
9
d. All the above statements are true.
e. All the above statements are false.
47. Oblique fibers are the most numerous among the
periodontal ligament fibers. What kind of forces do they
resist?
a. Lateral forces. b. Masticatory forces.
c. Traumatic forces. d. Vibratory forces.
48. Which of the following statements about the intrinsic fibers
of cementum are true?
a. They are formed by the cementoblasts and they belong to
the cemental matrix.
b. They are laid parallel to the cementum and do not aid in
anchoring the tooth.
c. Both a and b are true. d. Both a and b are false.
49. Cementum attachment protein is a collagenous cementum
derived protein, a type of cementum unique molecule. It
is an
a. Adhesion molecule. b. Division molecule.
c. Cohesion molecule.
50. Which of the following is a type of molecule unique to
cementum?
a. Cementum attachment protein (CAP).
b. Emdogain. c. Osteonectin.
d. Osteopontin.
51. Intermediate cementum is the first layer of cementum
formed by the inner cells of Hertwigs epithelial root sheath.
It is also called as_____________.
a. Acellular cementum. b. Hyaline layer of Hopewell-smith.
c. Saltier layer. d. Afibrillar cementum.
Chapter - 1 : Normal Periodontium
10 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
52. When cementum is deposited in an irregular rhythm, it
results in unevenly spaced incremental lines.Name these
incremental lines.
a. Incremental lines of Saltier.
b. Incremental lines of Hopewell Smith.
c. Incremental lines of Tomes.
d. Incremental lines of Retzius.
53. Which of the following tissues is avascular?
a. Alveolar bone. b. Cementum.
c. Gingiva. d. Periodontal ligament.
54. Cementum is avascular tissue. Where does it receive its
nutrients?
a. Alveolar bone. b. Bundle bone.
c. Gingiva. d. Periodontal ligament.
55. The line separating the repair tissue from normal
underlying tissue is ________________________.
a. Reversal line. b. Resorption line.
c. Incremental line. d. Saltier line.
56. An average of ____________ fiber bundles of the
periodontal ligament insert into each square millimeter of
root cementum.
a. 54,000. b. 32,000.
c. 28,000. d. 43,000.
57. Hypercementosis refers to a prominent thickening of the
cementum. Hypercementosis of entire dentition may occur
in patients with _________________.
a. Pagets disease. b. Fibro osseous Dysplasia.
c. Both the above. d. None of the above.
58. Cementoenamel junction is also called
as______________________.
a. Amelo-cemental junction. b. Crown-root junction.
c. Gingival line. d. Neck of the tooth.
11
59. Why cementum does not sense pain?
a. Because it lacks neural component.
b. Because it is avascular. c. Because it lacks cells.
d. Because it lacks fibers.
60. __________________ are technically present within the
periodontal ligament but functionally they belong to
cementum.
a. Cementoblasts. b. Fibroblasts.
c. Cementocytes. d. Osteoblasts.
61. Which area of the root has the narrowest width of
periodontal ligament?
a. Apical area. b. Middle area.
c. Cervical area. d. Furcation area.
62. Alveolar bone is that part of the mandible and maxilla which
surrounds and supports the roots of the tooth. Is this
statement true or false?
a. True. b. False.
63. The bone of the jaw located apically but unrelated to the
teeth is
a. Basal bone. b. Bundle bone
c. Alveolar bone. d. None of the above.
64. Alveolar bone proper is also called
a. Cribriform plate. b. Lamina dura.
c. All of the above. d. None of the above.
65. _______________ is that bone in which the principal fibers
of the periodontal ligament are anchored.
a. Bundle bone. b. Basal bone
c. Alveolar bone. d. Endochondral bone.
66. What type of fiber orientation is present in bundle bone?
a. Single fiber orientation. b. Double fiber orientation.
c. Multiple fiber orientation. d. Unilateral fiber orientation.
Chapter - 1 : Normal Periodontium
12 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
67. What is the width of functional bundle bone in human
beings?
a. 50 to 100 μm. b. 100 to 200μm.
c. 150 to 250μm. d. 200 to 300 μm.
68. Osteoclasts are multinucleated giant cells that are
involved in the resorption of the bone. Which of the
following is not true about their origin?
a. They have a heamopoietic origin.
b. They originate from macrophages.
c. Their origin is unknown.
69. Statement: (a) At the point of insertion into the bone,
sharpey’s fibers get mineralized. (b) With the periphery
being hypomineralized and the core hyper mineralized.
a. Statement a and b are true.
b. Statement a is true and b is false.
c. Statement a is false and b is true.
d. Statement a and b are false
70. Which type of osteoclasts exhibit a sealing zone and a
ruffled surface?
a. Resting osteoclasts. b. Inactive osteoclasts.
c. Active osteoclasts. d. All of the above.
71. Name a few enzymes secreted by the osteoclasts?
a. Acid phosphatase, aryl-sulfatase and â-glucuronidase.
b. Cysteine proteinases and tissue plasminogen inhibitor.
c. MMP-1 and lysozyme. d. All of the above.
72. Which cell synthesizes osteoid?
a. Osteocyte. b. Osteoblast.
c. Osteoclast. d. Osteoprogenitor cells.
73. In rare occasions bone is resorbed by osteocytes. What
is this phenomenon called?
a. Osteocytic osteolysis. b. Osteoblastic resorption.
c. Osteoclasting. d. Osteoblastosis.
13
74. What is the interdependency of osteoblasts and
osteoclasts in remodeling the bone called?
a. Doubling. b. Transcytosis.
c. Coupling. d. Adapting.
75. Human gingival epithelium contains langerhans cells.
What are they?
a. Nerve cells. b. Part of the immune defense system.
c. Cells of unknown function. d. Related to melanocytes.
76. Gingiva is that part of the oral mucosa that covers the
alveolar process of the jaws and surrounds the necks of
the teeth. Is this statement true or false?
a. True. b. False.
77. Which of the following is not the colour of normal healthy
gingiva?
a. Coral pink with melanin pigmentation.
b. Coral pink. c. Fiery red.
d. Salmon pink.
78. Gingiva is that part of masticatory mucosa, which covers
the alveolar process and surrounds the necks of the teeth.
It is composed of
a. Alveolar bone proper and epithelium.
b. Epithelium and alveolar mucosa.
c. Epithelium and connective tissue.
d. Lamina propria and connective tissue.
79. Gingival epithelium in most cases is
a. Orthokeratinized. b. Parakeratinized.
c. Non-keratinized. d. None of the above.
80. The gingival fibers are composed of
a. Type I collagen. b. Type II collagen.
c. Type III collagen. d. Type IV collagen.
Chapter - 1 : Normal Periodontium
14 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
81. Gingival fibers are a meshwork of fibers that support the
gingiva and attach to the alveolar bone and the tooth. They
are also known as
a. Inter-radicular connective tissue fibers.
b. Sub-crestal connective tissue fibers.
c. Supra-crestal connective tissue fibers.
d. Trans-septal connective tissue fibers.
82. Transseptal fibers connect
a. Alveolar bone with the furcation area of tooth.
b. Alveolar bone with the tooth.
c. Tooth with the adjacent tooth.
d. With hemidesmosomes.
83. Desmosomes and hemidesmosomes are specialized cell
junctions. Which among the following are the features of
desmosomes?
a. Cell to cell connection between two epithelial cells.
b. Epithelial cells to basal lamina.
c. All of the above. d. None of the above.
84. Desmosomes and hemidesmosomes are specialized cell
junctions. What among the following are the features of
hemidesomosomes?
a. Cell to cell connection between two epithelial cells.
b. Epithelial cell to basal lamina.
c. All of the above. d. None of the above.
85. Hemidesmosomes is
a. Cell-to-cell connection.
b. Epithelial cell to basal lamina connection.
c. Half the shape of desmosomes.d. All of the above.
86. Which one of the following is not among gingival fibers?
a. Alveologingival fibers. b. Dentogingival fibers.
c. Dentoperiosteal fibers. d. Interradicular fibers.
e. Transseptal fibers.
15
87. Gingival epithelium and connective tissue interface is
characterized by deep extensions of epithelium that reach
into the connective tissue. What are these epithelial ridges
termed?
a. Finger pegs. b. Hen pegs.
c. Rete pegs. d. Uneven pegs.
88. In histological sections, the depth of the gingival sulcus
has been reported to be _______ with variations from 0
mm to 6mm.
a. 2 mm. b. 1.8mm.
c. 2.3 mm. d. 1.9 mm.
89. What is the most common type of the cementoenamel
junction joint?
a. Butt joint. b. Cementum overlaps enamel.
c. Gap junction.
90. Sulcular epithelium is
a. Keratinized epithelim. b. Non-keratinized epithelium.
c. Specialized epithelium. d. Stratified squamous epithelium.
91. Which of the following are the features of junctional
epithelium?
a. Attached to the tooth. b. No rete pegs.
c. Specialized epithelium. d. Two basal laminae.
e. All of the above.
92. Juctional epithelium cells are attached to the tooth surface
by internal basal lamina and hemidesmosomes.
a. True. b. False.
93. Juctional epithelium cells are attached to the connective
tissue by external basal lamina.
a. True. b. False.
94. What is the orange peel appearance of gingiva called?
a. Stippling. b. Ablation.
c. Abrasion. d. Erosion.
Chapter - 1 : Normal Periodontium
16 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
95. The width of the attached gingiva is defined as the distance
between the _____________(a)__________ and the
projection on the external surface of the bottom of the
________________(b)____________________.
a. (a) Mucogingival junction, (b) Gingival sulcus/Periodontal
pocket.
b. (a) Free gingival groove (b) Gingival sulcus.
c. (a) Junctional epithelium (b) sulcular epithelium.
d. (a) Crest of the gingiva (b) periodontal pocket.
96. How is the width of the attached gingiva determined?
a. Distance between the crest of the gingival margin and the
mucogingival junction – the depth of the gingival sulcus/
pocket.
b. Distance from the cement-enamel junction (CEJ) to the base
of the sulcus/pocket.
c. Distance from the crest of the gingival margin to the
mucogingival junction.
d. Distance between the crest of the gingival margin and the
cement-enamel junction (CEJ).
97. The width of attached gingiva is greatest in
____________(a)_____________ and is
________(b)______ in maxilla and _______(c)_________
in mandible.
a. (a) Incisor region,(b) 3.5-4.5 mm (c)3.3-3.9mm
b. (a) Canine region,(b) 3.5-4.5 mm (c)3.3-3.9mm
c. (a) Premolar region,(b) 3.5-4.5 mm (c)3.3-3.9mm
d. (a) Molar region,(b) 3.5-4.5 mm (c)3.3-3.9mm
98. The width of attached gingiva is least in
____________(a)_____________ and is
________(b)______ in maxilla and _______(c)_________
in mandible.
a. (a) 1st Molar (b) 1.9mm (c)1.8mm.
b. (a) 1st Premolar (b) 1.9mm (c)1.8mm.
17
c. (a) Canine (b) 1.9mm (c)1.8mm.
d. (a) Incisor (b) 1.9mm (c)1.8mm.
99. Which of the following statement is true? Statement a. The
attached gingiva becomes wider as a patient ages. b. The
attached gingiva becomes narrower as patient ages.
a. Both a and b are true. b. Only a is true.
c. Only b is true. d. Both a and b are false.
100. What is the width of the keratinized gingiva?
a. Free gingiva +attached gingiva.
b. Free gingiva + palatal mucosa.
c. Marginal gingiva.
d. Sulcular epitheium+junctional epithelium.
101. The mucosa over the hard palate and attached gingiva is
keratinized and is directly exposed to mastication. What
is it termed as?
a. Junctional epithelium. b. Masticatory mucosa.
c. Non-keratinized mucosa. d. Specialized mucosa.
102. What are the cytokines that stimulate the keratinocyte
division?
a. Epidermal growth factor.
b. Transforming growth factor-á
c. Transforming growth factor-â
d. a and b.
e. b and c.
103. Which of the following cytokines inhibits the keratinocyte
division?
a. Epidermal growth factor.
b. Platelet derived growth factor.
c. Transforming growth factor-á
d. Transforming growth factor-â
Chapter - 1 : Normal Periodontium
18 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
104. Which of the following are non-keratinocytes?
a. Langerhans cells. b. Lymphocytes.
c. Melanocytes. d. Merkel cells.
e. All of the above.
105. The mucogingival line is the line of demarcation between
the attached and unattached gingiva. This line is visible
when stained with iodine solution because the non
keratinized alveolar mucosa is iodine positive, while the
keratinized gingiva is not. Name the iodine solution that
is used for staining?
a. Lugols solution. b. Schiller solution.
c. All of the above. d. None of the above
106. Which of the following is unattached gingiva?
a. Free gingiva. b. Marginal gingiva.
c. All of the above. d. None of the above.
107. Mucogingival junction is the demarcation between
attached and unattached gingiva. Is there a mucogingival
junction on the palate?
a. Yes. b. No.
c. Cannot say.
108. Col is not seen clinically. Is it true or false?
a. True. b. False.
109. What is the oxygen consumption of normal gingiva?
a. QO2 1.8 ± 0.47. b. QO2 1.9 ± 0.33.
c. QO2 1.6 ± 0.37. d. QO2 1.5 ± 0.39.
110. In experimental animals, renewal of Junctional
epithelium has been found to occur between
a. Between 1 to 6 days. b. Between 1 to 6 hours.
c. Between 1 to 6 months. d. Between 1 to 6 weeks.
19
111. Which among the following is not true about Junctional
epithelium?
a. Does not permit any substance to pass through.
b. Has cells with intercellular spaces.
c. Is attached to the tooth by hemidesmosomes.
d. Is non-keratinized.
112. The sulcular epithelium has the potential to keratinize
under certain conditions:(1).When it is reflected and
exposed to the oral cavity. (2). When the bacterial film of
the sulcus is totally eliminated. Identify the correct
statements.
a. Both 1 and 2 are correct. b. Only 1 is correct .
c. Only 2 is correct. d. Both 1 and 2 are false
113. What is the temperature of a healthy gingival sulcus?
a. 33.9± 0.4 ºC. b. 31.6± 0.5ºC.
c. 32.3 ± 0.4 ºC. d. 34.1±0.4ºC.
114. What is the colour of cementum?
a. Coral pink. b. Pale yellow.
c. Salmon pink. d. White.
115. Which part of the gingiva may be pigmented in dark-
skinned individuals?
a. Free gingiva. b. Attached gingiva.
c. Gingival sulcus. d. Col.
116. Epithelial attachment apparatus consists of cells
________________________ and an internal basal
lamina.
a. Easily attached to the tooth (EAT cells).
b. Directly attached to the tooth (DAT cells).
c. Loosely attached to the tooth (LAT cells).
d. Freely attached to the tooth (FAT cells).
Chapter - 1 : Normal Periodontium
20 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
117. Which of the following is not a feature of basal lamina?
a. It connects the epithelium and the connective tissue.
b. It is 300 to 400 Å thick.
c. It consists of lamina lucida and lamina densa.
d. It is permeable to fluids.
e. It is also permeable to particulate matter.
118. The principal fibers of the periodontal ligament anchor
the tooth to the socket. In which of the following teeth is
inter-radicular fiber group seen?
a. Mesiodens. b. Molars.
c. Peg shaped lateral incisors. d. Single rooted teeth.
119. Which of the following is lined by epithelium?
a. Alveolar bone. b. Periodontal ligament.
c. Cementum. d. Gingiva.
120. Which epithelium forms the base of the gingival sulcus?
a. Ciliated epithelium. b. Junctional epithelium.
c. Sulcular epithelium. d. Stratified epithelium.
121. Which of the following are non-keratinized epithelia?
a. Attached gingiva. b. Junctional epithelium.
c. Sulcular epithelium. d. a and b.
e. b and c.
122. Which of the following are the anatomic parts of gingiva?
a. Attached gingiva and free gingiva.
b. Interdental gingiva. c. All of the above.
d. None of the above.
123. Junctional epithelium is a collar like bandof stratified
squamous epithelium. The part of juctional epithelium
that provides the attachment consists of
a. Hemidesmosomes. b. Lamina densa.
c. Lamina lucida. d. All of the above.
e. None of the above.
21
124. Is gingival recession an inevitable consequence of aging?
a. Yes. b. No.
c. Cannot say.
125. What is the most abundant protein in the animal
kingdom?
a. Collagen. b. Oxytalin.
c. Eluanin. d. Elastin.
126. Collagens are divided into Fibril forming collagens, fibril-
associated collagens and _____________________.
a. Non-fibrillar collagens. b. Foaming collagens.
c. Rippled collagens. d. Denatured collagens.
127. Which is the most abundant collagen in the mammals?
a. Type I b. Type II
c. Type III d. Type IV
128. Which is the second most abundant collagen in the
mammals?
a. Type IV. b. TypeIII.
c. Type II. d. Type I.
129. Type IV collagen is present in
_______________________ of the cell.
a. Nucleus. b. Rough endoplasmic reticulum.
c. Mitochondria. d. Basement membrane.
130. Which of the following types of collagen is present in blood
vessels?
a. Type I b. Type II
c. Type III d. Type V
131. Collagen molecule contains
__________________________ and hydroxylysine.
a. Adrenaline. b. Analine.
c. Hydroxyproline d. Proline.
e. Hydroxyguanine.
Chapter - 1 : Normal Periodontium
22 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
132. A number of proteins are synthesized during the
keratinization process. The precursors of fillaggrin are
packed into
a. Keratohyalin granules. b. Odland bodies.
c. Involucrin. d. Macrophagicvacoules.
133. Which of the following forms the matrix of the most
differentiated epithelial cell-corneocyte?
a. Keratolinin. b. Involucrin.
c. Fillaggrin.
134. Which is the least common form of epithelium found in
the oral cavity?
a. Orthokeratinized stratified epithelium.
b. Parakeratinized stratified epithelium.
c. Nonkeratinized stratified epithelium.
d. Lining epithelium.
135. Which is the most common form of epithelium found in
the oral cavity?
a. Orthokeratinized stratified epithelium.
b. Parakeratinized stratified epithelium.
c. Non-keratinized stratified epithelium.
d. Lining epithelium.
136. Which is the most commonly occurring leukocyte in the
oral mucosa?
a. Polymorpho nuclear leukocyte.
b. Macrophage
c. Langerhans cells. d. Merkels cells.
137. Merkel cell is a dendritic cell present in the deeper
layers of oral epithelium. What is its origin?
a. Neural crest origin. b. Heamopoeitic origin.
c. Endodermal origin. d. Mesodermal origin.
23
138. What is the maximum overall amount of mesial drift in a
lifetime?
a. 1 mm. b. 1 cm.
c. 2.3 mm. d. 2 cm.
139. Which of the following statements are true about mast
cells?
a. They are found in connective tissue.
b. They contain basophilic granules.
c. They release histamine on injury.
d. All of the above statements are true.
e. None of the above statements are true.
140. Which of the following cells are involved in acute
inflammation?
a. Basophils. b. Mast cells.
c. Platelets. d. All of the above.
e. None of the above.
141. What is the type of intercellular junction that involves an
attachment of a cell to a nearby noncellular surface?
a. Desmosome. b. Junction.
c. Hemidesmosome. d. None of the above.
142. What type of ossification occurs by formation of osteoid
within dense connective tissue?
a. Intramembraneous ossification.
b. Cartilaginous ossification.
c. All of the above. d. None of the above.
143. Histamine is an important mediator of inflammation. It
causes vasodilation and increases vascular permeability.
Among the following.Which of the cells do not contain a
store of histamine?
a. Basophils. b. Clear cells.
c. Mast cells. d. Platelets.
Chapter - 1 : Normal Periodontium
24 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
144. What are the prominent granules in the cytoplasm of
certain epithelial cells that form a chemical precursor for
the keratin?
a. Hyaline granules. b. Fordyce’s spots.
c. Keratohyaline granules. d. Von ebners glands.
145. What is the turnover time of epithelial cells in gingiva?
a. 52 to 75 days. b. 4 to 14 days.
c. 25 days. d. 41 to 57 days.
146. The layers of the oral mucosal epithelium are the basal
cell layer, prickle cell layer, intermediate layer and the
superficial layer. Name the two layers among them, which
form ½ to 2/3 of the epithelial thickness?
a. Basal cell layer and prickle cell layer.
b. Prickle cell layer and intermediate layer.
c. Intermediate layer and superficial layer.
d. Superficial layer and keratin flakes.
147. What is the steady rise in GCF amount, from 6:00 am to
10:00 pm and a fall afterwards referred?
a. Circadian periodicity. b. Cyclic periodicity.
c. Gingival alternation. d. Ovulation rhythm.
148. Which of the following is not true about Merckel’s cells?
a. Connected to adjacent cells via desmosomes.
b. Harbor nerve endings.
c. Produce melanin pigmentation.
d. Tactile perceptors.
149. Basal layer, prickle cell layer and the intermediate layer
contain nucleated living cells. What are these layers
collectively called?
a. Single layer b. Tomes layer.
c. Malpighian layer. d. Malpighian tubule.
25
150. Langerhan’s cells are nonkeratinocyets seen
predominately in suprabasal layers. What are the
characteristic features of these cells?
a. Langerhan’s granules. b. Has no desmosomes.
c. No tonofilaments. d. All of the above.
e. None of the above.
151. Melanocytes, Langerhan’s cells, Merkel’s cells and
Lymphocytes are __________________________
present in oral epithelium.
a. Keratinocytes b. Non-keratinocytes
c. Clear cells d. Inflammatory cells
152. The Langerhan’s cells are seen in ____________ of oral
epithelium.
a. Supra basal layers. b. Corneal layer.
c. Granular layer d. Spinous layer
153. At what level of oral epithelium are the Merkels cells
located?
a. Basal layer. b. Supra basal layers.
c. Horny layer. d. All of the above.
154. At what level are the Melanocytes cells located in oral
epithelium?
a. Basal and spinous layers. b. Granular layer.
c. Stratum corneum. d. Suprabasal layers.
155. Which of the following epithelia is non-keratinized,
stratified squamous epithelium without rete pegs?
a. Ortho keratinized epithelium.
b. Para keratinized epithelium.
c. Sulcular epithelium.
156. Which of the following epithelia is keratinized and has
retepegs?
a. Alveolar mucosa. b. Junctional epithelium.
c. Keratinized gingiva. d. Sulcular epithelium.
Chapter - 1 : Normal Periodontium
26 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
157. Langerhan’s cells are dendritic nonkeratinocytes.
Ultrastructurally they have small rod or flask shaped
granules. Name these granules.
a. g-specific granules /Birbeck granules.
b. Langerhan’s tatoos. c. Merkels granules.
d. Rod granules.
158. Melanocytes are the pigment producing cells of the oral
mucosa. What is the origin of melanocytes?
a. Neural crest origin. b. Ectodermal origin.
c. Hematopoietic origin. d. None of the above.
159. Some cells lack desmosomal attachments to surrounding
cells, therefore they appear clear in histologic sections.
What are they called?
a. Foam cells. b. Clear cells.
c. Non-attached cells. d. None of the above.
160. Langerhans cells are also called as
a. High level clear cells. b. Keratinocytes.
c. Host cells. d. Rigid cells.
161. Langerhans cells possess antigenic properties. What are
they considered to be?
a. Macrophages. b. Melanocytes.
c. Melanophores. d. Merkel cells.
162. Neutrophils form the first line of defense. What is the
relative volume of neutrophils in a clinically normal
gingiva?
a. 73%. b. 83%.
c. 32%. d. 64%
163. What is the length of junctional epthelium?
a. 0.25-1.35mm. b. 0.10-0.20 mm.
c. 0.11-0.28 mm. d. 0.18-0.28 mm.
27
164. Junctional epithelium has a low density of desmosomes.
They are ______________less than that in gingival
epithelium.
a. 5 times. b. 2 times
c. 4 times. d. 7 times.
165. Which of the following is not true about the junctionalepithelium?
a. It is 3 to 4 layers thick in early life.
b. It is a collar like band of stratified squamous non-keratinizing
epithelium.
c. It is a continually self renewing structure.
d. It originates only from the reduced enamel epithelium.
166. Which of the following does not determine the colour of
the gingiva (attached and marginal)?
a. Degree of keratinization of the epithelium.
b. Presence of pigment containing cells.
c. Thickness of keratinization of the epithelium.
d. Thickness of the sulcular epithelium.
e. Vascular supply.
167. Polymorphonuclear leukocytes migrate continually to the
oral fluid via
a. Junctional epithelium. b. Sulcular epithelium
c. Keratinized epithelium. d. Alveolar mucosa
168. What is the estimated amount of neutrophils that migrate
every minute into the oral cavity via junctional
epithelium?
a. 4000 b. 1500.
c. 800. d. 3000.
169. The periodontal ligament, the cementum and the alveolar
bone comprise a functional unit. They form a joint like
connection between the tooth and bone. What is this joint
referred as?
a. Syndesmosis. b. Gomphosis.
c. Fibrous joint. d. All of the above.
Chapter - 1 : Normal Periodontium
28 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
170. Where are the cells of the periodontal ligament, alveolar
bone and cementum derived from?
a. Dental follicle. b. Enamel organ.
c. Dental sac proper. d. Dental papilla.
171. The arterioles and the venules in the periodontal space
form a single-layered vascular mesh. What is the
diameter of the vessels of this plexus?
a. 15 to 100μm. b. 20 to 100μm.
c. 70 to 150μm. d. 10 to 30μm.
172. The arterioles and the venules in the periodontal space
form a single-layered basket- like plexus. In which
direction do the main vessels of this plexus run?
a. Coronoapical direction. b. Apicocoronal direction.
c. Apicodistal direction. d. Apicomesial direction.
173. The alveolar mucosa stains with Schiller’s iodine solution
while the attached gingiva does not. Why is it so?
a. The alveolar mucosa has an accumulation of intraepithelial
glycogen and this is the basis of its staining. While it is not
present in the gingiva.
b. The alveolar mucosa has a number of blood vessels and this
is the reason of its staining. Such excess of blood vessels is
absent in the attached gingiva.
c. Both of the above said reasons are true.
d. Both of the above said reasons are false.
174. What is the width of an individual stipple noted in healthy
gingiva?
a. 0.6 to 1.4 mm. b. 2.0 to 2.2 mm.
c. 1.0 to 1.2 mm. d. 2.2 to 2.4 mm.
175. Stippling is not seen in attached gingiva. What is the
reason?
a. Degraded gingival fibers.
b. Normal variation in gingival topography.
29
c. Presence of Long and thick gingival fibers.
d. Underlying Connective tissue oedema.
176. Can healthy gingiva be without stippling?
a. Cannot say. b. Never.
c. No. d. Yes.
177. Stippling is usually not visible until ___________ of age.
a. 5-6 years. b. 10-11 years.
c. 15-16 years. d. 20-21 years.
178. Stippling disappears in
a. Adults b. Adolescents
c. Children d. Geriatrics
179. Transseptal fibers extend between adjacent teeth and are
sometimes classified as periodontal fibers. Which of the
following is not true about them?
a. They are not attached to alveolar crest.
b. They are not found on the facial aspect.
c. They are present on the buccal aspect.
d. They maintain the integrity of the dental arches.
180. Cemental spurs are symmetrical spheres of the cementum
attached to the cemental root surface. Do they serve to
anchor collagen?
a. Yes. b. No.
c. Cannot say.
181. The gingival tissues are capable of rapid regeneration
because of the high turnover rate of their epithelial and
connective tissue components. How long will it take for
the junctional epithelium to form if the marginal gingiva
along with junctional epithelium is removed by
gingivectomy?
a. 1 week. b. 2 weeks.
c. 3 weeks. d. 4 weeks.
Chapter - 1 : Normal Periodontium
30 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
182. Which of the principal fibers of the periodontal ligament/
gingival fibers are reconstructed even after the
destruction of the alveolar bone resulting from the
periodontal disease?
a. Alveolar crest group. b. Apical fibers.
c. Oblique group. d. Transseptal fibers.
183. Mesial migration is the mesial shift of the complete
dentition towards the centre of the arch as the age
increases. Which group of fibers is primarily responsible
for this mesial migration?
a. Apical fibers. b. Circular fibers.
c. Transseptal fibers. d. Alvelo periosteal fibers.
184. Which part of the oral epithelium is poorly suited to
prevent the penetration of bacterial products?
a. Junctional epithelium. b. Masticatory mucosa.
c. Parakeratinized epithelium. d. Ortho keratinized epithelium.
185. Attached gingiva prevents the free gingiva from being
pulled away from the tooth surface during mastication.
a. No. b. Yes. c. Cannot say.
186. The junctional epithelium along with gingival fibres forms
a functional unit. They are referred to
as______________.
a. Dento alveolar unit. b. Dento functional unit.
c. Dentogingival unit. d. None of the above.
187. Keratinization of gingiva is a dynamic process, it changes
with age. What happens to the keratinisation of gingiva
with age?
a. Decreases. b. Increases then decreases.
c. Increases. d. Remains the same.
188. What is the consistency of normal healthy gingiva?
a. Firm and resilient. b. Soft and spongy.
c. All of the above. d. None of the above.
31
189. The periodontal ligament is narrowest at the axis of
rotation of the tooth. What is the shape of the PDL?
a. Hourglass. b. Cylindrical.
c. Rectangular. d. Linear.
190. Which of the following types of collagen is related to loose
connective tissue subepithelially and around blood
vessels?
a. Type I. b. Type III.
c. Type V. d. Type VII.
191. Which of the following collagen types represents dense
fibers?
a. Type I. b. Type III.
c. Type V. d. Type VII.
192. Which of the following is not an antimicrobial mechanism
that exists in junctional epithelium?
a. Activated epithelial products.
b. Funneling effect.
c. Presence of basement membrane.
d. Production of neutrophils.
e. Rapid shedding.
f. Release of antimicrobial substances like Defensins and
lysozymes.
193. Which of the following is not a function of junctional
epithelium?
a. Acts as a barrier. b. Antimicrobial defence.
c. Attachment to the tooth. d. Provides gingival pigmentation.
194. The acids secreted by osteoclasts in bone resorption
include
a. Citric acid b. Lactic acid
c. Acetic acid d. Both a & b
e. All of the above
Chapter - 1 : Normal Periodontium
32 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
195. The perforating canals seen in alveolar bone proper are
called
a. Haversian canals b. Volkmann’s canals
c. Lamellar canals d. Howship’s canals
196. Matrix degradation by osteoclasts is through
a. Collagenase b. Cathepsin B1
c. Lysozymes d. Acid proteases
e. All of the above
197. Marrow tissue is richer in
a. Maxilla b. Mandible c. Both a & b
198. The radiopacity seen along the periodontal ligament
space in radiographs represent
a. Bundle bone b. Lamina dura
c. Alveolar bone proper d. All of the above
e. None of the above
199. Severed fibers, Adhesive fibers, Arborized fibers and
Continuous fibers represent variations in attachment of
a. Sharpey’s fibers b. Alveolar mucosa
c. Gingival fibers d. Junctional epithelium
200. Areas of resorption in alveolar bone are called
a. Cutting cone b. Resorption tunnel
c. Both a & b d. None of the above
201. If a tooth is drifting mesially, the alveolar bone
undergoes,
a. Resorption in the mesial wall
b. Apposition in the distal wall
c. Resorption in distal wall d. Apposition in mesial wall
e. Both a & b f. Both c & d
202. Fatty infiltration of marrow spaces are evident in
a. Children b. Adolescent
c. Adults d. Old age
33
203. Total absence of cementum is noted in
a. Hypo-parathyroidism b. Rickets
c.Hypo-phosphatasia d. Scurvy
204. Calcified bodies seen in cementum and periodontal
ligament are called
a. Denticles b. Cementicles
c. Enameloma d. Odontoma
205. The periodontal ligament (PDL) is thinnest around
a. Coronal third of roots b. Middle third of roots
c. Apical third of roots d. Furcation areas
206. The most numerous group of fibers in periodontal ligament
are
a. Alveolar crest group b. Inter-radicular group
c. Oblique group d. Horizontal group
207. Each fibroblast of PDL is in communication with
neighboring cells by about _____ intercellular junctions
a. 10 b. 15
c. 20 d. 25
208. Higher innervation of periodontal ligament is noted in
a. Coronal third b. Middle third
c. Apical third d. Furcation area
209. The approximate number of recognized collagen species
a. 6 b. 12
c. 15 d. 19
210. Ruffini-like endings & Meissner’s corpuscles are related
to
a. Formative function b. Remodeling
c. Nutrition d. Sensation
Chapter - 1 : Normal Periodontium
34 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
211. There is no increase or decrease in the width of cemento-
dentinal junction with age and its width appears to remain
relatively stable.
a. Both statements are True b. Both statements are False
c. First statement is true but latter is false.
d. First statement is false but latter is true.
212. Fusion of cementum and alveolar bone with obliteration
of the periodontal ligament is termed
a. Cemental resorption b. Ankylosis
c. Hypercementosis d. Cemental repair
213. Parathormone stimulates osteoblasts to release
____________ ,which stimulate monocyte migration into
the bone.
a. Interleukins b. Leukemia-inhibiting factor
c. Calcitonin d. Osteocalcin
214. Which one of the following statements is false?
a. Red marrow is not evident in embryo and newborn.
b. The color of inactive and hematopoietic bone marrow is
yellow and red
c. Red marrow is common in maxillary tuberosity, molar region
of jaws, mandibular symphysis and angle of ramus.
d. Red marrow is physiologically replaced by yellow marrow.
215. On teeth with lingual version, the facial bony plate is
thicker than normal.
a. True b. False
216. On teeth in labial version, the margin of labial bone is
a. Blunt and horizontal b. Knife-edged and arcuate
c. Rounded and horizontal d. Both a & b
217. Isolated, denuded areas devoid of marginal bone is called
a. Fenestration b. Dehiscence
c. Boneless window d. Lacunar resorption
35
218. The structure that separates the dental follicle from the
dental papilla is
a. Dental lamina b. Enamel organ
c. Epithelial diaphragm d. Reduced enamel epithelium
219. The PDL fibers are arranged parallel to the root surface
in disuse atrophy or afunctional atrophy.
a. True b. False
220. The blood supply increases from incisors to molars,
greatest in gingival third and least in middle third of roots.
a. All statements are true. b. All statements are false.
c. First and second statements are true but third is false.
d. First statement is true and rest are false.
221. The effects of aging on the immune response is called as
immunosenescence.
a. True b. False
222. Age is considered as _____________ in periodontal
disease
a. Associated factor b. Definitive factor
c. All of the above d. None of the above
223. The width of attached gingiva and keratinized gingiva is
not identical.
a. True b. False
224. Oxytalan fibers have been found exclusively
in___________________.
a. Fascia. b. Periodontal ligament.
c. Pterygomandibular ligament. d. Tendons.
225. Retromolar pad is penetrated by the following muscle
fibres.
a. Superior constrictor, temporalis and buccinator muscle.
b. Massetar, temporalis and lateral pterygoid.
c. Orbicularis oris and buccinator.
d. Temporalis and sternocleidomastoid muscle.
Chapter - 1 : Normal Periodontium
36 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
226. The distance between the tip of the interdental papilla
and the underlying bone is on average about _____ when
the anterior teeth display ideal position and contact
relationship.
a. 1 mm. b. 3 mm
c. 5 mm. d. No average exists.
227. Which of the following is not a feature of the contour of
normal healthy gingiva?
a. Firmly attached gingiva.
b. Knife edge shaped free gingival margin.
c. Papillae filling inter proximal spaces.
d. Rolled free gingival margin. e. Scalloped gingiva.
228. Which of the following statements are true about gingival
clefts?
a. The cleft generally occur on the facial surface.
b. These are apostrophe-shaped indentations extending from
and into the gingival margin for varying distances.
c. They represent narrow triangular shaped gingival recession.
d. All of the above. e. None of the above.
229. Which of the following are peculiar inflammatory changes
of marginal gingiva?
a. Gingival pockets. b. Idiopathic gingival enlargements.
c. McCall festoons. d. Stillman’s clefts.
e. a & b. f. c & d.
230. The soft tissue defects in gingiva are
a. McCall Festoon’s and Stillman’s clefts
b. Free gingival groove and mucogingival junction.
c. Fenestration and dehiscence. d. All of the above.
231. Gingiva and periodontal ligament have a similar
extracellular matrix. Which of the following are present
in the extracellular matrix of periodontal ligament?
a. Chondrotin-4 and-6 sulphates. b. Dermatan sulphate.
c. Heparin sulphate. d. Hyaluronic acid.
e. All of the above. f. None of the above.
37
232. Alveolar bone is that part of maxilla and mandible that
surrounds and supports the tooth. It is a
_____________________ entity.
a. Age dependent. b. Facial profile dependent.
c. Sex dependent. d. Tooth dependent.
233. Which of the following cells control collagen turnover?
a. Cementoclasts. b. Fibroblasts.
c. Osteoblasts. d. Osteoclasts.
234. Dehiscence is a bony defect on buccal or lingual bone
overlaying the root of tooth. The area is exclusively
covered by
a. Cementum only. b. Periodontal ligament only.
c. Soft tissue only. d. None of the above.
235. Supporting alveolar bone is thicker in mandible than in
__________.
a. Coronoid process. b. Maxilla.
c. Palate. d. Zygoma.
236. The epithelium attachment of the junctional epithelium
at normal level should be on enamel or at the
____________________.
a. Apical to cementoenamel junction.
b. Cementoenamel junction (CEJ).
c. Cementum. d. Middle third of the root.
237. Can the width of the attached gingiva on the palate be
measured?
a. No. b. Yes.
238. Which of the following is a temperature receptor in
gingiva?
a. Encapsulated spindles. b. Krause-type end bulbs.
c. Markel’s cells. d. Meissner-type corpuscles.
Chapter - 1 : Normal Periodontium
38 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
239. What is the average depth of healthy gingival sulcus?
a. 0.69 mm. b. 0.96 mm.
c. 0.18 mm. d. 3 mm.
240. Which of the following is not true about the gingival
connective tissue?
a. Eosinophil’s are in abundance.
b. It consists of collagen fibers (60%) and matrix (35%).
c. It consists of collagen, reticular and elastic fibers.
d. It is also know as lamina propria, consists of a papillary layer
with reticular layer.
e. Its main cellular type is fibroblast.
241. Which of the following types of collagen in gingival fibers
help in maintaining the mass and tensile strength of the
dentogingival complex?
a. Type I. b. Type II.
c. Type III. d. Type IV.
242. The thickness of the periodontal ligament varies with:
a. Individual’s age and history of trauma.
b. Stage of eruption and the function of the tooth.
c. Both a and b. d.None of the above.
243. Under reduced occlusal forces, the periodontal ligament
appears thin, the PDL fibers reduce in number and
density, the number and thickness of the alveolar bone
trabeculae are reduced. What is this phenomenon
termed?
a. Disuse atrophy. b. Afunctional atrophy.
c. All of the above. d. None of the above.
244. The distance between the apical extent of the junctional
epithelium and the alveolar bone is _________________.
a. Constant. b. Changing.c. Unstable. d. Variable.
39
245. The distance between the apical extent of the junctional
epithelium and the crest of the alveolar bone is constant.
What is this average distance?
a. 1.07 mm. b. 1.28 mm.
c. 2 mm. d. 3 mm.
246. The position of the mucogingival junction is genetically
determined. How can the distance from the base of the
mandible in the lower jaw and the anterior nasal spine in
the maxilla to the mucogingival junction be described?
a. Changing. b. Constant /stationary.
c. Unstable. d. Variable.
247. What is the adequate width of keratinized gingiva
necessary to maintain gingival health (Lang and Löe)?
a. 2 mm. b. 3 mm.
c. 4 mm. d. 5 mm.
248. The biologic widthis defined as the physiologic dimension
of the ______________________ and connective tissue
attachment.
a. Attached gingiva. b. Junctional epithelium.
c. Keratinized epithelium. d. Sulcular epithlium.
249. The biologic width (B.W)is defined as the physiologic
dimension of the junctional epithelium (J.E) and
connective tissue attachment (C.T.A). What is the
average, biological width (B.W), junctional epithelium
(J.E) and connective tissue attachment (C.T.A)?
a. B.W (2.04) = (0.97mm) J.E+ (1.07mm)C.T.A
b. B.W (2.94) = (0.97mm) J.E+ (1.97mm)C.T.A
c. B.W (3) = (0.99mm) J.E+ (2.01mm)C.T.A
d. B.W (3.04) = (0.97mm) J.E+ (2.07mm)C.T.A
Chapter - 1 : Normal Periodontium
40 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
250. Which of the following is the correct description of the
sensory supply to the periodontal ligament?
a. Free nerve endings- ruffini-like configuration-pain sensation,
treelike mechano receptors-primarly present in apical area,
coiled Meissner’s corpuscles-mechano receptors-Mid root
region, spindle like pressure & vibration endings-apex.
b. Free nerve endings-treelike configuration- mechano
receptors, ruffini-like pain sensation -primarly present in apical
area, coiled Meissner’s corpuscles-mechano receptors- apex,
Spindle like pressure & vibration endings- Mid root region.
c. Free nerve endings-treelike configuration-pain sensation,
ruffini-like mechano receptors-primarly present in apical area,
coiled Meissner’s corpuscles-mechano receptors-Mid root
region, spindle like pressure & vibration endings-apex.
d. Free nerve endings-treelike configuration-pain sensation,
ruffini-like mechano receptors- apex, coiled Meissner’s
corpuscles-mechano receptors-Mid root region, spindle like
pressure & vibration endings- primarly present in apical area.
251. Gingival sulcular epithelium is semipermeable membrane.
Which of the following does not pass through the gingival
sulcular epithelium?
a. Bacterial toxins. b. Drugs: tetracycline and Metronidazole.
c. Solid foods. d. Transudate/exudate
252. Gingival crevicular fluid (GCF) expressed from clinically
normal sulci is a _________________.
a. Transudate. b. Exudate.
c. All of the above. d. None of the above.
253. A number of techniques have been used to collect GCF
for examination. With Brill’s technique absorbing paper
strips are inserted into the pocket until resistance is
encountered. This can elicit irritation by itself. Which of
the following researchers, to minimize the irritation caused
by Brill’s technique, placed the filter paper strip at the
entrance of the pocket?
a. Löe and Holm-Pedersen. b. Weinstein.
c. Squier and Johnson. d. Brill and Krasse.
41
254. Experiments have shown a number of substances
penetrate the sulcular epithelium. What is the maximum
molecular weight of substance that can pass through the
sulcular epithelium?
a. 10000 kD. b. 1000 kD.
c. 100 kD. d. 10 kD.
255. The normal ratio of T-lymphocytes to B-lymphocytes is
about 3:1. What is the ratio of T-lymphocytes to B-
lymphocytes in GCF?
a. 3:1. b. 1:3
c. 4:5 d. 1:1.
256. Which of the following is the main port of entry of
leukocytes into the oral cavity?
a. Salivary glands. b. Attached gingiva.
c. Gingival sulcus. d. Tonsils.
257. What is the part of the root that extends from the
cementoenamel junction (CEJ) to the furcation termed?
a. Root trunk. b. Furcation involvement.
c. Roof of the furcation. d. Roots.
258. In which of the embrasure types, the interdental papilla
fills the embrasure space completely?
a. Type I embrasure. b. Type II embrasure.
c. Type III embrasure. d. All of the above.
e. None of the above.
259. In which of the embrasure types, the height of the
interdental papilla is reduced and partial recession of
papilla can be noticed?
a. Type I embrasure. b. Type II embrasure.
c. Type III embrasure. d. All of the above.
e. None of the above.
Chapter - 1 : Normal Periodontium
42 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
260. In which of the embrasure types, the interdental papilla
is missing and the embrasure space is not filled by the
papilla?
a. Type I embrasure. b. Type II embrasure.
c. Type III embrasure. d. All of the above.
e. None of the above.
261.What is the distance between the cementoenamel junction
(CEJ) to the marginal bone in health?
a. 1-3mm b. 1.5mm-2.0mm.
c. 1.8 mm. d. 2-4 mm
262.Which of the following is not among the meshwork of
gingival terminal argyrophilic fibers innervation?
a. Cavite bodies. b. Encapsulated spindles.
c. Krause-type end bulbs. d. Meissner type tactile corpuscles.
263. Amelogenins secrete Hertwigs epithelial root sheath
during tooth development. What do they do?
a. Induce acellular cementum formation.
b. Induce cellular cementum formation.
c. Induce osteoclast formation.
d. Induce dentine formation.
43
ETIOLOGY AND
PATHOGENESIS OF
PERIODONTAL DISEASE
264. _________________ is the distance from the gingival
margin to the base of the probable crevice.
a. Probing depth. b. Attachment loss.
c. Clinical attachment level. d. Relative attachment level.
265. The carbohydrate which is not associated with dental
plaque
a. Glucose b. Levans
c. Dextrose d. Rhamnose.
266. How is friction from the soft tissues in gingiva termed?
a. Gingival ablation. b. Gingival cleft.
c. Gingival inflammation. d. Gingival abrasion.
267. What is the first detectable sign of gingival
inflammation?
a. Dull pain. b. Increased bleeding on probing.
c. Increased gingival crevicular flow.
d. Reddening of gingiva.
268. Which of the following is not a cause of increase in
GCF?
a. Gingival inflammation.
b. Healing phase of periodontal surgery.
c. Pregnancy. d. Smoking.
e. Trauma from occlusion.
269. When occlusal forces exceed the adaptive capacity of
the tissues, tissue injury results. What is the resultant
injury termed?
a. Trauma from occlusion. b. Traumatic occlusion.
c. Adaptive pressure. d. Malocclusion.
Chapter -2 : Etiology and pathogenesis of periodontal disease
44 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
270. Which of the following are the predominant immune
cell type seen in Stage I gingivitis / initial lesion?
a. Lymphocytes. b. Merkel’s cells.
c. Plasma cells. d. Polymorpho nuclear leukocytes.
271. Which of the following are the predominant immune
cell type seen in Stage II gingivitis / early lesion?
a. Lymphocytes. b. Merkel’s cells.
c. Plasma cells. d. Polymorpho nuclear leukocytes.
272. Which of the following are the predominant immune
cell type seen in Stage III gingivitis / established lesion?
a. Lymphocytes. b. Merkel’s cells.
c. Plasma cells. d. Polymorpho nuclear leukocytes.
273. Stage II gingivitis / early lesion evolves from Stage I
gingivitis/ initial lesion within _______________ after
the beginning of plaque accumulation.
a. 1 day. b. 2-4 days.
c. 4-7 days. d. 14-21 days.
274. Stage III gingivitis/ established lesion/ chronic gingivitis
occurs _________________ after the beginning of the
plaque accumulation.
a. 14-21 days. b. 1-7 days.
c. 2-4 days. d. 4-7 days.
275. Which of the following is the predominant cell of the
developing stage of gingivitis?
a. Lymphocytes. b. Macrophages.
c. Monocytes. d. Neutrophils.
276. Which of the following is the predominant cell of the
chronic gingivitis?
a. Clear cell.b. Ghost cell.
c. Plasma cell. d. Red blood cells.
45
277. What do Plasma cells synthesize?
a. Antibodies. b. Antigens.
c. a & b. d. None of the above
278. What is the predominantly seen cell in the inflammatory
exudates of an acute periodontal abscess?
a. Lymphocytes. b. Mast cells.
c. Plasma cells. d. Neutrophils.
279. A patient has marginal tissue recession, which did not
extend to the mucogingival junction in relation to his
right maxillary central incisor. There is no soft tissue
loss interdentally. Radiographs show no interdental
bone loss. Which class of Millers classification of
marginal recession does it suit?
a. Class-I. b. Class-II.
c. Class-III. d. Class-IV.
280. A patient has marginal tissue recession, which extends
to the mucogingival junction in relation to his left
maxillary central incisor. There is no soft tissue loss
interdentally. Radiographs show no interdental bone
loss. Which class of Millers classification of marginal
recession does it suit?
a. Class-I. b. Class-II.
c. Class-III. d. Class-IV.
281. A patient has marginal tissue recession, which extends
to the mucogingival junction in relation to his right
maxillary canine. There is soft tissue loss interdentally.
Radiographs show interdental bone loss. Which class
of Millers classification of marginal recession does it
suit?
a. Class-I. b. Class-II.
c. Class-III. d. Class-IV.
Chapter -2 : Etiology and pathogenesis of periodontal disease
46 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
282. A patient has marginal tissue recession, which extends
beyond the mucogingival junction in relation to his right
maxillary central incisor. There is severe soft tissue
loss interdentally. Radiographs shows severe
interdental bone loss. Which class of Millers
classification of marginal recession does it suit?
a. Class-I. b. Class-II.
c. Class-III. d. Class-IV.
283. How is any movement of mandible away from the
maximum intercuspation described?
a. Extrusive movement. b. Latero trusion.
c. Protrusion. d. Retrusion.
284. How is the movement of the mandible laterally to the
right or the left from maximum intercuspation
described?
a. Extrusive movement. b. Laterotrusion.
c. Protrusion. d. Retrusion.
285. How is the movement of the mandible anterior from
the maximum intercuspation described?
a. Extrusive movement. b. Laterotrusion.
c. Protrusion. d. Retrusion.
286. How is the posterior movement of the mandible
described?
a. Interference. b. Laterotrusion.
c. Protrusion. d. Retrusion.
287. How is the side of either dental arch corresponding to
the side of the mandible moving toward the midline
described?
a. Balancing side. b. Non-working side.
c. All of the above. d. None of the above.
47
288. How is the side of either dental arch corresponding to
the side of mandible moving away from the midline
described?
a. Working side. b. Non-working side.
c. Balancing side. d. Disclusion.
289. How is any contact, in the centric-relation closure arc,
in the maximum intercuspation, or in excrusions, that
prevents the remaining occlusal surfaces from
achieving stable contact described?
a. Interference. b. Supracontact.
c. All of the above. d. None of the above.
290. How is an occlusion that presents no signs of
dysfunction or disease and no treatment is indicated?
a. Nonphysiologic occlusion. b. Physiologic occlusion.
c. Therapeutic occlusion. d. Traumatic occlusion.
291. How is the occlusion resulting from specific
interventions designed to treat dysfunction or disease
described?
a. Non-physiologic occlusion. b. Physiologic occlusion.
c. Therapeutic occlusion. d. Traumatic occlusion.
292. How is the occlusion associated with disease or
dysfunction caused by tissue injury, and where
treatment may be indicated?
a. Non-Physiologic occlusion. b. Traumatic occlusion.
c. All of the above. d. None of the above.
293. What is the occlusion that produces tissue injury
(trauma from occlusion) called?
a. Physiologic occlusion. b. Traumatic occlusion.
c. Therapeutic occlusion. d. Malocclusion.
294. Which of the following is not caused due to bruxism?
a. Masticatory system disorders. b. Muscle pain.
c. Periodontal pain. d. Dental caries.
e. Tooth fracture. f. Tooth mobility.
g. Tooth wear.
Chapter -2 : Etiology and pathogenesis of periodontal disease
48 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
295. Which of the following describes the diurnal or
nocturnal parafunctional activity that includes
clenching, bracing, gnashing, and grinding of the teeth?
a. Bruxism. b. Clenching.
c. Grinding. d. Myofacial pain dysunction syndrome.
296. What are the joint sound heard through a stethoscope
or Doppler instruments termed?
a. Clicking. b. Crepitus.
c. Diffuse sounds. d. Notes.
297. Which of the following is the most damaging form of
occlusal parafunction?
a. Clenching. b. Grinding. c. Bracing.
298. Attrition is tooth wear caused by tooth to tooth contact.
Which of the following are the types of attrition?
a. Physiological attrition. b. Pathologic attrition.
c. All of the above. d. None of the above.
299. Which of the following are the requirements for occlusal
stability?
a. Maximum intercuspation.
b. No trauma from occlusion.
c. Smooth excursive movements without interferences.
d. All of the above. e. None of the above.
300. Which of the following indicates maximum
intercuspation?
a. Cross-tooth stability.
b. Forces directed along long axis of the tooth.
c. Light or absent anterior contacts.
d. Well-distributed posterior contacts.
e. All of the above. f. None of the above.
301. Which of the following forces are more likely to injure
the periodontium?
a. Lateral (horizontal) forces. b.Torque (rotational) forces.
c. All of the above. d. None of the above.
49
302. How is the selective reshaping of occlusal surfaces with
the goal of establishing a stable, non-traumatic occlusion
termed?
a. Coronoplasty. b. Occlusal adjustment.
c. Occlusal Equilibration. d. All of the above.
e. None of the above.
303. Which of the following are correct descriptions of
osseous craters?
a. Inter proximal. b. Two wall defects.
c. Saucer shaped. d. Common bony lesions.
e. All of the above. f. None of the above.
304. Hemiseptal defects are bony defects. Which of the
following are the correct descriptions of hemiseptal
defects?
a. Common around mesially tipped teeth.
b. Seen around super erupted teeth.
c. All of the above. d. None of the above.
305. Which of the following is not a feature of biofilm?
a. Bacteria attached to a surface.
b. Bacteria attached to each other.
c. Extracellular slime layer.
d. Solitary bacteria.
e. Well organized bacterial community.
306. Dental plaque has a dynamic continually adjusting
bacterial flora. What is known as climax community?
a. Final stable community of bacteria.
b. Final unstable community of bacteria.
c. Initial stable community of bacteria
d. Initial unstable community of bacteria.
307. The oral cavity of human fetus is sterile. When does
the microbial colonization of oral cavity start?
a. At adolescence. b. At childhood.
c. At puberty. d. At the time of birth.
Chapter -2 : Etiology and pathogenesis of periodontal disease
50 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
308. Human body is a host to a number of microorganisms.
Bacteria are _____________ more than human cells.
a. 10 times. b. 15 times.
c. 2.5 times. d. 5 times.
309. Prolonged use of systemic antibiotics disturbs the
normal oral flora. What kind of infections develop when
this normal flora is reduced?
a. Iatrogenic infections. b. Idiopathic infections.
c. Viral infections. d. Yeast infections.
310. Which of the following is the primary cause of halitosis,
dental caries, gingivitis, peri-implantitis and
periodontitis?
a. Calculus. b. Food debris.
c. Materia Alba. d. Plaque/dental biofilm.
311. Which of the following are the primary habitat for
periodontal pathogens.
a. Dorsum of the tongue. b. Oral epithelium.
c. Teeth. d. Tonsils.
312. Cariogenicbacteria are generally seen on solid
surfaces. What type of bacteria is Streptococcus
mutans?
a. Anaerobe. b. Obligate periphyte.
c. Periodontopath. d. Saprophyte.
313. Dental plaque is an organized biofilm. Which of its
components hinders its removal on rinsing?
a. Bacteria. b. Matrix.
c. Salivary pellicle. d. Serumal proteins.
314. Which of the following can be displaced from the oral
cavity with a water spray?
a. Dental calculus. b. Materia Alba.
c. Subgingival plaque. d. Supragingival plaque.
51
315. Which of the following is true in relation to Materia
Alba?
a. Yellow or grayish white.
b. Soft accumulations of bacteria and tissue cells.
c. Lack organized structure of plaque.
d. Easily displaced by water spray.
e. All of the above. f. None of the above.
316. Which of the following bacteria is not primarily a later/
secondary colonizer of plaque?
a. Capnoctyophaga spp. b. F.nucleatum.
c. P.intermedia. d. P.loescheii.
e. Porphyromonas gingivalis. f. Streptococcus sanguis.
317. Which of the following bacteria is not primarily an early/
primary colonizer of plaque?
a. Porphyromonas gingivalis. b. Streptococcus sangius.
c. A.viscosus. d. A.odontolyticus.
318. Dental plaque is an organized biofilm. How dental
plaque is broadly classified?
a. Marginal plaque. b. Subgingival plaque.
c. Supragingival plaque. d. All of the above.
e. None of the above.
319. In a mature supragingival plaque, which type of the
following bacteria predominates at the outer surface?
a. Gram negative bacteria. b. Gram positive bacteria
c. Both gram positive and gram negative bacteria.
d. Only aerobic cocci.
320. In a mature supragingival plaque, which type of the
following bacteria predominates at the tooth surface?
a. Both gram positive and gram negative bacteria.
b. Gram-negative bacteria. c. Gram positive bacteria
d. Only aerobic cocci.
Chapter -2 : Etiology and pathogenesis of periodontal disease
52 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
321. How is the supragingival plaque directly in contact with
the gingival margin referred?
a. Epithelium associated plaque. b. Marginal plaque.
c. Sulcular plaque. d. Tooth associated plaque.
322. Which of the following plaque is primarily responsible
for the initiation and development of gingivitis?
a. Marginal plaque. b. Sub gingival plaque.
c. Supra gingival plaque. d. Tooth associated plaque.
323. Which of the following plaque is critical in calculus
formation and root caries?
a. Marginal plaque. b. Supragingival plaque.
c. Tissue associated subgingival plaque.
d. Tooth associated subgingival plaque.
e. a and c. f. b and d.
324. Which of the following plaque is responsible for tissue
destruction in different forms of periodontitis?
a. Marginal plaque. b. Supra gingival plaque.
c. Tissue associated subgingival plaque.
d. Tooth associated subgingival plaque.
325. What is the type of majority of bacteria seen in bacterial
plaque when periodontium is healthy?
a. Anaerobic gram negative. b. Motile, gram negative.
c. Non motile, gram positive. d. All of the above.
326. Which type of sub gingival plaque is the most
detrimental to the periodontal tissues?
a. Epithelial-attached plaque. b. Tooth-attached plaque.
c. Unattached plaque.
327. Which mechanism of biofilm makes possible the
movement of nutrients to the bacteria?
a. Endotoxin. b. Extracellular matrix.
c. Fluid channels. d. Quorum.
53
328. Does subgingival plaque become devoid of gram-
positive bacterial layer at any stage?
a. Cannot say. b. No.
c. Yes, as it matures. d. Yes.
329. Which of the following gives the most realistic image
of the level of the alveolar bone?
a. Bisecting angle/Short cone technique.
b. Long cone paralleling technique.
c. All of the above. d. None of the above.
330. Which of the following are the four criteria established
by Prichard to determine the adequate angulation of
periapical radiographs?
a. The radiograph should show the tips of molar cusps with
little or none of the occlusal surface showing.
b. Enamel caps and pulp chambers should be distinct.
c. Interproximal spaces should be open.
d. Proximal contacts should not overlap unless teeth are out
of line anatomically.
e. All of the above. f. None of the above.
331. How should the earliest signs of periodontal disease
be detected?
a. Clinically. b. Radiographically.
c. All of the above. d. None of the above.
332. In periodontal disease, what does the radiographs
show?
a. It shows the amount of remaining bone.
b. It shows the amount of bone lost.
333. Which of the following diseases give a distortion of
normal trabecular pattern-ground glass appearance in
radiographs?
a. Fibrous dysplasia. b. Langerhans cell histiocytosis.
c. Paget’s disease. d. Scleroderma.
Chapter -2 : Etiology and pathogenesis of periodontal disease
54 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
334. Which of the following is not a technique to locate
calculus?
a. Infrared light examination. b. Tactile examination.
c. Visual examination using compressed air.
d. Visual examination.
335. Which of the following are tests related to bacteria?
a. Phase contrast microscopy. b. Culture and sensitivity.
c. DNA probe analysis. d. All of the above.
e. None of the above.
336. Which among the following are periodontal diseases?
a. Gingivitis. b. Periodontitis.
c. All of the above. d. None of the above.
337. How can subclinical gingivitis be detected?
a. Clinical visible signs. b. Histologically.
c. All of the above d. None of the above.
338. In a site, where inflammation is present, __________is
used to clinically differentiate between gingivitis and
periodontitis.
a. Clinical attachment level. b. Pocket depth.
c. All of the above. d. None of the above.
339. Which of the following measurement explains the loss
of periodontal tissue accurately?
a. Clinical attachment level. b. Clinical Probing depth.
c. Histological probing depth. d. All of the above.
e. None of the above.
340. What is the actual distance between the gingival margin
and the coronal end of the junctional epithelium?
a. Biologic depth / histologic depth.
b. Probing depth / clinical depth.
c. All of the above. d. None of the above.
55
341. Biologic depth / histologic depth is the actual distance
between the gingival margin and the coronal end of the
junctional epithelium. How can this be measured?
a. Histologic sections. b. Using a Periodontal probe.
c. Clinically. d. Using an Electronic probe.
342. Gingivitis is reversible destruction and periodontitis is
irreversible destruction of periodontium.
a. True. b. False. c. Cannot say.
343. In dental plaque, gram-positive bacteria excrete
Vitamin-K analogues & succinic acid. Which bacteria
utilizes and metabolizes them?
a. Fusobacterium sp. b. Neisseria sp.
c. Porphyromonas gingivalis. d. Veillonella sp.
344. Which of the following bacteria can substitute
progesterone or estradiol for Vitamin-K as an essential
growth factor?
a. Porphyromonas gingivalis. b. Fusobacterium sp.
c. Prevotella intermedia. d. Eikenella corrodens.
345. Calcium phosphate is the main inorganic component of
a. Plaque. b. Calculus.
c. Bone. d. Cartilage.
346. What is the approximate amount of saliva secreted and
swallowed daily?
a. ¼ Liter. b. 1/3 Liter.
c. ½ Liter. d. 2/3 Liter.
347. Which of the following is not an antibacterial agent
presented in saliva?
a. Agglutinins. b. Leucotoxin.
c. Lysozyme and lactoferrin.
d. Peroxidase/thiocynate system.
348. What results in a gingival/false/pseudo pocket?
a. Gingival enlargement. b. Osseous crater.
c. Three walled defect. d. Vertical bone loss.
Chapter -2 : Etiology and pathogenesis of periodontal disease
56 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
349. What results in periodontal/true pocket?
a. Destruction of periodontium. b. Gingival enlargement.
c. Gingivitis. d. All of the above.
350. What are periodontal pockets, spiral in shape
originating on one tooth surface and twisting around
the tooth to involveone or more additional surfaces,
termed?
a. Complex pocket. b. Compound pocket.
c. Gingival pocket. d. Simple pocket.
351. Where are the complex pockets-spiral shaped pockets
common?
a. Central incisors. b. Furcation areas.
c. Palatogingival groove.
352. Which of the following is not a clinical sign that suggests
the presence of a periodontal pocket?
a. Bluish red, thickened marginal gingiva.
b. Diastema formation.
c. Gingival bleeding and suppuration.
d. Localized pain. e. Tooth mobility.
353. Which of the following is not a clinical symptom that
suggests the presence of a periodontal pocket?
a. Localized pain b. Pain “deep in the bone”.
c. Foul taste in localized areas.
d. Gingival bleeding on gentle probing.
354. Which of the following is a reliable means for locating
and determining the extent of periodontal pocket?
a. Careful probing along the gingival crevice.
b. Fremitus test. c. Mobility test. d. Rolling test.
355. Which of the following is a histopathologic feature that
causes the gingival wall of pocket to present various
degrees of bluish red discoloration?
a. Atrophy of epithelium. b. Circulatory stagnation.
c. Destruction of gingival fibers. d. Edema and degeneration.
57
356. Which of the following is a histopathologic feature that
causes the pus to express from the periodontal pocket
on application of digital pressure?
a. Atrophy of epithelium. b. Circulatory stagnation.
c. Destruction of gingival fibers.
d. Edema and degeneration.
e. Suppurative inflammation of inner pocket wall.
357. Which of the following are the histopathologic features
that are responsible for the ease of bleeding from the
pocket wall?
a. Increased vascularity.
b. Proximity of the engorged vessels to inner surface.
c. Thinning and degeneration of epithelium.
d. All of the above. e. None of the above.
358. In the soft tissue wall of the periodontal pocket, the
connective tissue is edematous and densely infiltrated
with plasma cells, lymphocytes and a scattering of
polymorpho neutrophils. What is the approximate
percentage of plasma cells in the connective tissue of
the soft tissue wall of periodontal pocket?
a. 50% b. 60%
c. 80%. d. 90%.
359. Pus is a common feature of periodontal disease. What
type of sign is pus?
a. Primary sign, subjective sign.
b. Secondary sign, Objective sign.
c. Primary sign, objective sign.
d. Secondary sign, subjective sign.
360. Which type of alveolar bone loss results in suprabony
pocket?
a. Horizontal bone loss. b. One walled defect.
c. Two walled defect. d. Vertical bone loss.
Chapter -2 : Etiology and pathogenesis of periodontal disease
58 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
361. Which type of alveolar bone loss results in infrabony
pocket?
a. Horizontal bone loss. b. Vertical bone loss.
c. Plateau formation. d. Maxillary tori.
362. Which of the following is not a feature of supra bony
pocket?
a. The base of the pocket is coronal to the level of the alveolar
bone.
b. Vertical bone loss. c. Horizontal bone loss.
d. Interproximally the transseptal fibers that are restored
during progressive periodontal disease are arranged
horizontally between the base of the pocket and alveolar
bone.
363. Which of the following is not a feature of infra bony
pocket?
a. The base of the pocket is apical to the level of alveolar
bone.
b. Vertical (angular) bone loss. c. Horizontal bone loss.
d. Interproximally the transseptal fibers that are restored
during progressive periodontal disease are arranged in
oblique direction and extend from the base of the pocket
to the adjacent tooth.
364. Trans-septal fibers that are restored in a oblique
direction during progressive periodontal disease is a
feature of
a. Supra-bony pocket b. Infra-bony pocket
c. Fenestration d. Dehiscence
365. What are areas of demineralization in root surface wall
of the periodontal pocket often related?
a. Cemental hypoplasia. b. Erosion.
c. Fissure caries. d. Root caries.
59
366. Bacterial antigens penetrate into the surface layers of
epithelium. Name the cells that recognize antigens and
present them to induce an immune response.
a. Langerhans cells. b. Merkels cells.
c. Red blood cells. d. White blood cells.
367. Which of the following is not a feature of chronic
gingivitis?
a. Bleeding from gingiva. b. Gingival enlargement/swelling.
c. Loss of attachment. d. Redness of gingiva.
368. Periodontitis is a classical example of
__________________________.
a. Acute inflammation. b. Allergic reaction.
c. Arthus reaction. d. Chronic inflammation.
369. Which among the following is not an antibacterial agent
produced by neutrophils that is active only in the
presence of oxygen?
a. Chloramines. b. Elastase.
c. Hydrogen peroxide. d. Hypochlorous acid.
370. Which among the following are antibacterial agents
produced by neutrophils that are not active both in
aerobic as well as anaerobic conditions?
a. Cathepsin G and defensins.
b. Cationic proteins and elastase.
c. Chloramines and Hypochlorous acid.
d. Lysozyme and lactoferrin.
371. Neutrophils are phagocytic cells and form the first line
of defense against infections. Can a neutrophil
phagocytose and kill many microorganisms at the same
time?
a. Cannot say. b. Never.
c. No. d. Yes.
Chapter -2 : Etiology and pathogenesis of periodontal disease
60 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
372. Interleukins are cytokines that communicate between
the ___________________.
a. Cementocytes. b. Erythrocytes.
c. Leucocytes. d. Osteocytes.
373. Which of the following is not true about the acquired
pellicle?
a. A thin, saliva-derived layer.
b. Forms nanoseconds after polishing of the teeth.
c. Forms from selective adsorption of environmental
macromolecules.
d. Solely salivary origin.
374. Which of the following is not the primary cause of
gingivitis and periodontitis?
a. Acquired pellicle. b. Calculus.
c. Material Alba. d. Stains.
e. All of the above. f. None of the above.
375. Which is the most important local factor in the etiology
(initiation, progression and recurrence) of periodontal
disease?
a. Calculus. b. Mouth breathing.
c. Plaque. d. Unreplaced missing teeth.
376. Biofilm protects the bacteria from the antimicrobial
agents
a. True. b. False.
377. Pocket formation without periodontal attachment loss
leads to pseudo pocket. Which of the following is not
the other name of pseudo pocket?
a. False pocket. b. Relative pocket.
c. Gingival pocket. d. True pocket.
378. Pocket formation without periodontal attachment loss
leads to pseudo pocket. It is related to
a. Gingival enlargement. b. Recession.
c. All of the above. d. None of the above.
61
379. Following plaque removal, plaque formation is rapid
on
a. Buccal surface. b. Interproximal surface.
c. Lingual surface. d. Occlusal surface.
380. What are the four local cardinal signs of acute
inflammation?
a. Heat (calor) b. Loss of function (functio laesia)
c. Pain (dolor). d. Redness (rubor)
e. Swelling (tumor). f. a, c, d and e.
g. b, c, d and e.
381. In which part of the periodontal pocket can the most
degenerative changes be seen?
a. Gingival crest epithelium. b. Junctional epithelium.
c. Lateral wall of periodontal pocket. d. Root surface.
382. Which of the following statements are true?
a. Gingipains are trypsin-like cysteine proteinases.
b. Gingipains are classified into lysine-specific gingipain
(Kgp) and arginine-specific gingipains (Rgps) by the
specificity of the proteolytic cutting sites.
c. Gingipains are potent virulence factors of P. gingivalis.
d. All of the above. e. None of the above.
383. Which of the following are virulence factors of
Porphyromonas gingivalis that are capable of
degrading host tissues?
a. Collagenase. b. Trypsinlike enzyme.
c. Neuraminidase. d. Fibronectin-degrading enzyme.
e. All of the above. f. None off the above.
384. Which of the following is an important cytokine-
regulating mediator that can regulate the inflammation
induced by TNF-ααααα?
a.Lipoxin A4. b. TNF-β
c. IL-8. d. ICAM.
Chapter -2 : Etiology and pathogenesis of periodontal disease
62 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
385. What is periodontain?
a. Virulence factor. b. Produced by P.gingivalis.
c. α1-proteinase inhibitor of human neutrophil elastase.
d. All of the above. e. None of the above.
386. Among what age groups are periodontal diseases most
common?
a. Adolescents. b. Adults.
c. Children. d. Infants.
387. Which of the following is not a clinical feature of
Leukemia?
a. Gingival color: Bluish-red.
b. Gingival consistency: soft and spongy.
c. Gingival size: enlarged. d. No bleeding on probing.
e. Shape of papilla: blunt.
388. In which of the following conditions can apical migration
of junctional epithelium and formation of a periodontal
pocket be noticed?
a. Allergic gingivitis. b. Herpetic gingivostomatitis.
c. Periodontitis. d. Plaque induced-gingivitis.
389. Periodontitis is classified based on extent as localized
and generalized. What is the percentage of sites to be
involved for the disease to be considered as localized?
a. ≤30% b. ≥30%
c. 30% d. 30%
390. Periodontitis can be classified on the basis of extent as
localized and generalized. What is the percentage of
sites to be involved for the disease to be considered as
generalized?
a. ≤≤≤≤≤ 30% b. ≥ 30%
c. 30% d. 30%
63
391. Periodontitis can be classified on the basis of severity
of clinical attachment loss. Severity of periodontitis is
characterized depending on the amount of clinical
attachment loss. What amount of clinical attachment
loss is slight attachment loss?
a. 1 or 2 mm. b. 3 or 4 mm.
c. ≥5 mm. d. ≤≤≤≤≤5 mm.
392. Periodontitis is classified based on severity of clinical
attachment loss. Severity of periodontitis is
characterized depending on the amount of clinical
attachment loss. What amount of clinical attachment
loss is moderate attachment loss?
a. 1 or 2 mm. b. 3 or 4 mm.
c. ≤≤≤≤≤ 5mm. d. ≥ 5mm.
393. Periodontitis can be classified on the basis of severity
of clinical attachment loss. Severity of periodontitis is
characterized depending on the amount of clinical
attachment loss. What amount of clinical attachment
loss in severe/advanced attachment loss?
a. 1 or 2 mm. b. 3 or 4 mm.
c. ≥ 5mm. d. ≤≤≤≤≤ 5mm.
394. What were the classes of periodontitis in 1989
classification?
a. Adult periodontitis. b. Early onset periodontitis.
c. Necrotizing ulcerative periodontitis.
d. Periodontitis associated with systemic diseases.
e. Refractory periodontitis.
f. All of the above. g. None of the above.
395. Which of the following is not among the gingival
diseases modified by systemic factors in the 1999
classification of periodontal diseases and conditions?
a. Ascorbic acid-deficiency gingivitis.
b. Diabetes mellitus-associated gingivitis.
Chapter -2 : Etiology and pathogenesis of periodontal disease
64 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
c. Leukemia-associated gingivitis.
d. Menstrual-cycle associated gingivitis.
e. Pregnancy-associated (gingivitis/pyogenic granuloma).
f. Puberty associated gingivitis.
396. Which of the following is among the gingival diseases
modified by malnutrition in the 1999 classification of
periodontal diseases and conditions?
a. Leukemia-associated gingivitis.
b. Menstrual-cycle associated gingivitis.
c. Ascorbic acid-deficiency gingivitis.
d. Pregnancy-associated (gingivitis/pyogenic granuloma).
397. Which of the following is among the gingival diseases
modified by medications in the 1999 classification of
periodontal diseases and conditions?
a. Drug-influenced gingival diseases.
b. Oral contraceptive-associated gingivitis.
c. All of the above. d. None of the above.
398. Which of the following is not a gingival lesion of specific
bacterial origin?
a. Neisseria gonorrhea-associated lesions.
b. Primary herpetic gingivostomatitis.
c. Streptococcal species-associated lesions.
d. Treponema pallidum-associated lesions.
399. Which of the following is not a gingival lesion of viral
origin?
a. Linear gingival erythema.
b. Primary herpetic gingivostomatitis.
c. Recurrent oral herpes.
d. Varicella zoster infections.
400. Which of the following is not a gingival disease of
fungal origin?
a. Generalized gingival candidiasis.
b. Hereditary gingival fibromatosis.
c. Histoplasmosis. d. Linear gingival erythema.
65
401. Which of the following materials used in dentistry can
elicit allergic response in gingiva?
a. Acrylic. b. Eugenol.
c. Mercury. d. Nickel.
e. All of the above. f. None of the above.
402. Which of the following types of traumatic lesions can
one see in gingiva?
a. Accidental. b. Factitious.
c. Iatrogenic. d. All of the above.
e. None of the above.
403. Which of the following are the causes of gingival
traumatic lesion?
a. Chemical injury. b. Physical injury.
c. Thermal injury. d. All of the above.
e. a and b only.
404. Which of the following is not a type of periodontitis
seen associated with genetic disorders?
a. Necrotizing ulcerative periodontitis.
b. Chediak-Higashi syndrome. c. Cohen syndrome.
d. Down syndrome. e. Ehlers-Danlos syndrome.
f. Familial and cyclic neutropenia.
g. Hypophosphatasia.
h. Infantile genetic agranulocytosis.
i. Leukocyte adhesion deficiency syndrome.
j. Papillon-Lefèvre syndrome.
405. Which of the following are the features seen in Down’s
syndrome?
a. Mongolism, b. Trisomy 21.
c. Mental retardation. d. Growth retardation.
e. Severe periodontal destruction. f. All of the above.
406. Which of the following oral microorganisms use Hemin
iron derived from the breakdown of host haemoglobin?
a. Prevotella intermedia b. Porphyromonas gingivalis
c. Prevotella melanogenicus d. Wollinella recta
Chapter -2 : Etiology and pathogenesis of periodontal disease
66 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
407. Phagocytes kill bacteria through which mechanism
a. Chemotaxis b. Oxidative and non-oxidative killing
c. Membrane attack complex killing d. Zipper killing
408. Which of the following diagnostic aid is considered as
gold standard for microbial assessment?
a. DNA probe b. Latex agglutination
c. Bacterial culture d. Perioscan
409. The lactoperoxidase thiocynate system present in
saliva is against
a. P.gingivalis b. Actinomyces
c. Streptococcus d. A.actinomycetem comitans
410. All of the following organisms can be detected by BANA
analysis except
a. Capnocytophaga b. Porphyromonas gingivalis
c. Tannerella forythia d. A. Actinomycetemcomitans
411. BANA test measures activity of
a. Elastase b. Cathepsin
c. Amylase d. Trypsin like enzyme
412. Bacterial communication with each other in a biofilm is
known as
a. Translocation b. Corncob appearance
c. Coaggregation d. Quorum sensing
413. The putative periodontal pathogens belong to
a. Purple complex b. Green complex
c. Orange complex d. Red complex
414. Which of the following microorganism reportedly is
seen in increased numbers in the mouths of children
with Down syndrome?
a. Prevotella intermedia. b. Porphyromonas gingivalis.
c. Fusobacterium nucleatum. d. Tanerella forsythia.
67
415. Which of the following is a protozoa found in human
oral cavity?
a. Entamoeba gingivalis. b. Porphyromonas gingivalis.
c. Fusobacterium nucleatum. d. Tanerella forsythia.
416. Which of the following are the localized tooth-related
factors that modify or predispose to plaque induced
periodontal diseases?
a. Cemental tears. b. Cervical root resorption.
c. Dental restorations/appliances. d. Root fractures.
e. Tooth anatomic factors. f. All of the above.
g. Only a and d.
417. Which of the following are mucogingival problems?
a. Inadequate attached gingiva. b. Shallow vestibule.
c. Periodontal pocket beyond the mucogingival junction.
d. Recession beyond the mucogingival junction.
e. High frenum. f. All of the above.
g. Only a and b.
418. Gingival recession is a common problem in dental
patients. It is the apical migration ofthe marginal
gingiva to the cementoenamel junction. Which of the
following is not an etiology of gingival recession?
a. Improper oral hygiene habits: excessive and improper
flossing, traumatic tooth brushing.
b. Gingival abalation. c. Gingival abrasion.
d. Gingival inflammation.
e. Gingival loss secondary to specific diseases i.e.,
Necrotizing ulcerative periodontitis, periodontitis
f. High frenal attachment g. Iatrogenic causes.
h. Oral habits resulting in gingival laceration, i.e., traumatic
tooth picking and eating hard foods.
i. Pocket reduction periodontal surgery.
j. Secondary to prominent roots/ tooth mal-position.
k. Smoking. i. Consuming acidic juice.
Chapter -2 : Etiology and pathogenesis of periodontal disease
68 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
419. Which of the following are the possible problem created
by gingival recession?
a. Unpleasant aesthetics.
b. Dentinal hypersensitivity: due to exposed root surface.
c. Root caries due to exposure of root surface.
d. Plaque accumulation. e. All of the above.
f. none
420. Which of the following, age groups can be affected by
chronic periodontitis?
a. Adoloscents. b. Adults. c. Children.
d. All of the above. e. None of the above.
421. Periodontal pocket depth reduction is the desirable
treatment outcome. What is the primary habitat of the
periodontopathic bacteria?
a. Carious lesions. b. Dorsum of the tongue.
c. Gingival sulcus. d. Periodontal pocket.
422. Which of the features are commonly shared by
generalized and localized forms aggressive
periodontitis?
a. Otherwise clinically healthy patients.
b. Rapid attachment loss. c. Rapid bone destruction.
d. Familial aggregation. e. All of the above.
f. None of the above.
423. Which of the following is not a secondary feature seen
in both forms of aggressive periodontitis?
a. Dental plaque inconsistent with severity of destruction.
b. Hyperresponsive macrophage phenotype.
c. Phagocyte abnormalities.
d. Rapid periodontal attachment loss.
424. Which of the following were the terms used to describe
necrotizing ulcerative gingivitis?
a. Fusobacterial stomatitis. b. Gilmer’s disease.
c. Trench mouth.
d. Vincent’s ulceromembranous gingivostomatitis.
69
e. Vincent-plaut disease. f. All of the above.
g. None of the above.
425. A pseudo membrane covering ulcerated gingival areas
characterizes necrotizing ulcerative gingivitis. Which
of the following describe the pseudo membrane?
a. Can be easily wiped off. b. Heterogenous film.
c. All of the above. d. None of the above.
426. Which of the following diseases can resemble NUG?
a. Bullous pemphegoid. b. Cicatricial pemphigoid.
c. Lichen planus. d. Pemphigus vulgaris.
427. In which of the following conditions the patient has
metallic foul taste and is conscious of an excessive
amount of pasty saliva?
a. Acute necrotizing ulcerative gingivitis (ANUG).
b. Epidermolysis bullosa. c. Herpetic gingivostomatitis.
d. Lichen planus.
428. Which of the following conditions if untreated may
progress to NUP?
a. Aggressive periodontitis. b. Chronic periodontitis.
c. Necrotizing ulcerative gingivitis.
d. Refractory periodontitis.
429. An abscess is circumscribed collection of
____________________________.
a. Bacteria and bacterial debris. b. Blood.
c. Clear fluid. d. Purulent exudate.
430. Which of the following features predispose to
periodontal abscess formation?
a. Closure of pocket orifice. b.Deep periodontal pocket.
c. Remnants of dental calculus in deep pockets.
d. All of the above. e. None of the above.
431. Bleeding on probing diminishes on
a. Drinking water. b. Scaling and root planing.
c. Sleeping. d. Smoking.
e. a and c. f. b and d.
Chapter -2 : Etiology and pathogenesis of periodontal disease
70 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
432. What is chronic marginal gingivitis referred to as?
a. Advanced lesion. b. Early lesion.
c. Established lesion. d. Initial lesion.
433. What is destructive periodontitis sometimes referred
to as?
a. Advanced lesion. b. Early lesion.
c. Established lesion. d. Initial lesion.
434. In which stage of gingivitis, a tendency to bleed on
probing, begins?
a. Advanced lesion. b. Established lesion.
c. Initial lesion. d. Mobile lesion.
435. Which of the following is a change seen in blood vessels
of Stage I gingivitis / initial lesion?
a. Vascular dilation. b. Vasculitis.
c. All of the above. d. None of the above.
436. Which of the following is a change seen in blood vessels
of Stage II gingivitis / early lesion?
a. Vascular dilation. b. Vasulitis.
c. Vascular proliferation.
d. Vascular proliferation plus blood stasis.
437. Which of the following is a change seen in blood vessels
of Stage III gingivitis / established lesion?
a. Vascular dilation. b. Vasulitis.
c. Vascular proliferation.
d. Vascular proliferation plus blood stasis.
438. Which of the following superimposes a somewhat bluish
hue on the reddened gingiva in stage III gingivitis/
established lesion?
a. Gingival anoxemia. b. Gingival erythema.
c. Gingival rete peg development. d. Gingival vasculitis.
439. Which of the following are the characteristics of
supragingival dental plaque?
a. Considerable amount of matrix.
b. Few motile bacteria. c. Gram positive flora.
71
d. Predominantly aerobic bacteria.
e. Sacrolytic bacteria. f. All of the above.
g. None of the above.
440. Which of the following are the characteristics of
subgingival plaque?
a. Anaerobic bacteria. b. Gram-negative bacteria.
c. Predominately motile bacteria.
d. Proteolytic metabolism. e. Trace amount of matrix.
f. All of the above. g. None of the above.
441. 530-bp deletion of DNA in the promoter region is seen
in the highly toxic strains of_________________.
a. Actinobacillus actinomycetemcomitans.
b. Porphyromonas gingivalis.
c. Tanerella forsythensis. d. Ekinella corredens.
442. Mutations in the genes that encodes Cathepsin-c
protein are seen in __________________________.
a. Pierre Robinson syndrome. b. Down’s syndrome.
c. Papillon-lefe’vre syndrome.
d. Acquired immunodeficiency syndrome.
443. Which of the following medications do not cause
gingival enlargement?
a. Dilantin sodium and cyclosporine A.
b. Diltazem and amlodipine.
c. Mycophenolate and interferon alpha-2 beta.
d. Nifedipine and verapamil.
e. Paracetamol and Ibuprofen.
f. Sertraline and primozide.
444. Toothbrush trauma usually occurs on prominent teeth
in the dental arch. In which teeth can one find it
commonly?
a. Canine. b. Incisors.
c. Molars. d. Premolars.
e. b and c. f. a and d.
Chapter -2 : Etiology and pathogenesis of periodontal disease
72 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
445. What is alveolar bone proper identified as in
radiographs?
a. Alveolar crest. b. Bundle bone.
c. Cribriform plate. d. Lamina dura.
446. Which pattern of bone loss results in an uneven defects,
without overall reduction in the height of the alveolar
bone?
a. Horizontal bone loss. b. Vertical bone loss.
c. All of the above. d. None of the above.
447. Oral structures are three-dimensional complex
structures. However, radiographs are only
a___________________.
a. Uni-dimensional image. b. Two dimensional image.
c. Three dimensional image. d. Multidimensional image.
448. Which of the following is revealed by radiographs?
a. Class IV furcation involvement (Mandibular molars).
b. Clinical attachment level. c. Early bone loss.
d. Incipient furcation involvement.
449. Which of the following is shown by radiographs?
a. Early alveolar bone loss. b. Late effects of the disease.
c. Periodontal disease activity. d. Tooth mobility.
450. What is the number of both old and new cases of a
disease that can be identified within a given population
at a given point in time referred to?
a. Endemic. b. Epidemic.
c. Incidence. d. Prevalence
451. What is the proportion of teeth or examined sites that
are affected with a given condition termed?
a. Extent. b. Severity.
c. Incidence.d. Prevalence.
452. How advanced or serious a given condition is
________________.
a. Incidence. b. Prevalence.
c. Extent. d. Severity.
73Chapter -2 : Etiology and pathogenesis of periodontal disease
453. What is a factor that may possibly lead to disease or
may be protective against a disease termed?
a. Extent. b. Severity.
c. Exposure. d. Risk factor.
454. A characteristic that is associated with a disease is a
____________________.
a. Extent. b. Severity.
c. Exposure. d. Risk factor.
455. What is a probable or putative risk factor that has been
associated with the disease through cross sectional
studies?
a. Risk factor. b. Risk indicator.
c. Risk predictor. d. Risk marker.
456. What is the proportion of persons in a population who
have disease of interest at a given point in or period of
time termed?
a. Endemic. b. Epidemic.
c. Incidence. d. Prevalence
457. What is a factor that is associated with increased
probability of future disease, but where causality is
usually not implied, termed?
a. Risk predictor. b. Risk marker.
c. All of the above. d. None of the above.
458. What is the degree to which the results of a
measurement can be replicated referred?
a. Reliability. b. Reproducibility.
c. Repeatability. d. All of the above.
e. None of the above.
459. What is a measure of the degree to which a test
measures what it purports to measure?
a. Validity. b. Reliability.
c. Reproducibility. d. Repeatability.
74 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
460. What is the number of new disease cases in a population
that occur during a given interval of time termed?
a. Endemic. b. Epidemic.
c. Incidence. d. Prevalence.
461. What is the average percentage of unaffected persons
who will develop the disease of interest during a given
period of time referred?
a. Cumulative incidence. b. Incidence.
c. Risk. d. All of the above.
e. None of the above.
462. What is the prediction of the course or the outcome of
the disease termed?
a. Diagnosis. b. Prognosis.
c. Differential diagnosis. d. Etiology
463. The probable course and outcome of a disease can be
forecasted as
a. Diagnosis. b. Prognosis.
c. Differential diagnosis. d. Etiology
464. What are the factors that increase the host susceptibility
to disease termed?
a. Co-factors. b. Associated factors
c. Predisposing factors. d. Risk factors.
465. Individuals with identical levels of plaque accumulation
and control at many times do not develop the same
amount of periodontal disease. Which of the following
could be the possible reason?
a. Different food habits. b. Different host response.
c. Different tooth paste. d. Different toothbrush types.
466. What does loss of attachment describe?
a. Alveolar bone loss. b.Periodontal ligament destruction.
c. All of the above. d. None of the above.
75Chapter -2 : Etiology and pathogenesis of periodontal disease
467. Which of the following are systemic risk factors for
periodontal diseases?
a. Diabetes mellitus & leukemia. b. Stress.
c. All of the above. d. None of the above.
468. What is the colour of the cyanotic outer gingival wall
of periodontal pocket?
a. Bluish-purple hue. b. Green-red hue.
c. Pinkish-blue hue. d. Red-violet hue.
469. Pathological tooth mobility increase is proportional to
the connective tissue loss. It does not depend on
a. Degree of inflammation of the tissues.
b. Magnitude of occlusal forces.
c. Amount of melanin pigmentation of the gingiva.
d. Remaining alveolar bone support.
470. Which of the following does not form a part of occlusal
analysis in periodontal diagnosis?
a. Excessive overbite. b. Cross bite.
c. Open bite. d. Trauma from occlusion: Fremitus test.
e. Tension test.
471. Which of the following are the causes of increased
mobility?
a. Loss of tooth support. (bone loss)
b. Trauma from occlusion. c. Hypofunction.
d. Temporarily following periodontal surgery.
e. Pregnancy, menstrual cycle & with hormonal
contraceptives.
f. Jaw pathologies. Eg osteomyelitis, tumors of the jaw.
g. All of the above. h. None of the above.
472. Which of the following is not a feature of plaque-
associated gingivitis?
a. Dental plaque. b. Gingival inflammation.
c. No alveolar Bone loss. d. No loss of attachment.
e. Recession.
76 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
473. Where is recession seen commonly?
a. Buccal surfaces of maxillary canines.
b. Labial surfaces of mandibular incisors.
c. Malpositioned/prominent tooth. d. All of the above.
474. Grade III Miller’s classification of mobility implies
a. Horizontal mobilityÃ1mm.
b. Horizontal mobilityÃ2 mm.
c. Vertical mobility. d. b and c. e. a and b.
475. What is a microorganism which grows in the presence
of oxygen called?
a. Aerobe. b. Anaerobe.
c. Proteolytic. d. Saccharolytic.
476. What is a micro organism which grows in the absence
of oxygen called?
a. Aerobe. b. Anaerobe.
c. Proteolytic. d. Saccharolytic.
477. What are the bacteria that require carbon dioxide for
growth called?
a. Aerobic. b. Anaerobic.
c. Capnophilic. d. Saccharolytic.
478. What are the microorganisms that although anaerobes
survive and grow in the presence of oxygen called?
a. Aerobic. b. Capnophilic.
c. Facultative anaerobes. d. Saccharolytic.
479. What are micro organisms that use carbohydrates as
energy source called?
a. Aerobic. b. Capnophilic.
c. Facultative anaerobes. d. Saccharolytic.
480. What is the commonest presentation of periodontal
clinical attachment loss?
a. Bleeding on probing. b. Labial migration of incisors.
c. Mobile teeth. d. Spacing of incisors.
e. a and c. f. b and d.
77
481. Which of the following periodontal microorganism
produces leukotoxin that helps it evade phagocytosis.
a. Actinobacillus actinomycetemcomitans.
b. Porphyromonas gingivalis.
c. Tanerella forsythensis.
d. Ekinella corredens.
482. Which of the following organ systems and conditions
are possibly influenced by periodontal infection?
a. Endocrine system: Diabetes mellitus.
b. Reproductive system: Preterm low birth weight infant
(LBW).
c. Cardiovascular system: Atherosclerosis, MI,
cerebrovascular accident (stroke) & cardiovascular
disease.
d. All of the above. e. None of the above.
483. Periodontitis-associated bacteremia with certain
platelet aggregation associated protein (PAAP) positive
strains of _______________may promote acute
thromboembolic events through interaction with
circulating platelets.
a. S.sanguis and P.gingivalis.
b. Tannella forsythia and Ekinella corredens.
c. A.actinomycetemcomitans and Ekinella corredens.
d. A.actinomycetemcomitans and S.sanguis.
484. What is unpleasant breath odor termed?
a. Breath malodor. b. Halitosis.
c. Bad breath. d. All of the above.
e. None of the above.
485. Which of the following are the predominant causes of
breath malodor?
a. Gingivitis. b. Periodontitis.
c. Tongue coating. d. All of the above.
e. None of the above.
Chapter -2 : Etiology and pathogenesis of periodontal disease
78 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
486. Who put forward: the specific and non-specific plaque
hypothesis?
a. Glickman. b. Gracey.
c. Hunter. d. Loesche.
487. The non-specific plaque hypothesis states
a. All plaque microorganisms are pathogenic.
b. Only certain plaque microorganisms are pathogenic.
c. Only certain plaque microorganism are pathogenic.
d. None of the plaque bacteria is pathogenic.
488. The specific plaque hypothesis states
a. All plaque microorganisms are pathogenic.
b. Only one plaque microorganism is pathogenic.
c. Only certain plaque microorganisms are pathogenic.
d. None of the plaque bacteria is pathogenic.
489. In the dental plaque, the bacterial cells are within a
sticky insoluble extracellular matrix, which contains
proteins, polysaccharides and lipids. What does it
contain?
a. Chitosan. b. Dextran.
c. Protectan. d. Triclosan.
490. With decrease in flow of saliva, dental plaque levels
a. Decrease. b. Do not change.
c. Increase. d. Remain same.491. Which of the following cells are not the sources of
interleukin-1 and tumor necrosis factor?
a. Endothelial cells and keratinocytes.
b. Lymphocytes and fibroblasts.
c. Macrophages. d. Ameloblasts.
492. Which of the following dental plaque bacteria produce
collagenases?
a. A.actinomycetemcomitans. b. P.gingivalis.
c. T.denticola. d. All of the above.
e. None of the above.
79
493. Which of the following cells of host origin produce
collagenase?
a. Gingival fibroblasts. b. Macrophages.
c. Neutrophils. d. All of the above.
494. Periodontal pocket is formed by the apical migration
of epithelium. What are the possible mechanisms for
the apical migration of epithelium?
a. Connective tissue destruction.
b. Rete-peg hyperplasia.
c. All of the above. d. None of the above.
495. Which of the following statements about IL-1 and TNF-
á are not correct?
a. IL-1 and TNF-á are produced by activated macrophages.
b. IL-1 and TNF-á share many of the same biologic
activities.
c. IL-1 and TNF-á stimulate bone resorption.
d. IL-1 and TNF-á are key molecules in pathogenesis of
periodontitis.
e. All of the above. f. None of the above.
496. Which of the following cells is a major source of IL-1
and TNF-á?
a. Monocyte. b. Macrophage.
c. T-cell. d. All of the above.
497. Which of the following cells are major sources of IL-6?
a. T-cell. b. Monocyte/Macrophage.
c. Fibroblast. d. Epithelial cell.
e. All of the above. f. None of the above.
498. Which of the following cells are the major source of
matrix metalloproteinases-1 (MMP-1)?
a. Fibroblast. b. Monocyte/macrophage.
c. Epithelial cells. d. All of the above.
e. None of the above.
Chapter -2 : Etiology and pathogenesis of periodontal disease
80 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
499. PGE2 is increased in periodontal sites with ongoing
inflammation and attachment loss. Which of the
following are primary cells responsible for PGE2 in the
periodontium?
a. Monocytes. b. Macrophages.
c. Fibroblasts. d. All of the above.
e. None of the above.
500. Which of the following are host-derived bone resorbing
agents?
a. Interleukin-1 and interleukin-6.
b. Platelet derived growth factor.
c. Prostaglandins and leukotrines. d. Tumor necrosis factor.
e. All of the above. f. None of the above.
501. In which part of the gingiva are the characteristic
punched-out, crater like lesions of ANUG commonly
seen?
a. Attached gingiva. b. Free gingiva.
c. Interdental papilla. d. Marginal gingiva.
502. Which of the following is not among the four histological
zones described in relation to the lesion of Necrotizing
Ulcerative Gingivitis (ANUG) by Listgarten?
a. Bacterial zone b. Macrophage rich zone.
c. Necrotic zone d. Neutrophil rich zone
e. The spirochetal infiltration zone
503. Which of the following periodontal diseases was
historically called periodontosis?
a. ANUG. b. Chronic localized periodontitis.
c. Generalized aggressive periodontitis.
d. Localized aggressive periodontitis.
504. Which of the following were the terms used earlier to
describe localized aggressive periodontitis?
a. Parodontitis marginalis progressiva. (Wennenmacher).
b. Periodontosis.
c. Juvenile periodontitis (Chaput et al, Baer).
d. All of the above. e. None of the above.
81
505. LAP is clinically characterized as having “localized first
molar/incisor presentation with interproximal
attachment loss on at least
________________________, one of which is a first
molar and involving no more than two teeth other than
first molars and incisors”.
a. Two permanent teeth. b. One permanent teeth.
c. Three permanent teeth. d. Four permanent teeth.
506. In which of the following periodontal diseases, the
amount of plaque is inconsistent with the amount of
periodontal destruction present, it rarely mineralizes
to form calculus.
a. Localized aggressive periodontitis.
b. Necrotizing ulcerative periodontitis.
c. Chronic periodontitis. d. Refractory periodontitis.
507. What is the rate of bone loss in localized aggressive
periodontitis (LAP) when compared to chronic
periodontits?
a. LAP has 3-4 times faster bone loss than in chronic
periodontitis.
b. LAP has 1-2 times faster bone loss than in chronic
periodontitis.
c. Chronic periodontitis shows 3-4 times faster bone loss
than LAP.
d. Chronic periodontitis shows 1-2 times faster bone loss
than LAP.
508. Which of the following is not a clinical feature of
ANUG?
a. Foul breath. b. Lymphadenopathy and fever.
c. Necrotic Punched out Interdental papilla & sudden onset
gingival bleeding.
d. Pain and Rapid Progression. e.Periodontal pocket.
Chapter -2 : Etiology and pathogenesis of periodontal disease
82 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
509. In localized aggressive periodontitis after initial
periodontal destruction, the progress of the disease
halts and the existing periodontal lesions may partially
resolve. What is this phenomenon called?
a. Bacterial phenomenon. b. Burn out phenomenon.
c. Non-specific plaque. d. Specific plaque.
510. Acute necrotizing ulcerative gingivitis is a mixed
bacterial infection caused by anaerobic “fuso-
spirochaetal complex”. Which spirochaetes and
fusiform bacterial species can be found in fuso-
spirochaetal complex?
a. F. nucleatum and Prev.intermedia.
b. T.denticola c. All of the above
d. None of the above.
511. In what stage of HIV infection can periodontal diseases
be seen?
a. I-III stages of HIV infection.
b. III-Iv stage of HIV infection.
c. II-IV stages of HIV infection.
d. I-IV stage of HIV infection.
512. In dental plaque, the bacterial cells are within a sticky
insoluble extracellular matrix, which contains proteins,
polysaccharides and lipids and is known as dextran
matrix. What is this matrix formed from?
a. Bacterial products. b. Saliva.
c. All of the above. d. None of the above.
513. What is cell-to-cell recognition of genetically distinct
partner cell types?
a. Coaggregation. b. Cryptitopes.
c. Adhesion. d. Corn-cob.
514. Which of the following is an example of “corncob”
formation?
a. Streptococci +Bacterionema Matruchotii/Actinomyces
species.
b. Filamentous bacteria+ gram-negative rods.
83
515. Which of the following is an example of “test-tube
brush” formation in plaque?
a. Streptococci +Bacterionema Matruchotii/Actinomyces
species.
b. Filamentous bacteria+ gram-negative rods.
516. Which of the following complexes of bacteria are not
among the early colonizers in plaque?
a. Yellow complex (streptococcus sp).
b. Purple complex. (Actinomyces Odontolyticus)
c. Red complex.( P.gingivalis, Tannerella forsythia &
Treponema Denticola)
517. Which of the following complexes of bacteria are not
primarily the late/secondary colonizers in plaque?
a. Yellow complex. (streptococcus sp).
b. Green complex.(Ekinella corrodens, Actinobacillus
actinomycetemcomitans & Capnocytophaga sp)
c. Red complex.(P.gingivalis, Tannerella forsythia &
Treponema Denticola)
d. Orange complex. (Fusobacterium,
Prevotella&Campylobacter sp)
518. What is the thickness of 3-day plaque?
a. 20-30 ìm. b. 10-20 ìm.
c. 50 ìm d. 15 ìm.
519. During the ___________, the plaque growth rate is
reduced by about 50%.
a. Day. b. Night.
c. Dawn. d. Dusk.
520. Which of the following bacteria is not associated with
periodontal health?
a. Viellonella parvula. b. C.ochraceus.
c. S.sanguis. d. P.gingivalis.
Chapter -2 : Etiology and pathogenesis of periodontal disease
84 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
521. Which of the following bacteria is not proposed to be
protective or beneficial to the host against the
periodontopathic bacteria?
a. Viellonella parvula. b. P.gingivalis.
c. C.ochraceus. d. S.sanguis.
522. Which of the following bacteria is not known to invade
the host tissue cells of the periodontium?
a. P.gingivalis. b. A.actinomycetemcomitans.
c. S.sanguis.
523. Which of the following is true about the microbial shifts,
when comparing the microbiota in health, gingivitis, and
periodontitis?a. From gram positive to gram negative.
b. From cocci to rods
c. From nonmotile to motile organisms.
d. From facultative anaerobes to obligate anaerobes.
e. From fermenting to proteolytic species.
f. All of the above. g. None of the above.
524. A. actinomycetemcomitans is generally accepted as a
primary etiologic agent in most but not in all cases of
localized aggressive periodontitis (LAP). Which of the
following bacteria compose about 90% of total
cultivable microbiota in LAP?
a. A. actinomycetemcomitans. b. P.gingivalis.
c. E.corrodens. d. C.rectus.
525. Which of the following microorganisms can produce
proteolytic enzymes that can destroy immunoglobulins
(IgA, IgM, IgG) or complement factors?
a. Treponema denticola. b. Peptostreptococcus micros.
c. Treponema pallidum. d. Prevotella nigrescens.
85
526. Clinical attachment loss occurs in periodontitis, but not
in gingivitis. What does clinical attachment loss
indicate?
a. Apical migration of the junctional epithelium.
b. Destruction of crestal alveolar bone.
c. Destruction of the periodontal ligament.
d. All of the above. e. None of the above.
527. Dental plaque induced chronic gingivitis is of common
occurrence. What is its prevalence?
a. Infrequently prevalent in adult population.
b. Universally prevalent along with periodontitis in children.
c. Universally prevalent in adult population.
d. None of the above.
528. Until what age is gingivitis of infrequent occurrence?
a. 6 years. b. 9 years.
c. 12 years. d. 15 years.
529. Chronic periodontitis is common form of periodontitis
seen in adults. Which of the following is not its other
name?
a. Adult periodontitis. b. Refractory periodontitis.
c. Slowly progressive periodontitis. d. All of the above.
530. Acute exacerbations of chronic periodontitis at times
may lead to
a. Apical periodontal abscess. b. Condensing ostitis.
c. Gingival abscess. d. Lateral periodontal abscess.
531. Chronic gingivitis and chronic periodontitis are usually
a. Painful. b. Painless.
c. With radiating pain. d. With sharp pain.
532. Which of the following conditions is not associated with
severe periodontal destruction?
a. Chediak-Higashi syndrome. b. Cyclic neutropenia.
c. Down’s syndrome. d. Leukaemias.
e. Papillon-lefèvre syndrome. f. Typhoid fever.
Chapter -2 : Etiology and pathogenesis of periodontal disease
86 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
533. In pregnancy, at times, a grossly hyperplastic localized
swelling can be observed in gingiva which is often
referred to as pregnancy epulis. It is actually a
a. Fibroma. b. Giant cell granuloma.
c. Lipoma. d. Pyogenic granuloma.
534. In a patient without gingival recession, the distance
between base of the pocket and cemento-enamel
junction is 4 mm and that of free gingival margin to
cemento-enamel junction is 3 mm. What is the total
depth of the pocket?
a. 10 mm. b. 3 mm.
c. 4 mm. d. 7 mm.
535. Which of the following represents early effect of
primary trauma from occlusion?
a. Generalized alveolar bone loss.
b. Heamorrhage and thrombosis of blood vessels in
periodontal ligament.
c. Undermining resorption. d. Vertical pockets.
536. Which of the following are window shaped alveolar bone
defects on the labial surface?
a. Dehiscence. b. Fenestration.
c. Osseous Crater. d. Plateau.
537. Accuracy of measurement of the proabable pocket
depths depends on:
a. Position, angulation and orientation of probe.
b. Presence of calculus and root morphology.
c. Probing force and degree of inflammation of tissues.
d. All of the above.
538. What is the probing force necessary to diagnose
osseous defects?
a. 25 grams. b. 50 grams.
c. 75 grams. d. 100 grams.
87
539. What is the ideal probing force for gentle probing?
a. 0.75 N b. 0.1 N
c. 0.25 N. d. 0.50 N.
540. Which of the following is not a local factor that leads to
gingival bleeding?
a. ANUG.
b. Mechanical trauma (from tooth brush, toothpicks)
c. Thermal gingival burn. d. Vitamin C deficiency.
541. A patient has a probing depth of 10 mm in maxillary
right canine (tooth number 13). The distance between
the gingival margin and the cemento enamel junction
is 4mm. Determine the loss of attachment.
a. 2 mm. b. 4 mm.
c. 6 mm. d. 8 mm.
542. A patient has a probing depth of 10 mm in maxillary
right canine (tooth number 13). The distance between
the gingival margin and the Cemento enamel junction
is 4mm. Determine the clinical finding.
a. Gingival pocket. b. Periodontal pocket.
c. Recession. d. Both b and c.
543. Many patients with localized aggressive periodontitis
have dysfunctional
a. Neutrophils. b. Eosinophils.
c. B cells. d. T cells.
544. Which of the following is not among the three-
proinflammatory cytokines that appear to have a
central role in periodontal destruction?
a. Interleukin-1 (IL-1). b. Interleukin-6 (IL-6)
c. Tumor necrosis factor (TNF) d. Interleukin-9 (IL-9).
545. Which of the following is not true about prostaglandin
(PGE2)?
a. It is associated with inflammation.
b. Primarly produced in periodontium by macrophages and
fibroblasts.
Chapter -2 : Etiology and pathogenesis of periodontal disease
88 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
c. PGE2 levels are elevated in active gingivitis and
periodontitis.
d. PGE2 was earlier referred to as “osteoclastic-activating
factor”.
546. Which of the following is the preselected teeth-
Ramfjord teeth used in the periodontal disease index?
a. Maxillary right 1st molar, maxillary left central incisor,
maxillary left 1st premolar, mandibular left 1st molar,
mandibular right central incisor and mandibular right 1st
premolar.
b. Maxillary right 1st molar, maxillary left central incisor,
maxillary left 2nd premolar, mandibular left 1st molar,
mandibular right central incisor and mandibular right 2nd
premolar.
c. Maxillary right 1st molar, maxillary left lateral incisor,
maxillary left 1st premolar, mandibular left 1st molar,
mandibular right lateral incisor and mandibular right 1st
premolar.
d. Maxillary right 2nd molar, maxillary left central incisor,
maxillary left 2nd premolar, mandibular left 2nd molar,
mandibular right central incisor and mandibular right 2nd
premolar.
547. Which of the following indices do not assess gingival
inflammation?
a. Periodontal index. b. Periodontal disease index.
c. Extent and severity index.
548. Which of the following was the first widely used index
system in periodontal epidemiology?
a. Russell’s periodontal index.
b. Ramfjord’s periodontal disease index.
c. Extent and severity index.
d. Community periodontal index.
89
549. Marked redness, edema, ulcerations; tendency toward
spontaneous bleeding were noticed in an individual.
What will be the apt score for the above situation as
per Löe and Silness’s gingival index?
a. Score-0: normal gingiva. b. Score-1: Slight gingiva.
c. Score-2: moderate inflammation.
d. Score-3: Severe inflammation.
550. What does Russell’s periodontal index score-6 indicate?
a. Normal gingiva. b. Mild gingivitis.
c. Gingivitis. d. Gingivitis with pocket formation.
e. Advanced destruction with loss of masticatory function.
551. What are the genes involved in complex multifactorial
diseases referred?
a. Susceptibility genes. b. Susceptibility alleles.
c. All of the above. d. None of the above.
552. Which of the following is true about Russell’s
periodontal index?
a. It does not distinguish between gingivitis and periodontitis.
b. It is carried out without the aid of a periodontal probe.
c. It carries out combined assessment of gingival
inflammation, periodontal pockets, and tooth mobility.
d. Yields unreliable results. e. All of the above.
f. None of the above.
553. What score does a pocket ≥≥≥≥≥ 6mm elicit in community
periodontal index of treatment needs (CPITN)?
a. Score-0. b. Score-1.
c. Score-2. d. Score-3. e. Score-4.
554. What score indicates plaque covering more than two
thirds of the crown of the tooth on the Turesky
modification of Quigley and Hein plaque index?
a.Score-0. b. Score-1.
c. Score-2. d. Score-3.
e. Score-4. f. Score-5.
Chapter -2 : Etiology and pathogenesis of periodontal disease
90 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
555. Which of the descriptions on the Silness and Löe‘s
plaque index denote score-2?
a. No plaque in gingival area.
b. No plaque visible by the unaided eye, but plaque is made
visible on the point of the probe.
c. Gingival area is covered with a thin to moderately thick
layer of plaque; deposit is visible to naked eye.
d. Heavy accumulation of soft matter, the thickness of which
fills out niche produced by gingival margin and tooth
surface: interdental area is stuffed with soft debris.
556. What are the enzymes that degrade collagen and other
matrix macromolecules into small peptides?
a. Amylases. b. Matrix metalloproteinases.
c. Oxygenases. d. Phosphatases.
557. Which of the following statements about Matrix
metalloproteinases is correct?
a. MMP are involved in periodontal tissue destruction.
b. MMP degrade extra cellular matrix such as collagen,
gelatin and elastin.
c. MMP’s are a family of proteolytic enzymes.
d. MMP’s are also produced by periodontal pathogens.
e. MMP’s are secreted in inactive/latent form.
f. All of the above.
558. Which of the following is correct about
Myeloperoxidase present in saliva?
a. Bactericidal to Actinobacillus.
b. Inhibits attachment of Actinomyces strains to
hydroxyapatite.
c. It is released by leukocytes. d. It’s antibacterial.
e. All of the above.
559. Smokers and non smokers with similar age and plaque
levels generally reveal smokers to have
a. Deeper pockets and greater attachment.
b. Greater amounts of alveolar bone loss.
91
c. Higher prevalence of furcation involvement.
d. All of the above.
560. The key molecules for the recruitment of
_____________ to the mucosal surface are IL-8 and
ICAM-1.
a. Neutrophils. b. Lymphocytes.
c. Monocytes/macrophages. d. Fibroblasts.
561. Supragingival margins of restorations, when compared
with subgingival margins is associated with only one of
the following:
a. Optimal periodontal health.
b. Enhanced gingival inflammation.
c. Increased plaque accumulation.
d. Increased flow of crevicular fluid.
562. The suitable markers for the study of periodontitis are
the human leukocyte antigens (HLAs) because
a. They are associated with immune responses.
b. They are highly pleomorphic.
c. The HLA gene region encodes immune response proteins.
d. All of the above.
563. The human cells that are affected by the
Aggregatibacter actnomycetemcomitans are
a. Neutrophils. b. NK T-cells
c. Gingival epithelial cells d. Monocytes
e. All of the above
564. What studies of identical twins suggest about the
susceptibility to periodontal disease due to host factors
(Michalowicz et al., 2000)?
a. 50% b. 30%
c. 20% d. 5%
565. Which of the following are genetic and inherited
disorders associated with aggressive periodontitis?
a. Leukocyte adhesion deficiency.
b. Chédiak-Higashi syndrome.
Chapter -2 : Etiology and pathogenesis of periodontal disease
92 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
c. Ehler-Danlos syndrome.
d. Papillion-Lefèvre syndrome. e. Kindler-syndrome.
f. All of the above. g. None of the above.
566. ___________________ micro-organisms found in the
dental plaque are associated predominately with
periodontal health.
a. Facultative, gram-negative.
b. Anaerobic, gram negative.
c. Anaerobic, gram-positive.
d. Facultative, gram-positive.
567. What were gram-negative non-motile bacteria,
Porphyromonas gingivalis previously known as?
a. Bacteriodes gingivalis. b. Bacteroides forsythus.
c. Prevotella gingivalis. d. Prevotella intermedia.
568. What were gram negative, non-motile bacteria,
Tannerella forsythensis earlier known as?
a. Bacteriodes gingivalis. b. Bacteroides forsythus.
c. Prevotella gingivalis. d. Prevotella intermedia.
569. What are the gram negative, non-motile bacteria
Actinobacillus actinomycetemcomitans recently called?
a. Aggregatibacter actinomycetemcomitans.
b. Bacteriodes gingivalis.
c. Prevotella actinomycetemcomitans.
d. Prevotella intermedia.
570. Aggregatibacter actinomycetemcomitans produces a
potent leukotoxin. What type of toxin is it?
a. Endotoxin. b. Enzyme.
c. Exotoxin. d. Lipopolysaccharide.
571. The “ red complex” bacteria are:
a. Actinobacillus actinomycetemcomitans, Ekinella
corrodens, Porphyromonas gingivalis.
b. Actinobacillus actinomycetemcomitans,
Porphyromonas gingivalis, Treponema denticola.
93
c. Bacteriodes forsythus, ekinella corrodens,
porphyromonas denticola.
d. Tannerella forsythia, Treponema denticola,
Porphyromonas gingivalis.
572. Which of the following is a gram negative, non-motile,
asaccharolytic bacteria found almost solely at
subgingival sites?
a. Aggregetibacter actinomycetemcomitans.
b. Ekinella corrodens.
c. Porphyromonas gingivalis.
d. Tannerella forsythia.
573. The yellow complex bacteria are:
a. S.mitis, S.oralis, S.sangius, S.gordonii, S.intermedia
and Streptococcus sp.
b. Bacteriodes forsythus, ekinella corrodens,
porphyromonas denticola.
c. Actinobacillus actinomycetemcomitans,
porphyromonas gingivalis, treponema denticola.
d. Actinobacillus actinomycetemcomitans, ekinella
corrodens, porphyromonas gingivalis
574. The violet complex bacteria are;
a. Actinobacillus actinomycetemcomitans, ekinella
corrodens, porphyromonas gingivalis.
b. V.parvula and A.odontolyticus.
c. Actinobacillus actinomycetemcomitans,
porphyromonas gingivalis, treponema denticola.
d. Bacteriodes forsythus, ekinella corrodens,
porphyromonas denticola.
575. The green complex bacteria are:
a. Bacteriodes forsythus, ekinella corrodens,
porphyromonas denticola.
b. E.corrodens, C.gingivalis, C.sputigena, C.ochracea,
c.condsus and A.actinomycetemcomitans.
c. Actinobacillus actinomycetemcomitans,
porphyromonas gingivalis, treponema denticola.
d. Actinobacillus actinomycetemcomitans, ekinella
corrodens, porphyromonas gingivalis.
Chapter -2 : Etiology and pathogenesis of periodontal disease
94 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
576. Orange complex bacteria are associated with the
developmental stages of periodontal disease. The
orange complex bacteria are:
a. Actinobacillus actinomycetemcomitans, Ekinella
corrodens, Porphyromonas gingivalis.
b. Actinobacillus actinomycetemcomitans,
Porphyromonas gingivalis, Treponema denticola.
c. Bacteriodes forsythus, Ekinella corrodens,
Porphyromonas denticola.
d. P.intermedia, P.nigrescens, P.micros, F.
nucleatum,Camplylobacter.
577. Which of the following are the parts of gingiva involved
in diffuse gingivitis?
a. Gingival margin and interdental papilla.
b. Gingival margin, attached gingiva and interdental papilla.
c. Interdental papilla.
d. Marginal gingiva and attached gingiva.
578. Which of the following are parts of gingiva involved in
marginal gingivitis?
a. Gingival margin and interdental papilla.
b. Gingival margin and part of attached gingiva.
c. Keratinized mucosa.
d. Marginal gingiva and oral mucosa.
579. Which of the following are parts of gingiva involved in
papillary gingivitis?
a. Col and junctional epithelium.
b. Interdental papilla and adjacent marginal gingiva.
c. Interdental papilla and attached gingiva.
d. Interdental papilla, attached gingiva and free gingiva.
580. Which organism increases in pregnancy gingivitis?
a. Eichenella corrodens.
b. Porphyromonas gingivalis.
c. Porphyromonas melanogenicus.
d. Prevotella intermedia.
95
581. Media supplemented by _______________________
enhances the growth of Tannerella forsythia.
a. Acetic acid. b. Ascorbic acid.
c. Butyric acid. d. N-acetyl muramic acid.
582. Which of the following bacterial species are referred
to as black-pigmented anaerobes?
a. Porphyromonas spp. b. Prevotella spp.
c. Tannerella spp. d. All of the above.
e. None of the above.
583. Halitosis or bad breath is present in periodontitis
patients. _____________________ is a volatile sulphur
compound mainly produced byperiodontal pathogens
that causes bad breath.
a. Hydrogen sulphide. b. Methyl mercaptan.
c. All of the above. d. None of the above.
584. Volatile sulfide compounds (VSC’s):
a. VSCs lead to unpleasant smell of breath.
b. VSCs are produced by bacteria associated with gingivitis
and periodontitis (Gram-negative).
c. VSCS levels correlate with the depth of the periodontal
pockets.
d. VSCs aggravate periodontitis.
e. VSCs impede wound healing. f. All of the above.
g. None of the above.
585. The prevalence of tongue coating is six times higher in
patient’s with________________.
a. Periodontitis. b. Dental caries.
c. Malocclusion.
586. Which of the following is not an intraoral cause of
halitosis?
a. Periodontitis. b. Dry mouth /xerostomia.
c. Coated tongue. d. Regurgitation esophagitis.
Chapter -2 : Etiology and pathogenesis of periodontal disease
96 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
587. Which of the following is not an extraoral cause of
halitosis?
a. Klebsiella ozenae. b. Chronic bronchitis.
c. Regurgitation esophagitis. d. Cirrhosis.
e. Type I diabetes. f. Xerostomia.
588. Which of the following conditions lead to a typical fishy
odor of breath, urine, sweat, expressed air and other
bodily secretions?
a. Trimethyaminuria-heridatary metabolic disorder.
b. Type-I diabetes. c. Klebsiella ozenae.
d. Chronic glomerulonephritis.
589. Increased progesterone levels during the menstrual
cycle give a typical breath odor. When do the Volatile
sulphur compunds increase in a female?
a. Day of ovulation. b. Premenstrual period.
c. All of the above. d. None of the above.
590. Which of the following medications impart a melon like
odor?
a. Eucalyptus. b. Metronidazole.
c. Arsenic. d. Tetracycline.
591. Arsenic in breath smells of __________________.
a. Rotten tomatoes. b. Rotten onions.
c. Melon. d. Fresh fruits.
592. Which of the following is true about specific
characteristics of breath odor?
a. Rotten eggs-Volatile sulphur compounds.
b. Rotten apples- Type I diabetes.
c. Fish odor-Trimethylaminuria. d. All of the above.
e. None of the above.
593. Which of the following is the specific malodor
associated with high proportions of spirochetes in
plaque?
a. Acidic malodor. b. Basic malodor.
c. Fish odor. d. Alkaline malodor.
97Chapter -2 : Etiology and pathogenesis of periodontal disease
594. Which of the following are the clinical and laboratory
examinations used to test oral malodor?
a. Organoleptic assessment.
b. Portable volatile sulfur monitor.
c. Gas chromatography.
d. All of the above. e. None of the above.
595. Nonsmokers with gingivitis have
a. More inflammation than smokers.
b. Less inflammation than smokers.
c. Same inflammation as smokers.
d. Same inflammation as former smokers.
596. What is a plasma cell?
a. A mature B cell. b. A mature T cell.
c. A naïve B cell. d. A naïve T cell.
597. Which of the following is not a microbial virulence
determinant in periodontal disease, which causes tissue
destruction?
a. Collagenase. b. Epithelial cell toxin.
c. Hyaluronidase. d. Amylase.
598. Which of the following is not a microbial virulence
determinant in periodontal disease, which helps in the
evasion of host immunity?
a. Collagenase. b. Cytotoxins.
c. Leukocidins. d. Proteases.
e. Siderophores.
599. Which of the following is not a microbial virulence
determinant in periodontal disease, which helps in
adhesion, colonization and biofilm formation?
a. “Corn-cob” formation. b. Capsules.
c. Fimbriae. d. Leukocidins.
e. Microbial antagonism and synergism.
98 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
600. Which of the following group of organisms/pioneer
organisms are the initial colonizers on the tooth surface?
a. Fusobacteria and spirals.
b. Gram negative cocci and rods.
c. Gram positive cocci and rods. d. Spirocheates.
601. Which of the following are principally the constituents
of dental plaque biofilm?
a. Bacteria and neutrophils.
b. Bacteria and polymer matrix.
c. Dead epithelium and polymer matrix.
d. Loose calculus and polymer matrix.
602. A number of enzymes degrade connective tissue
components. Some of them degrade proteins in the
presence of metal ions, usually calcium or magnesium.
What are they termed as?
a. Collagenases. b. Elastase.
c. Lipase. d. Metalloproteinases.
603. The following are the major organic components of
calculus except:
a. Dead microorganisms.
b. Desquamated epithelial cells and leukocytes.
c. Protein-polysaccharide complexes.
d. Compound lipids.
604. Which of the following is the most common clinical sign
of trauma from occlusion?
a. Increased tooth mobility. b. Occlusal wear facets.
c. Pathological attrition. d. Tooth fractures.
605. Which of the following is not among the tissue-invading
microorganisms seen in LAP?
a. A. actinomycetemcomitans.
b. Capnocytophaga sputigena.
c. Mycoplasma species. d. Spirochetes
e. Staphylococcus aureus.
99Chapter -2 : Etiology and pathogenesis of periodontal disease
606. Some cases of LAP have a reported familial clustering
of ________________.
a. Macrophage abnormalities. b. Neutrophil abnormalities.
c. Osteoblast abnormalities. d. Osteoclast abnormalities.
607. A developmental defect in the form of a groove is some
times seen on the palatal surface of the incisors, which
causes plaque retention. What is it called?
a. Palatocemental groove. b. Palatodentinal groove.
c. Palatogingival groove. d. Palato-oral groove.
608. A developmental defect in the form of a groove is
sometimes seen on the palatal surface of the incisors,
which causes plaque retention. It is referred to as
palatogingival groove. It is seen on radiographs as dark
lines. What are they called?
a. Accessory lines. b. Paracemental lines.
c. Paraoral lines. d. Parapulpal lines.
609. ________________________ among the following
inflammatory cells is efficient enough at phagocytosis
to be considered a “professional phagocyte”
a. Basophil. b. Macrophage.
c. Eosinophil. d. B cell.
610. Nutritional deficiencies
a. Can cause gingivitis or periodontitis.
b. Alter the physiology of the periodontium.
c. Can influence or aggravate the severity of periodontal
disease.
d. Have minimal or no effect on the periodontium.
611. As the plaque mature, a steady shift in the composition
of plaque can be observed. What type of dental plaque
bacterial community can one observe in periodontal
diseases?
a. Aerobic sacrolytic gram-positive bacterial community.
b. Anaerobic proteolytic gram-negative bacterial community.
100 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
c. Facultative aerobic bacterial community.
d. All of the above.
612. Enumerate the crystals present in calculus-
a. Brushite. b. Hydroxyapatite.
c. Octacalcium phosphate.
d. Tricalcium phosphate (whitlochite) e. All of the above.
613. Calculus is a ____________________ in the etiology
of periodontal diseases.
a. Contributing factor. b. Modifiable factor
c. Prime factor. d. a and b only.
614. ______________________ is a periodontopathic
bacteria that has been demonstrated to cause direct
tissue invasion.
a. Ekinella corrodens. b. Prevotella intermedia.
c. Porphyromonas gingivalis.
d. Camphylobacter rectus.
615. “Corn cob” appearance is seen in
a. Subgingival calculus. b. Subgingival plaque.
c. Supra gingival calculus. d. Supra gingival plaque.
616. What is the occlusion that produces injury to the
attachment apparatus termed?
a. Canine-guided occlusion. b. Class IV occlusion.
c. Physiologic occlusion. d. Traumatic occlusion.
617. When trauma from occlusion results from reduced
ability of the tissues to resist the occlusal forces, it is
known as
a. Primary trauma from occlusion.
b. Secondary trauma from occlusion.
c. Acute trauma from occlusion.
d. Chronic trauma from occlusion.
618. Which one of the following statements is not true?
a. Trauma from occlusion acts as co-destrauctive factor
during periodontitis.
b. Trauma from occlusion alters the pathway of
inflammation.
101Chapter -2 : Etiology and pathogenesisof periodontal disease
c. Trauma from occlusion can cause gingivitis.
d. Trauma from occlusion alters the arrangement of
transseptal fibers.
619. Which of the following are caused by overhanging
margin or restoration?
a. Creates plaque retentive area.
b. Plaque removal unattainable. c. All of the above.
d. None of the above.
620. Refractory periodontitis/ non-resolution of periodontitis
despite excellent patient compliance and appropriate
periodontal therapy are commonly seen
among__________________.
a. Adult patients. b. Geriatric patients.
c. Pediatric patients. d. Tobacco smokers.
621. ________________ is an interproximal defect:
a. Dehiscence. b. Exostosis.
c. Ledges. d. Osseous crater.
622. Increased gingival inflammatory response to minimal
dental plaque is seen among pregnant women. What is
pregnancy-associated pyogenic granuloma called?
a. Fibroma. b. Lipoma.
c. Pregnancy tumor. d. Sarcoma.
623. Malocclusions are not necessarily injurious to
periodontium. Which of the following are terms used
to refer to traumatic occlusal relationships?
a. Functional imbalance. b. Occlusal disharmony.
c. Occlusal dystrophy. d. All of the above.
624. Which one of the following statements is true about
trauma from occlusion?
a. It accentuates bone loss in Periodontitis.
b. It causes periodontal pocketing.
c. It is a prerequisite for periodontitis.
d. It occurs in all malocclusions.
102 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
625. Which of the following is the change seen in cases of
excessive occlusal force within the physiologic limits?
a. Narrowing of PDL. b. Periodontal pocketing.
c. Trauma from occlusion. d. Widening of PDL.
626. Polymorphonuclear leukocytes or neutrophils are
immune cells and they are important in maintaining
periodontal health. Severe forms of periodontal
diseases can be seen in cases of their compromised
function. Which of the following diseases are
characterized by impaired PMNs function and increased
risk of periodontal diseases?
a. Chédiak-Higashi syndrome.
b. Down’s syndrome (trisomy 21). c. Job syndrome.
d. Papillon-Lefèvre syndrome. e. All of the above.
f. None of the above.
627. What is an increase in the size of the gingiva, produced
by an increase in the number of its component cells
termed?
a. Gingival enlargement. b. Gingival hyperplasia.
c. Gingival hypertrophy. d. Gingival overgrowth.
628. What is an increase in the size of the gingiva, produced
by an increase in the size of its component cells termed?
e. Gingival enlargement. f. Gingival hyperplasia.
g. Gingival hypertrophy. h. Gingival atrophy.
629. Who is considered the father of microbiology?
a. Antonie van Leeuwenhoek. b. Louis Pasteur.
c. P.D.Miller.
630. A young patient having a drug-induced gingival
enlargement visited a dental clinic. The gingival
enlargement was generalized and was covering three
quarters of his clinical crown. How can his degree of
gingival enlargement be scored?
a. Grade 0. b. Grade I.
c. Grade II. d. Grade III.
103Chapter -2 : Etiology and pathogenesis of periodontal disease
631. Which among the following is a type of acute
inflammatory gingival enlargement?
a. Conditioned gingival enlargement.
b. Drug-induced gingival enlargement.
c. Gingival abscess/periodontal abscess.
d. Idiopathic gingival enlargement.
632. Which of the following is the attributed cause of gingival
irritation among mouth breathers that leads to gingivitis
and gingival enlargement?
a. Drug induced. b. Hormonal.
c. Idiopathic. d. Surface dehydration.
e. Surface hydration.
633. Which of the following is frequently encountered in
cases involving an anterior open bite with mouth
breathing?
a. Marginal and papillary gingivitis- maxillary anterior
sextant.
b. Marginal and papillary gingivitis-mandibular anterior
sextant.
c. Diffuse gingivitis- Maxillary posterior sextant.
d. Diffuse gingivitis-Mandibular posterior sextant.
634. The intake of which of the following drugs that induce
gingival enlargement is reported to cause structural
changes in the outer epithelial cell surface.
a. Cyclosporine. b. Nifedipine.
c. Phynetoin. d. Verapamil.
635. Which of the following types of gingival enlargements
can occur among patients with no significant plaque
deposits?
a. Chronic inflammatory gingival enlargement.
b. Conditioned gingival enlargement.
c. Drug-induced gingival enlargement.
d. Pregnancy gingival enlargement.
104 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
636. Which of the following types of gingival enlargements
can occur among patients with no significant plaque
deposits?
a. Chronic inflammatory gingival enlargement.
b. Conditioned gingival enlargement.
c. False gingival enlargement.
d. Pregnancy gingival enlargement.
637. Which of the following classes of medications are
related to drug induced gingival enlargement?
a. Anticonvulsants. b. Calcium channel blockers.
c. Immunosuppressants. d. All of the above.
e. None of the above.
638. Which of the following are contributing factors that
increase individual’s susceptibility to periodontitis?
a. Genetic factors. b. Smoking.
c. Systemic disease. d. All of the above.
e. None of the above.
639. Desquamative gingivitis is only a clinical term that
describes a peculiar
a. Clinical picture. b. Histological picture.
c. Morphological feature. d. None of the above.
640. Localized aggressive periodontitis is more prevalent
in
a. Blacks/negroids. b. Caucasians.
c. Mongoloid. d. Pigmies.
641. Which one of the following periodontal diseases is
characterized by robust serum antibody response to
infecting agents?
a. Chronic gingivitis. b. Chronic periodontitis.
c. Localized aggressive periodontitis.
d. Generalized aggressive periodontitis.
105Chapter -2 : Etiology and pathogenesis of periodontal disease
642. Generalized aggressive periodontitis is clinically
characterized by generalized inter proximal attachment
loss affecting atleast ________________________
other than first molars and incisors.
a. Four permanent teeth. b. One permanent teeth.
c. Three permanent teeth. d. Two permanent teeth.
643. ___________________ is not a characteristic of
localized aggressive periodontitis.
a. Deep periodontal pockets.
b. Distolabial migration of maxillary incisors.
c. Minimal amount of dental plaque.
d. Severe gingival inflammation.
644. Dental erosion is defined as “loss of dental hard tissue
by a ________________ that does not involve the
influence of bacteria”
a. Chemical process. b. Mechanical abrasion.
c. Physical process. d. Stress build up.
645. Which of the following are detectable on the
radiographs?
a. Calculus. b. Caries.
c. Restoration overhang. d. All of the above.
e. None of the above.
646. Which of the following diseases present clinically as
desquamative condition?
a. Crohn’s disease. b. Lichen planus.
c. Pemphigus vulgaris. d. Sarcoidosis.
e. All of the above. f. None of the above.
647. Gingivitis is gingival inflammation without concomitant
loss of attachment. What extent is gingivitis limited?
a. Gingiva and cementum.
b. Gingiva and periodontal ligament.
c. Gingival tissues. d. Periodontal ligament.
106 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
648. Periodontitis is gingival inflammation with concomitant
loss of attachment. What are the structures that are
involved in periodontitis?
a. Alveolar bone and cementum.
b. Alveolar bone and periodontal ligament.
c. Gingiva and periodontal ligament.
d. Periodontium.
649. Periodontitis is generally characterized by true
periodontal pocket. Name the unique type of
periodontitis where periodontal pockets are not present.
a. Chronic periodontitis.
b. Generalized aggressive periodontitis.
c. Necrotizing ulcerative periodontitis.
d. Prepubertal periodontitis.
650. Gingival abscess occurs in previously disease free
areas.
a. True b. False.
651. Periodontal cyst produces localized destruction of the
periodontal tissues along a lateral root surface. Which
of the following is not an etiologyof periodontal cyst?
a. Lateral dentigerous cyst. b. Odontogenic cyst.
c. Osseous defects.
d. Primordial cyst of supernumerary tooth germ.
652. An adolescent reported with a red smooth, shiny and
fluctuant lesion in his marginal gingiva. He reported of
injuring his gums while eating fish and had no history
of ailment. On examination, adjacent teeth were
sensitive to percussion. What is the most probable
diagnosis?
a. Gingival abscess. b. Periapical abscess.
c. Pericoronal abscess. d. Periodontal abscess.
107Chapter -2 : Etiology and pathogenesis of periodontal disease
653. Primodial cyst produces localized destruction of the
periodontal tissues along a lateral root surface. What
is the common site of its occurrence?
a. Mandibular 3rd molar area.
b. Mandibular canine-premolar area.
c. Maxillary canine-premolar area.
d. Maxillary lateral incisor-canine area.
654. Which of the following are periodontal diseases?
a. Gingival abscess. b. Gingivitis.
c. Periodontal abscess. d. Periodontitis.
e. All of the above. f. None of the above.
655. Which of the following is the salient difference between
gingivitis and periodontitis?
a. Bleeding on probing. b. Loss of attachment.
c. Pocket formation. d. Trauma from occlusion.
656. Which of the following are forms of periodontitis
characterized by rapid destruction of periodontium?
a. Generalized aggressive periodontitis.
b. Localized aggressive periodontitis.
c. Necrotizing ulcerative gingivitis.
d. All of the above. e. None of the above.
657. Which of the following periodontal diseases is the most
common?
a. Chronic periodontitis. b. Gingival abscess.
c. Gingivitis. d. Periodontitis.
658. Which of the following is not a predisposing factor for
NUG?
a. Immune suppression b. Local trauma.
c. Malnutrition d. Poor oral hygiene.
e. Previous history of gingivitis/ NUG.
f. Psychological stress g. Smoking
h. All of the above. i. None of the above.
108 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
659. Which of the following are the most important
predisposing factors for NUG?
a. Local gingival trauma. b. Smoking.
c. Preexisting gingivitis. d. All of the above.
e. None of the above.
660. Which of the following are the local predisposing factors
for ANUG?
a. Local gingival trauma. b. Pericoronal flaps.
c. Pre-existing gingivitis. d. Smoking.
e. All of the above.
661. Which of the following is not among the abscess of
periodontium?
a. Gingival abscess. b. Periapical abscess.
c. Pericoronal abscess. d. Periodontal abscess.
662. Which of the following are among the different forms
of necrotizing periodontal diseases?
a. Necrotizing ulcerative gingivitis.
b. Necrotizing ulcerative periodontitis.
c. Aggressive periodontitis. d. a and b.
e. b and c.
663. Which of the following are mucogingival deformities
and conditions around the teeth?
a. Aberrant frenum. b. Decreased vestibular depth.
c. Gingival recession. d. Lack of keratinized gingiva.
e. All of the above.
664. Which of the following is not a periodontal manifestation
in HIV patients?
a. Kaposi’s sarcoma.
b. Linear gingival erythema.
c. Necrotizing ulcerative gingivitis.
d. Necrotizing ulcerative periodontitis.
109Chapter -2 : Etiology and pathogenesis of periodontal disease
665. Which of the following is not among the localized tooth
related factors that modify or predispose to plaque-
induced gingival diseases or periodontitis?
a. Cervical root resorption. b. Dental restorations.
c. Gingival recession. d. Root fractures.
e. Tooth anatomic factors.
666. Occlusal trauma is classified as primary occlusal trauma
and secondary occlusal trauma.
a. True. b. False.
667. Which of the following is not a periodontal disease
manifestation associated with genetic disorder?
a. Down-syndrome. b. Ehler-Danlos syndrome.
c. Gingivostomatitis. d. Hypophosphatasisa.
668. What are the forms of gingivitis based on the duration
of gingivitis?
a. Acute gingivitis. b. Chronic gingivitis.
c. Sub acute gingivitis. d. Recurrent gingivitis.
e. All of the above. f. None of the above.
669. The presence of which of the following microorganism
is strongly associated with the progression of gingivitis
and the onset of periodontitis in healthy children.
a. A.actinomycetemcometens b. P.gingivalis.
c. P.intermedia. d. T.Forsythus.
670. How is the gingivitis classified based on the extent?
a. Acute gingivitis. b. Generalized gingivitis.
c. Localized gingivitis d. a and b.
e. b and c.
671. How is gingivitis classified based on the distribution?
a. Diffuse. b. Marginal.
c. Papillary. d. All of the above.
e. None of the above.
110 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
672. Which of the following is a type of gingivitis based on
the distribution of inflammation in gingiva?
a. Acute gingivitis. b. Diffuse gingivitis.
c. Localized gingivitis. d. Recurrent gingivitis.
673. Which of the following is not a clinical sign of gingivitis?
a. Bleeding on probing. b. Bone loss.
c. Elevated sulculur temperature. d. Increased GCF flow.
674. Which of the following are the causes for non-dental
plaque induced gingivitis?
a. Allergic reactions. b. Fungal infections.
c. Viral infections. d. All of the above.
675. Which of the following is not the cause for non-dental
plaque induced gingivitis?
a. Aggressive periodontitis. b. Allergic reactions.
c. Dermatologic diseases. d. Mechanical/chemical trauma.
676. Localized gingival erythema has a microflora that
mimics
a. Gingivitis. b. Desquamative gingivitis.
c. Periodontitis. d. None of the above.
677. Which of the following represents the junction between
the keratinized gingiva and nonkeratinized mucosa?
a. Free gingival groove. b. Gingival margin.
c. Mucogingival junction. d. Rugae.
678. Which of the following is not a multirooted tooth that
does not have furcated root area?
a. Mandibular lateral incisor. b. Mandibular molar teeth.
c. Maxillary first premolars. d. Maxillary molar teeth.
679. What is hemiseptum?
a. One-walled defect. b. Two-wall defect.
c. Three-wall defect. d. Combined osseous defect.
111Chapter -2 : Etiology and pathogenesis of periodontal disease
680. Which of the following is not a recommended method
of GCF collection?
a. Absorbing paper strips placed within the sulcus.
b. Preweighted twisted threads placed around the gingival
crevice.
c. Micropipettes placed at the opening of periodontal pockets.
d. Crevicular washings.
681. Which of the following is not a clinical or radiographic
sign of trauma from occlusion?
a. Fremitus. b. Sharp radiating pain.
c. Tender to percussion.
d. Widened periodontal ligament space.
682. Which of the following is not an abscess of periodontium
according to 1999 international workshop for
classification of periodontal diseases by AAP?
a. Gingival abscess. b. Periapical abscess.
c. Periodontal abscess. d. Pericoronal abscess.
683. Periodontal diseases are multifactorial. Which of the
following statements best describe the aetiology of the
periodontal disease?
a. Systemic diseases initiate periodontitis.
b. Systemic diseases are of no relation to periodontitis.
c. Systemic diseases aggravate the response of the tissues
to local irritants.
d. Systemic diseases are sole etiology of periodontitis.
684. Which of the following is the preventable risk factor
for periodontal disease?
a. Diabetes. b. HIV infection.
c. Smoking. d. Stress.
685. What is the colour of the normal gingiva of the
deciduous dentition?
a. Coral pink. b. Pale pink.
c. Salmon pink. d. All of the above.
e. None of the above.
112 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
686. What is the mean sulcus depth of the deciduous
dentition?
a. 2.1 mm (±0.2 mm). b. 3 mm (±0.2 mm).
c. 4 mm (±0.3 mm). d. 3 mm (±0.5 mm).
687. If a primary tooth has been lost prematurely, or in a
first molar erupting behind the deciduous second molar,
a cyst may form. These cysts present as a bluish
enlargement of the gingiva over the erupting tooth.
What are these cysts termed?
a. OKC. b. Gingivalcyst.
c. Eruption cyst. d. Periodontal cyst.
688. Which of the following is the most prevalent type of
gingival disease in child- hood?
a. Chronic marginal gingivitis. b. Candidiasis.
c. Necrotizing ulcerative gingivitis.
d. Primary herpetic gingivostomatitis.
689. Which of the following are true about Type I Diabetis?
a. Autoimmune destruction of pancreatic â-cells.
b. Commonly seen in children and adoloscents.
c. It was formely called “insulin dependent diabetes”.
d. All of the above.
e. None of the above.
690. Which of the following are true about Type II Diabetes?
a. Previously called non-insulin dependent diabetes.
b. Results from insulin resistance.
c. Most of the patients are obese.
d. All of the above.
e. None of the above.
691. Which of the following are the types of Diabetes?
a. Type I Diabetes. b. Type II Diabetes.
c. Gestational diabetes. d. All of the above.
e. a and b
113Chapter -2 : Etiology and pathogenesis of periodontal disease
692. Which of the following are the complications of
diabetes?
a. Retinopathy. b. Nephropathy.
c. Neuropathy.(Sensory, Autonomic)
d. Macro vascular diseases. (Cerebrovascular,
Cardiovascular, Peripheral vascular)
e. Altered wound healing. f. Periodontal diseases.
g. All of the above. h. None of the above.
693. What is the life span of erythrocytes?
a. 116±60days. b. 120±13days.
c. 123±23days. d. 150±33days.
694. Which of the following are facts about gestational
diabetes?
a. Onset usually in the 3rd trimester.
b. Most women return to normoglycemic state after
parturition.
c. All of the above. d. None of the above.
695. The more one smokes, the __________ is the risk for
periodontal disease.
a. Greater. b. Lesser.
696. Smoking is a known risk factor for periodontal diseases.
Which of the following are caused by smoking?
a. Smoking affects periodontal vasculature.
b. Smoking promotes proliferation of periodontal pathogens.
c. Smoking reduces immune response to the invading
periodontal bacteria.
d. All of the above. e. None of the above.
697. Which of the following are included in the WHO
recognized risk factors for periodontal disease?
a. Poor oral hygiene. b. Stress and diabetes.
c. Tobacco and alcohol use. d. All of the above.
e. None of the above.
114 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
698. Chronic diseases progress slowly and generally do not
alarm the patient. Can a subject have periodontitis even
without knowing its presence?
a. Cannot say. b. No. c. Yes.
699. What is the migration of junctional level apical to
Cemento enamel junction called?
a. Clinical attachment loss. b. Clinical Pocket depth.
c. Histological pocket depth. d. Recession.
700. Can healthy gingiva contain or express exudative
suppuration/pus?
a. Yes. b. No. c. Cannot say.
701. Active periodontal pocket is often characterized by the
presence of exudates. What do the presence of pus
and the ease with which it can be expressed from the
pocket indicate?
a. Indicates the depth of the periodontal pocket.
b. Indicates the nature of inflammatory changes in the pocket
wall.
c. Indicates the severity of the periodontal attachment loss.
d. Indicates the type of the bone loss.
702. Which of the following systemic diseases, initially
presenting with striking alterations confined to the
gingival tissues: gingival erythema and enlargement,
what is often described as strawberry gums?
a. Diabetes mellitus. b. Erythrema multiforma.
c. Lichen planus. d. Wegener’s granulomatosis.
703. The syndrome with cutaneous neonatal bullae,
poikiloderma, photosensitivity, and acral atrophy along
with oral lesions clinically consistent with desquamative
gingivitis is ____________________.
a. Hain-Munk syndrome. b. Kindler syndrome.
c. Leukocyte adhesion deficiency syndrome.
d. Papillon-Lefèvre syndrome.
115Chapter -2 : Etiology and pathogenesis of periodontal disease
704. Bruxism is a significant parafunction habit of the
stomatognathic system. Which of the following does it
consist of?
a. Clenching. b. Gnashing.
c. Grinding. d. Gritting.
e. All of the above.
705. Bruxism is a parafunctional habit of repetitive and
continous grinding, clenching or gritting of the teeth.
How is it categorized?
a. Diurnal bruxism b. Nocturnal bruxism
c. All of the above. d. None of the above.
706. Which of the following are among the multiple
etiological factors related to the development of dental
erosion?
a. Diet. b. Salivary buffering capacity.
c. Salivary flow rate. d. All of the above.
e. None of the above.
707. What is the habit of holding carbonated drinks in the
mouth and sucking it in and out to make a froth called?
a. Apposition. b. Bruxism.
c. Clenching. d. Frothing.
708. Which of the following are the primary etiologic factors
of dental erosion?
a. Acidic food intake. b. Gartric reflux.
c. All of the above. d. None of the above.
709. Which of the following dietary changes are appropriate
for patient with dental erosion?
a. Avoid tooth brushing after meals.
b. Finish meals with alkaline food-cheese/milk.
c. Limit acidic food intake.
d. Limit drinks to mealtimes. e. All of the above.
f. None of the above.
116 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
710. Which of the following about bleeding on probing is
true?
a. It is an objective sign.
b. It is clinically easily detectable.
c. Appears from ulcerated pocket wall.
d. May appear 30 – 60 seconds after probing.
e. All of the above.
f. None of the above.
711. What is the common clinical sign of trauma from
occlusion?
a. Bleeding on probing. b. Horizontal bone defect.
c. Suppuration. d. Tooth mobility.
712. Trauma from occlusion leads to funneling of the
periodontal ligament space at the crest. Funneling is
also called as ___________.
a. Biangulation. b. Cone-shaped defects.
c. Plateau. d. Triangulation.
713. Occlusal trauma is defined as injury resulting in tissue
changes within the periodontal attachment apparatus
as a result of ____________.
a. Horizontal forces. b. Lateral forces.
c. Muscular forces. d. Occlusal forces.
714. Occlusal trauma can only be confirmed
_____________.
a. By history. b. Clinically.
c. Histologically. d. Radiographically.
715. Primary occlusal trauma occurs in the presence of the
following features:
a. Excessive occlusal forces.
b. Normal attachment levels.
c. Normal bone levels. d. All of the above.
e. None of the above.
117Chapter -2 : Etiology and pathogenesis of periodontal disease
716. Secondary occlusal trauma occurs in the presence of
the following features:
a. Alveolar bone loss. b. Clinical attachment loss.
c. Normal/excessive occlusal forces.
d. All of the above. e. None of the above.
717. What is the most posterior relation of the mandible to
the maxilla at the established vertical relation termed?
a. Centric relation. b. Centric occlusion.
c. Organic relation. d. Centric slide.
718. What is the movement of the mandible from centric
relation to centric occlusion termed?
a. Centric slide.
b. Centric relation/centric occlusion slide.
c. CR/CO slide. d. All of the above.
e. None of the above.
719. What is the jaw position of maximum tooth contact/
inter-cuspation called?
a. Acentric occlusion. b. Canine-guided occlusion.
c. Centric occlusion. d. Organic occlusion.
720. Which of the following are the clinical indicators of
occlusal trauma?
a. Fractured tooth/teeth. b. Fremitus.
c. Occlusal discrepancies.
d. Occlusal wear facets (in the presence of other indicators).
e. Progressive mobility. f. Thermal sensitivity.
g. Tooth migration. h. All of the above.
i. None of the above. j. a, b and c.
721. Which of the following terms best describe the wearing
away of the tooth substance during mastication,
influenced by the abrasivity of the food?
a. Abfraction. b. Abrasion.
c. Attrition. d. Demastication.
e. Erosion.
118 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
722. Which of the following is not among the wasting
diseases of the teeth?
a. Erosion. b. Attrition.
c. Abrasion. d. Abfraction.
e. Dental stains.723. Which of the following combinations describe
demastication?
a. Abrasion + attrition. b. Attrition + erosion.
c. Abfraction + abrasion. d. Erosion + TFO.
724. Which of the following is “the pathologic loss of hard
tooth substance by biomechanical loading forces”?
a. Abfraction. b. Abrasion.
c. Attrition. d. Erosion.
725. How are the defects that occur at the cementoenamel
junction of the affected teeth by abfraction best
described?
a. Angular defects.
b. Cuneiform shaped defects.
c. Wedge shaped defects.
d. a and c.
e. b and c.
726. Where can one observe the abfraction defects?
a. Bone-implant junction.
b. Cemento-enamel junction.
c. Mucogingival junction.
727. Toothbrush abrasion most commonly seen in
_____________________.
a. Maxillary arch + Buccal side.
b. Maxillary arch + Lingual side.
c. Mandibular arch + Buccal side.
d. Mandibular arch + lingual side.
119Chapter -2 : Etiology and pathogenesis of periodontal disease
728. Robert Koch, a German general practitioner defined
criteria for attributing an organism as the cause of
specific disease. Though these criteria were ideal, they
were unattainable in case of many oral and periodontal
organisms. Name the scientist who modified the Koch’s
postulates for the oral bacteria.
a. Cawson. b. Glickman.
c. Scully. d. Socransky.
729. Which of the following is not among the Koch’s
postulates for the identification of the causative agent?
a. Must be routinely isolated from diseased individual.
b. Must be grown in pure culture in the laboratory.
c. Must demonstrate a host response, in the form of an
alternation in the host cellular or humoral immune
response.
d. Must produce a similar disease when inoculated into
susceptible laboratory animals.
e. Must be recovered from lesions in a diseased laboratory
animal.
730. Which of the following is not among the Socrancky’s
proposed criteria by which periodontal microorganisms
may be judged aspotential pathogens?
a. Must be associated with disease, as evident by increases
in the number of organisms at diseased sites.
b. Must be eliminated or decreased in sites that demonstrate
clinical resolution of disease with treatment.
c. Must demonstrate a host response, in the form of an
alteration in the host cellular or humoral immune response.
d. Must be capable of causing disease in experimental animal
models.
e. Must be recovered from lesions in a diseased laboratory
animal.
f. Must demonstrate virulence factors responsible for
enabling the microorganism to cause destruction of
periodontal tissues.
120 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
731. Supra gingival calculus, all are true except:
a. Clay like consistency
b. Occurs frequently near the orifices of the salivary ducts.
c. Dense, Dark- brown or greenish-black in colour.
d. Located coronal to the gingival margin.
732. Which one of the following types of crystal forms is
frequently detected in the supra gingival calculus and
constitutes the bulk of the specimen?
a. Hydroxyapatite & Octacalcium phosphate.
b. Brushite &Hydroxyapatite.
c. Magnesium whitlockite & Hydroxyapatite.
d. Octacalcium phosphate & Magnesium whitlockite.
733. Which of the following types of crystal forms seen in
calculus is most common in mandibular anterior region?
a. Hydroxyapatite. b. Brushite.
c. Magnesium whitlockite. d. Octacalcium phosphate.
734. Which of the following types of crystal forms seen in
calculus is most common in mandibular posterior
region?
a. Hydroxyapatite. b. Brushite.
c. Magnesium whitlockite. d. Octacalcium phosphate.
735. Subgingival calculus, all are true except:
a. Homogenous.
b. Located apical to the crest of gingival margin.
c. Flint-like consistency.
d. Occurs frequently in interproximal areas.
e. White - yellowish white in colour.
736. What is the calculus deeply embedded in cementum,
may appear morphologically similar to cementum
termed?
a. Supragingival calculus. b. Supgingival calculus.
c. Calculocementum. d. Cemental calculus.
121Chapter -2 : Etiology and pathogenesis of periodontal disease
737. Calculus formation continues until it reaches a
maximum, after which it may reduce. What is this
decline from the maximal calculus accumulation
termed?
a. Epitactic concept. b. Incremental line.
c. Reversal line. d. Reversal phenomenon.
738. Which of the following are theories of mineralization
of calculus?
a. Booster mechanism: Mineral precipitation resulting from
local rise in saturation of calcium and Phosphate ions.
b. Epitactic concept / Heterogenous nucleation.
c. All of the above. d. None of the above.
739. Which of the following is generally associated with
marginal gingival recession?
a. Abfraction. b. Abrasion.
c. Attrition. d. Erosion.
740. Which of the sites in both primary and permanent
dentition is most commonly affected by periodontitis
and progressive destruction?
a. Distal surface of canines.
b. Distal surfaces of premolar.
c. Mesial surface of incisor.
d. Proximal surface of 1st molar.
741. When should the growing plaque at least be removed
completely in periodontally healthy individuals to
prevent inflammation?
a. Every 8 hours. b. Every 12 hours.
c. Every 24 hours. d. Every 48 hours.
742. Which site on the tooth harbor the periodontal lesions
commonly?
a. Buccal location. b. Lingual location.
c. Interdental locations. d. Palatal locations.
122 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
743. One of the constituents of dentifrices is abrasive agents.
They are insoluble inorganic salts. Which of the
following tissues is abraded fastest?
a. Cementum. b. Dentine. c. Enamel.
744. Do “calculus control toothpastes” reduce sub gingival
calculus formation?
a. Yes. b. No.
745. Which of the following are associated with tooth
mobility?
a. Occlusal trauma. b. Pathologies of the jaws.
c. Periodontal status of the tooth (alveolar bone loss,
periodontal inflammation and loss of clinical attachment).
d. Periodontal surgery. e. Pregnancy.
f. All of the above. g. None of the above.
746. The probing pocket depth is affected by the :
a. Age of the patient. b. Gingival inflammation.
c. Presence or absence of systemic diseases.
d. Type of periodontitis.
747. Pseudo pocket is also known as false pocket and has
no concurrent attachment loss. It results from:
a. Apical migration of epithelial attachment.
b. Crestal bone loss.
c. Enlargement of the marginal gingiva.
d. Gingival recession.
748. What frequently causes localized gingival recession
especially on the buccal surfaces of prominent teeth?
a. Heavy deposits of gingival plaque.
b. Improper tooth brushing.
c. Oral herpes infection. d. Shallow vestibule.
749. Which among the following can cause gingival
deformities that require gingivoplasty to eliminate
them?
a. Acute herpetic gingivostomatitis.
b. Desquamative gingivitis.
123Chapter -2 : Etiology and pathogenesis of periodontal disease
c. Erosive lichen planus.
d. Necrotizing ulcerative gingivitis.
750. Which of the following are acute gingival infections
seen in childhood?
a. Primary herpetic gingivostomatitis.
b. Necrotizing ulcerative gingivitis.
c. All of the above. d. None of the above.
751. A 5 year old boy reported, with fever as high as 102°F
, had intraoral small ulcerated lesions with a red,
elevated halo-like margin and a depressed grayish white
central region. What is the most probable diagnosis?
a. ANUG. b. Primary herpetic gingivostomatitis.
c. Pericoronitis. d. Candidiasis.
752. What is the inflammation of the gingiva in relation to
the crown of an incompletely erupted tooth termed?
a. ANUG. b. Gingivitis.
c. Periocoronitis. d. Periodontitis.
753. Where does pericoronitis most commonly occur?
a. Mandibular third molar area.
b. Maxillary third molar area.
c. Mandibular first molar area.
d. Maxillary first premolar area.
754. Which of the following are possible sequelae of acute
pericoronitis?
a. Peritonsillar abscess. b. Cellulitis.
c. Ludwig’s angina. d. All of the above.
755. What are the cells showing “ballooning degeneration”
consistingof acantholysis, nuclear clearing, and nuclear
enlargement seen in HSV-1 targeted epithelial cells
called?
a. Tzanck cells. b. Dendritic cells.
c. Neoplastic cells.
124 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
756. Herpes simplex virus-1 (HSV-1) targets:
a. Epithelial cells. b. Osteoblasts.
c. Endothelial cells. d. Neutrophils.
757. Among the following patients gingival enlargement can
be expected in all except:
a. COPD patient. b. Epileptic patient.
c. Patient on hypertensive therapy.
d. Renal transplantation patient.
758. Which of the following is not a defining clinical feature
of chronic periodontitis?
a. Periodontal supporting tissue inflammation.
b. Progressive attachment loss.
c. Progressive bone loss. d. Trauma from occlusion.
759. Which of the following periodontal diseases is a site-
specific disease?
a. Aggressive periodontitis. b. Chronic periodontitis.
c. All of the above. d. None of the above.
760. Which of the following is not a proposed disease
progression model that explains the disease
progression in chronic periodontitis?
a. Asynchronous, multiple-burst model.
b. Continuous model.
c. Linear, random burst model.
d. Random model/episodic-burst model.
761. Which one of the following statements is true about
periodontitis?
a. Periodontitis is an age related disease.
b. Periodontitis is an age-associated disease.
c. All of the above. d. None of the above.
762. Which among the following is not a characteristic seen
in adult periodontitis?
a. Abnormality in phagocyte function.
b. Slow progression.
125Chapter -2 : Etiology and pathogenesis of periodontal disease
c. Plaque levels consistent with the amount of tissue
destruction.
d. Presence of subgingival calculus.
763. In cases of periodontitis, which of the following is how
the severity of periodontitis classified based on?
a. Initial/Slight/Mild=1-2 CAL
b. Moderate =3-4mm CAL
c. Severe/Advanced ≥5mm CAL
d. All of the above e. None of the above.
764. Chronic periodontitis has slow to moderate progression.
Can it have periods of rapid progression?
a. Yes. b. No. c. Cannot say.
765. Which of the following factors other than systemic
disease modify chronic periodontitis?
a. Emotional stress. b. Smoking.
c. All of the above. d. None of the above.
766. Where can we see an isolated recession on a single
tooth most commonly?
a. Labially prominent canines. b. Occlusal trauma.
c. Vigorous tooth brushing. d. All of the above.
767. What are the radiographic changes seen in teeth that
are not in function?
a. Narrowing of the PDL space.
b. Reduced trabeculation of the bone
c. All of the above. d. None of the above.
768. Which among the following is not a finding associated
with excessive occlusal forces?
a. Ankylosis. b. Cemental tear.
c. Necrosis of the pulp.
d. Periodontal regeneration. e. Root resoprtion.
769. What does bleeding on probing in the absence of local
irritants most probably indicate?
a. Chronic periodontitis. b. Plaque induced gingivitis.
c. Systemic disease. d. Trauma from occlusion.
126 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
770. Which of the following are the two earliest signs of
gingivitis?
a. Bleeding on probing. b. Gingival colour change.
c. Gingival oedema. d. Increased GCF.
e. a and d. f. b and c.
771. Which of the following is the most objective diagnostic
sign of gingivitis?
a. Bleeding on probing. b. Gingival colour change.
c. Gingival edema. d. Increased GCF.
772. Which of the following are features seen in gingival
tissue in sites that bleed on probing?
a. Cell-poor tissue. b. Cell-rich tissue.
c. Collagen-poor tissue. d. Collagen-rich tissue.
e. a and d. f. b and c.
773. Which of the following are the causes of acute gingival
bleeding?
a. Gingival chemical burns.
b. Gingival laceration-tooth brush bristles etc.
c. Gingival thermal burns-hot foods.
d. All of the above. e. None of the above.
774. What duration of plaque presence can elicit gingival
bleeding on probing?
a. 2 days. b. 5 days.
c. 7 days. d. 9 days.
775. Which of the following is not a cause of gingival
bleeding due to systemic changes?
a. Allergy eg. Schönlein-Henoch purpura.
b. Angiogranuloma.
c. Coagulation defects: hemophilia, leukemia.
d. Multiple myeloma.
e. Platelet disorders: thrombocytopenic purpura, Vit K
defiency.
f. Post-rubella purpura.
g. Vitamin C defiency.
127Chapter -2 : Etiology and pathogenesis of periodontal disease
776. PAMP’s refer to
a. Pathogen-associated molecular patterns.
b. Periodontal antigen molecular patterns.
c. Pathogen-associated matrix metalloproteinase.
777. Which of the following is not a metal which when
absorbed therapeutically, accidentally or as an
occupational hazard may change the colour of the
gingiva and the oral mucosa?
a. Arsenic. b. Bismuth.
c. Gold. d. Lead.
e. Mercury. f. Silver.
778. Which of the following metal intoxication causes bluish
black discoloration of the gingival margin?
a. Arsenic. b. Bismuth.
c. Chromium. d. Lead.
779. Gingival metallic pigmentation has been reported
though rarely. What is the shape of metallic
pigmentation seen in gingiva?
a. Circular. b. Linear.
c. Ovoid. d. Patchy.
780. Which of the following is not the cause for endogenous
gingival pigmentation?
a. Bilirubin. b. Iron
c. Carbon monoxide. d. Melanin.
781. Which of the following is not a disease that increases
gingival/oral melanin pigmentation?
a. Addison’s disease.
b. Albright’s syndrome.
c. Peutz-Jeghers syndrome.
d. Tuberculosis.
e. Von Reckling hausen’s disease.
128 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
782. A patient presented with a violet marginal line in his
gingiva. History revealed that he was a goldsmith.
Which of the following metals is responsible for the
same?
a. Arsenic. b. Gold.
c. Lead. d. Silver.
783. Blue-gray discoloration of gingiva-oral mucosa is seen
in ___________.
a. Addison’s disease. b. Hemochromatosis.
c. Peutz-Jeghers sysndrome.
d. Polyostotic fibrous dysplasia.
784. Addison’s disease or hypoadrenocorticism is caused
by adrenal dysfunction. Hyperpigmentation is a
characteristic finding. ______________________
colored pigmentation can be seen in buccal mucosa,
gingiva, lips, palate and ventral surface of the tongue.
(Addison’s disease produces isolated patches of
discoloration varying from)
a. Black. b. Bluish black to brown.
c. Grayish white. d. Yellow.
785. Which of the following changes the position of gingival
margin?
a. Gingival enlargement. b. Gingival pocket.
c. Recession. d. All of the above.
786. Which of the following furcation classification systems
consider both horizontal and vertical bone loss?
a. Easley and Drennan. b. Tarnow and Fletcher.
c. All of the above. d. None of the above.
787. Which one of the following furcation involvement
classification systems classifies the furcation
involvement primarily based on horizontal component
of destruction?
a. Easley and Drennan. b. Tarnow and Fletcher.
c. Glickman.
129Chapter -2 : Etiology and pathogenesis of periodontal disease
788. Herpes labialis is caused by herpes simplex virus. It is
otherwise called as_______________________.
a. Primary herpes. b. Secondary herpes.
c. Strawberry lips. d. Tertiary herpes.
789. Furcation invasion refers to the “pathologic resorption
of bone within a ___________________.”
a. Alveolar bone. b. Furcation.
c. Interdental area. d. Root.
790. A molar with short root trunk is relatively
a. Has better prognosis when furcaly involved.
b. Vulnerable to furcal involvement.
c. All of the above. d. None of the above.
791. What is hypersensitivity associated with?
a. Exposed cementum. b. Exposed dentine.
c. Exposed enamel. d. Exposed periodontal ligament.
792. A molar with long root trunk relatively:
a. Has poor prognosis when furcally involved.
b. Less vulnerable to furcal involvement.
c. All of the above. d. None of the above.
793. Smoking affects the prevalence, extent and severity
of periodontal disease. What type of risk factor is
smoking for periodontaldisease?
a. Modifiable risk factor. b. Local risk factor.
794. Which of the following groups have reduced
inflammation in response to plaque accumulation?
a. Current smokers. b. Nonsmokers.
c. Former smokers.
795. The time needed to recover from local anesthesia
increases in _________________.
a. Diabetes patients. b. Typhoid patients.
c. Current smokers. d. Periodontal patients.
130 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
796. Which of the following condition reduces sub gingival
temperature?
a. Smoking. b. Fever.
c. Periodontal inflammation. d. Drug addiction.
797. Which of the following is the most common form of
periodontitis?
a. Chronic periodontitis.
b. Necrotizing ulcerative periodontitis.
c. Aggressive periodontitis.
d. Periodontitis as a manifestation of systemic disease.
798. Refractory/recurrent periodontitis, periodontitis does
not heed to regular-conventional periodontal therapy.
In which of the following groups do you commonly see
refractory periodontitis?
a. Alcoholics. b. Dark complexioned.
c. Geriatric patients. d. Smokers.
799. Which of the following is not a type of diabetes
Mellitus?
a. Type I diabetes. b. Type II diabetes.
c. Gestational diabetes. d. Cushing’s diabetes.
800. Diabetes leads to a chronic hyperglycemic state,
wherein proteins and matrix macromolecules undergo
a non-enzymatic glycosylation. How are such end
products called?
a. Advanced glycation end products (AGEs).
b. Altered gycation end products (AGEs).
c. Advanced glucose end products (AGEs)
d. Altered glucagon end products (AGEs).
801. Does pregnancy cause gingivitis?
a. Yes.
b. No.
c. Cannot say.
d. May be.
131
802. A woman maintains poor oral hygiene and has
gingivitis. Will her gingivitis be severe during her
pregnancy or otherwise?
a. During pregnancy. b. After parturition.
c. All of the above d. None of the above.
803. Inflamed gingiva in pregnant woman appears as
discrete tumor-like mass. It is referred to as pregnancy
tumor. Histologically it is ____________________.
a. Angiogranuloma. b. Infiltrating lipoma.
c. Fibroma. d. Chondroma.
804. Which of the following is not a cause for recurrence of
periodontal disease in previously treated patient?
a. Improper/inadequate restorations.
b. Inadequate treatment.
c. Incomplete calculus removal.
d. Patient’s noncompliance to return for periodic checkup.
e. Stress.
f. Systemic diseases.
805. What is a factor that increases the probability that the
disease will occur?
a. Compliance factor.
b. Incidence factor.
c. Prevalence factor.
d. Risk factor.
806. Tobacco smoking is a risk factor for the periodontal
disease. Pack years is the number of cigarettes (packs)
smoked per day multiplied by the number of
__________ that an individual smoked.
a. Months.
b. Years.
c. Days.
d. Hours.
Chapter -2 : Etiology and pathogenesis of periodontal disease
132 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
807. The dental calculus is a calcified mass of dental plaque.
The supra gingival calculus is yellowish white in colour
and its colour changes depending on the presence of
pigment in food, tobacco use etc. The subgingival
calculus appears dark brown or greenish black. Which
of the following is the reason for its colour?
a. Leukocytes. b. Dead sub gingival flora.
c. Hemosiderin-hemolysis of RBCs. d. All of the above.
808. The supra gingival calculus is deposited in layers hence
it is heterogenous. It is also termed as____________.
a. Chalky calculus. b. Flint calculus.
c. Salivary calculus. d. Serumal calculus.
809. The subgingival calculus is small and hidden within the
sulcus and is homogenous. It is also termed
as______________.
a. Chalky calculus. b. Flint calculus.
c. Salivary calculus. d. Serumal calculus.
810. Which of the following is not a site of supra gingival
calculus occurrence?
a. Apical to the gingival margin.
b. Buccal surfaces of maxillary molars. (Stensen’s duct)
c. Crowded teeth/malocclusion.
d. Lingual surfaces of the lower incisors (Wharton’s duct
and Bartholin’s duct).
811. Which of the following are the normal adult blood
pressure values?
a. Systolic <120 Diastolic <80.
b. Systolic 120-139 Diastolic 80-89.
c. Systolic 140-159 Diastolic 90-99.
d. Systolic ≥160 Diastolic ≥100.
812. Which of the following adult blood pressure values are
classified as prehypertension?
a. Systolic <120 Diastolic <80.
b. Systolic 120-139 Diastolic 80-89.
133
c. Systolic 140-159 Diastolic 90-99.
d. Systolic ≥160 Diastolic ≥100.
813. Which of the following adult blood pressure values are
classified as stage 1 hypertension?
a. Systolic <120 Diastolic <80.
b. Systolic 120-139 Diastolic 80-89.
c. Systolic 140-159 Diastolic 90-99.
d. Systolic ≥160 Diastolic ≥100.
814. Which of the following adult blood pressure values are
classified as stage 2 hypertension?
a. Systolic <120 Diastolic <80.
b. Systolic 120-139 Diastolic 80-89.
c. Systolic 140-159 Diastolic 90-99.
d. Systolic ≥160 Diastolic ≥100.
815. What is the hypertension that occurs when no
underlying pathologic abnormality can be found to
explain the disease called?
a. Essential/primary hypertension.
b. Prehypertension.
c. Secondary hypertension. d. Stage 2 hypertension.
816. What is the hypertension in which the underlying
etiology can be found and treated referred to?
a. Secondary hypertension. b. Prehypertension.
c. Essential/primary hypertension.
d. Stage 1 hypertension.
817. What is temporary myocardial ischemia that results
when myocardial oxygen demand exceeds supply
termed?
a. Angina pectoris.
b. Congestive heart failure.
c. Hypertension.
d. Infective endocarditis.
Chapter -2 : Etiology and pathogenesis of periodontal disease
134 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
818. Which of the following is a side effect of
antihypertensive drugs of which many patients are
unaware?
a. Depression. b. Gingival overgrowth.
c. Nausea. d. Sedation.
819. What would undiagnosed hypertension, if persistent,
eventually lead to?
a. Coronary heart disease. b. Angina.
c. Myocardial infarction. d. Congestive heart failure.
e. Cerebrovascular accident. f. Kidney failure.
g. All of the above.
820. Which of the following is not a cause of congestive heart
disease?
a. Increased oxygen demand.eg: anaemia, thyrotoxicosis.
b. Increased workload. Eg: hypertension, valvular disease.
c. Myocardial damage: eg myocardial infarction, rheumatic
fever.
d. Nutritional challenges: eg: marasmus, Vit C deficiency.
821. Which of the following is a disease in which
microorganisms colonize the damaged endocardium or
heart valves?
a. Angina pectoris. b. Congestive heart failure.
c. Infective endocarditis. d. Myocardial infarction.
822. Which of the following microorganism is most
commonly encountered in infective endocarditis?
a. α hemolytic streptococcus (Streptococcus viridans).
b. Bacteriodes fragilis. c. Leptotrichia spp.
d. Borrelia burgdorferi.
823. The virion seen as a large, spherical particle in serum
of Hepatitis B patients is termed as
a. Civette bodies. b. Dane particle.
c. Odland bodies. d. Barr bodies.
135
824. Which of the following is a DNA virus?
a. Hepatitis A virus. b. Hepatitis B virus.
c. Hepatitis C virus. d. HIV
825. Hepatitis B and C Virus infection may lead to :
a. Chronic hepatitis. b. Cirrhosis.
c. Liver cancer d. Jaundice
e. Death f. All of the above.
826. Which of the following are oral manifestations of HIV/
AIDS?
a. Kaposi’s sarcoma. b. Oral candidiasis.
c. Acute necrotizing ulcerative gingivitis.
d. Hairy leukoplakia. e. Herpetic infections.
f. Xerostomia. g. Apthous ulceration.
h. Lichen planus/lichenoid reaction.
i. Linear gingival erythema.
j. Necrotizing ulcerative periodontitis.
k. Atypical periodontitis. l. All of the above.
827. A persistent, linear easily bleeding, erythematous
gingivitis has been described in some HIV-positive
patients. It is termed as linear gingival erythema
(LGE). What does the microflora of LGE mimic?
a. Microflora of gingivitis.
b. Microflora of periodontitis.c. All of the above. d. None of the above.
828. Which of the following microorganisms have been
implicated as a cause of linear gingival erythema?
a. Candida dubliniensis.
b. Porphyromonas gingivalis.
c. Prevotella intermedia.
d. Tanerella forsythia.
829. Which of the following is the most infectious?
a. HIV.
b. Hepatitis-B.
c. Hepatitis-C.
Chapter -2 : Etiology and pathogenesis of periodontal disease
136 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
830. What does World Health Organization (WHO) term a
white patch or plaque that does not rub off and cannot
be diagnosed as any other disease?
a. Erythroplakia. b. Leukoplakia.
c. Materia Alba.
831. Which of the following microorganism increases
significantly during pregnancy?
a. Prevotella intermedia
b. Treponema denticoa.
c. Porphyromonas gingivalis.
d. Tanerella forsythia
832. Which of the following cells are destroyed by the
increased levels of female sex hormones?
a. Neutrophils. b. Orogranulocytes.
c. Gingival melanocytes. d. Gingival mast cells.
833. Which of the following is not true about the periodontal
finding in Leukemic patients?
a. Accumulation of leukemic cells in connective tissue-
leukemia cutis.
b. Gingival bleeding.
c. Infiltrating cell type in gingiva-independent of type of
leukemia.
d. Leukemic gingival infiltration- Leukemic gingival
enlargement.
834. What is the abnormal accumulation of leukemic cells
in dermal and subcutaneous connective tissue called?
a. Leukemia cutis. b. Leukemic pigmentation.
c. Leukemic patches. d. Leukemic appearance.
835. Which of the following can be an early sign of leukemia?
a. Bleeding gingiva.
b. Reddish gingiva.
c. Soft and swollen gingiva.
d. Multiple mobile teeth.
137
836. In which of the following conditions, is osteoporosis of
the jaws with a peculiar stepladder alignment of the
trabaculae of the interdental septa.
a. Chédiak-Higashi syndrome b. Down syndrome.
c. Papillon-Lefèvre syndrome. d. Sickle cell anaemia.
837. Which of the following is not a feature seen in Chédiak-
Higashi syndrome?
a. Aggressive periodontitis. b. Healthy periodontium.
c. Mild bleeding disorder. d. Partial albinism.
e. Recurrent bacterial infections.
838. Which of the following are the features of lazy
leukocyte syndrome?
a. Increased susceptibility to aggressive periodontitis.
b. Abnormal inflammatory response.
c. Defective neutrophil chemotaxis.
d. Neutropenia.
e. Susceptibility to microbial infections.
f. All of the above.
839. Which of the following is not a feature of Papillon-
Lefèvre syndrome?
a. Palmar plantar hyperkeratosis
b. Rapid periodontal destruction.
c. Calcification of dura. d. Ossified cartilages.
840. A linear steel gray pigmentation is seen in cases of
lead intoxication. What is it referred?
a. Burtonian line. b. Racial pigmentation.
c. Raspberry gingiva. d. Ptyalism.
841. Which of the following type of bacteria are associated
with gingivitis and periodontitis?
a. Gram-positive.
b. Gram-negative.
c. Aerobic.
d. All of the above.
Chapter -2 : Etiology and pathogenesis of periodontal disease
138 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
842. Which of the following drug does not induce gingival
enlargement?
a. Acetaminophen. b. Calcium-channel blocker.
c. Cyclosporine. d. Phenytoin.
843. Idiopathic gingival fibromatosis is a gingival
enlargement of unknown etiology commonly having a
familial occurrence. Which of the following is not a
designated term for IGF?
a. Tuberous sclerosis. b. Elephantiasis.
c. Gingivomatosis. d. Congenital familial fibromatosis.
844. Which of the following is a syndrome associated with
gingival fibromatosis?
a. Cowden’s syndrome (multiple hamartomas).
b. Zimmerman-Laband syndrome (defects of bone, nail, ear,
and nose, splenomegaly, syndactily).
c. Murray-Purelie Drescher syndrome (multiple dental
hyaline tumors).
d. Rutherford syndrome (corneal dystrophy).
e. Jones syndrome (sensori-neural deafness).
f. Cross syndrome (hypopigmentation with athetosis).
g. All of the above.
845. Which of the following initiates the conditioned gingival
enlargement?
a. Bacterial plaque. b. Phenytoin.
c. Impacted tooth.
846. Which of the following is not true about conditioned
gingival enlargement?
a. Dental plaque initiates conditioned gingival enlargement.
b. Drug-induced gingival enlargements are a type of
conditioned enlargements.
c. Hormonal, nutritional and allergic are types of conditioned
enlargements.
d. Occurs when systemic condition alters the gingival
response to plaque.
139Chapter -2 : Etiology and pathogenesis of periodontal disease
847. Which of the following types of gingival enlargement
is often seen in mouth breathers?
a. Chronic inflammatory gingival enlargement.
b. Conditioned gingival enlargement.
c. Drug induced gingival enlargement.
d. Idiopathic gingival enlargement.
848. Which of the following terms were used in the past to
denote gingival enlargement or gingival overgrowth?
a. Hypertrophic gingivitis. b. Gingival hyperplasia.
c. All of the above. d. None of the above.
849. Which of the following is a generic term used clinically
to designate all discrete tumors and tumorlike masses
of the gingiva?
a. Epulis. b. Gingival enlargement.
c. Gingival overgrowth. d. Gingival hyperplasia.
850. Which of the following is a systemic disease-
granulomatous disease that causes gingival
enlargement?
a. Epilepsy. b. Plasma cell gingivitis.
c. Pyogenic granuloma. d. Wegener’s granulomatosis.
851. Which of the following is not a type of conditioned
gingival enlargement?
a. Allergic (plasma cell gingivitis)
b. Drug induced gingivitis (cyclosporine, sodium valproate.
etc)
c. Hormonal (Pregnancy, puberty).
d. Nutritional (associated with Vit C)
852. Which type of periodontal pocket is seen with horizontal
bone loss?
a. Suprabony pocket.
b. Infrabony pocket.
c. Intrabony pocket.
d. All of the above.
e. None of the above.
140 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
853. A 55 years old female has a localized purulent
inflammation in the periodontal tissues in relation to
her maxillary second premolar. Which of the following
is not a term used to describe.
a. Lateral abscess. b. Parietal abscess.
c. Periodontal abscess. d. Phoenix abscess.
854. What is the radius of action of plaque in causing bone
destruction?
a. 1.5-2.5mm. b. 1-3 mm.
c. 1-2 mm. d. 2.5-3.5mm.
855. Angular defects and buttressing bone formation is seen
in____________.
a. Trauma from occlusion. b. Food impaction.
c. Aggressive periodontitis. d. Furcation involvement.
856. Which of the following is not a type of vertical bony
defect?
a. One wall defect. b. Two wall defect.
c. Three wall defect. d. Combination defect.
e. Exostosis.
857. In which sites three-wall defects frequently occur?
a. Mesial surface of molars.
b. Mesial surface of premolars.
c. Mesial surface of incisors.
d. Distal surface of canines.
858. An individual has a single three wall defect mesial to
his 1st mandibular molar. How many remaining walls
does his three-wall bony defect have?
a. One wall.
b. Two walls.
c. Three walls.
d. Four walls.
e. No walls.
141Chapter -2 : Etiology and pathogenesis of periodontal disease
859. Which of the following Glickman’s grade of furcation
involvement represents partial bone loss/cul de sac in
the furcation area?
a. Grade I b. Grade II
c. Grade III d. Grade IV
860. Severe pressure that forces a tooth-root against the
bone causes bone resorption from the marrow spaces.
What is such type of bone resorption called?
a. Undermining resorption. b. Bone modelling.
c. Frontal bone resorption d. Hyalinization.
861. Which of the following statements are true about
trauma from occlusion (TFO)?
a. TFO may alter the pathway of extension of gingival
inflammation to the underlying tissues.
b. TFO does not affect the gingiva.
c. TFO does not alter the blood supply to marginal gingiva.
d. TFO does not cause gingivitis.
e. TFO does not cause pockets.
f. TFO does not increasegingival crevicular fluid flow.
g. All of the above.
h. None of the above.
862. Which of the following organisms can induce apoptotic
cell death in monuclear and poly morphonuclear cells?
a. Campylobacter rectus.
b. Fusobacterium nucleatum.
c. Peptostreptococcus micros.
d. Treponema denticola.
863. Which of the following bacteria does not induce
apoptotic host cell death?
a. Tannerella forsythia.
b. Fusobacterium nucleatum.
c. Porphyrimonas gingivalis.
d. Peptostreptococcus micros.
142 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
864. Which of the virulence factors of
A.actinomycetemcomitans forms pores in neutrophil
granulocytes, monocytes and some lymphocytes, which
consequently die because of osmotic pressure?
a. Collagenase. b. Leukotoxin.
c. Lipopolysaccharide. d. Protease.
865. Which of the following bacteria are harboured in
significantly higher proportions in mobile teeth in
humans?
a. Campylobacter rectus and Peptostreptococcus micros.
b. Aggregatibacter actinomycetemcomitans and
Fusobacterium nucleatum.
c. Porphyromonas gingivalis and Prevotella intermedia.
d. Tanerella forsythia and Streptococcus milleri.
866. Drifting of tooth into extraction spaces is of common
occurrence. Which of the following teeth generally drift
distally?
a. Incisors. b. Canines.
c. Premolars. d. Molars.
867. Generalized periodontitis is loss of attachment in
________________.
a. 30% sites only. b. 30% or less sites.
c. 30% or more sites. d. All of the above.
e. None of the above.
868. Chronic periodontitis is classified based on severity of
loss of attachment as mild, moderate and severe. What
is the amount of general periodontal destruction to be
considered moderate?
a. 1-2mm. b. 3-4 mm.
c. 4-5mm d. 5mm and above.
869. Which of the following is not a risk factor for chronic
periodontitis?
a. Smoking. b. Type II diabetes.
c. Plaque-retentive factors. d. Fluoridated toothpaste.
143Chapter -2 : Etiology and pathogenesis of periodontal disease
870. NUP features progressive ulceration and destruction
of periodontal attachment. Which of the following is
not a feature of NUP?
a. Periodontal pocket. b. Bone loss.
c. Loss of attachment. d. Interdental osseous craters.
871. Which of the following is not a feature of aggressive
periodontitis?
a. Distolabial rotation of maxillary central incisors.
b. Arc shaped bone loss in relation 1st molars.
c. Robust antibony serum response.
d. Lack of clinical inflammation.
e. Deep interdental osseous craters.
872. Which of the following is not among the gingival and
periodontal diseases seen in HIV infected individuals?
a. Linear gingival erythema.
b. Necrotizing ulcerative gingivitis and periodontitis.
c. Chronic periodontitis.
d. Kaposi’s sarcoma.
873. Attrition is the occlusal wear resulting from functional
contacts of opposing teeth. What are the occlusal or
incisal areas worn by attrition called?
a. Occlusal wear facets. b. Flexure defects.
c. Cuniform defects. d. Saucer shaped defects.
874. Increased tooth mobility is seen in pregnancy. Which
of the following is the probable reason for this increased
tooth mobility?
a. Increased inflammation.
b. Increased levels of relaxin.
c. All of the above.
d. None of the above.
875. Which of the following increase during pregnancy?
a. Cardiac output. b. Heart rate.
c. Tooth mobility. d. All of the above.
144 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
876. Repair is described as healing with______________.
a. Regeneration. b. New attachment.
c. Reconstruction. d. Scar.
877. Which of the following syndromes have the following
characteristics of gingivitis, malocclusion and enamel
hypoplasia?
a. Naegeli-Franceschetti-Jadassohn syndrome
b. Nevoid basal cell carcinoma syndrome
c. Papillon-Lefe‘vre syndrome
d. Sjögren-Larsson syndrome
878. Which one of the following syndromes has the following
characteristics of destructive periodontitis and loosened
teeth?
a. Gardner syndrome.
b. Hyperimmunoglobulin E syndrome.
c. Incontinentia pigmenti.
d. Langerhans cell histiocytosis.
879. Which one of the following sydromes has the following
characteristics of hypomineralization and hypoplasia
of cementum and Generalized progressive
periodontitis?
a. Gardner syndrome.
b. Hyperimmunoglobulin E syndrome.
c. Incontinentia pigmenti.
d. Leukocyte adhesion deficiency syndrome.
880. Which one of the following syndromes has the following
characteristics of palmar-plantar keratosis, periodontal
destruction?
a. Gardner syndrome.
b. Hyperimmunoglobulin E syndrome.
c. Incontinentia pigmenti.
d. Papillon-Lefèvre syndrome.
145
881. Which of the following are the Localized tooth related
factors that modify or predispose to plaque-induced
gingival diseases / periodontitis?
a. Cervical root resorption and cemental tears.
b. Dental restorations/appliances
c. Root fractures d. Tooth anatomic factors
e. All of the above. f. None of the above.
882. The Cervical enamel projection is defined as a dipping
of enamel from the cemento enamel junction towards
and often into the furcation area. Where are the CEP’S
frequently seen?
a. Buccal surface maxillary 2nd molar.
b. Buccal surface-mandibular 1st molar.
c. Buccal surface-mandibular 2nd molar.
d. Buccal surface-maxillary 1st molar.
883. Which of the following statements about cervical
enamel projections are true?
a. CEPs can affect plaque removal.
b. CEPs can complicate scaling and root planning
c. CEPs can predispose furcation involvement.
d. CEPs can retain plaque. e. All of the above.
884. Enamel pearls are ectopic deposits of enamel located
apical to the normal cemento-enamel junction. Large
enamel pearls may contain_______________.
a. Cementum. b. Granulomas.
c. Periodontopathic bacteria. d. Pulp.
885. Intermediate bifurcation ridge is a convex excrescence
of cementum that primarily consists of cementum
connecting the mesial and distal roots of a mandibular
molar. Who described it first?
a. Everett.
b. Hopkins.
c. Masters.
d. Glickman.
Chapter -2 : Etiology and pathogenesis of periodontal disease
146 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
886. Intermediate bifurcation ridge is a convex excrescence
of cementum that primarily consists of cementum
connecting the mesial and distal roots of a mandibular
molar. What is its common site of occurrence?
a. Canine. b. Central incisors.
c. First molar. d. Second molar.
887. Palatogingival groove/Palatogingival groove is a
development groove. Where do we find this anomaly
frequently?
a. Mandibular 1st molars
b. Mandibular lateral incisors.
c. Maxillary 1st molars. d. Maxillary lateral incisors.
888. Palatogingival groove/Palatogingival groove is a
development groove. On radiographs, it appears as
dark lines parallel or imposed on the root canal. What
are these lines termed?
a. Alternate pulpal lines. b. Funnel shaped lines.
c. Parapulpal lines. d. Tubular lines.
889. Extraction of impacted third molars in individuals of
more than ________ age frequently results in the
creation of vertical defects distal to the second molars.
a. 10 years. b. 15 years.
c. 25 years d. 30 years.
890. What is the pathological migration in the occlusal or
incisal direction termed?
a. Extrusion. b. Intrusion.
c. Supra eruption. d. Mesial drift.
891. What is the tooth displacement that results when the
balance among the factors that maintain physiologic
tooth position is disturbed by periodontal disease?
a. Pathological migration.
b. Mesial drifting. c. Distal drifting.
147
892. Which of the following is an early sign of localized
aggressive periodontitis?
a. Gingival inflammation. b. Mesial drifting.
c. Pathologic migration. d. Dentinal hypersensitivity.
893. Which of the following are the causes of food
impaction?
a. Occlusal tooth wear/Extrusion/ Improper restoration.
b. Open contacts/Loss of proximal support.
c. Excessive anterior overbite.
d. Congenital morphologic abnormalities.
e. All of the above. f. None of the above.
894. What are the cusps that tendto forcibly wedge food
interproximally termed?
a. Talon cusp. b. Extruded cusps.
c. Impacted cusps. d. Plunger cusps.
895. Food impaction can be either vertical or lateral food
impaction. Which of the following are the causes of
lateral food impaction?
a. Lateral pressure-Lips. b. Lateral pressure-cheeks.
c. Lateral pressure-tongue. d. All of the above.
896. Which of the following microorganism is not a
predominant microorganism in periodontal health?
a. Actinomyces viscosus. b. Streptococcus oralis.
c. Streptococcus sanguinis. d. Tanerella forsythia.
897. Which of the following microorganism is not
predominantly seen in chronic marginal gingivitis?
a. Actinomyces naeslundii. b. Fusobacterium nucleatum.
c. Prevotella intermedia. d. Streptococcus milleri.
e. Streptococcus sanguinis. f. Veilonella spp.
898. Which of the following microorganism is not
predominant in chronic periodontitis?
a. Actinomyces viscosus.
b. Aggregatibacter actinomycetemcomitans.
Chapter -2 : Etiology and pathogenesis of periodontal disease
148 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
c. Fusobacterium nucleatum.
d. Porphyromonas gingivalis.
e. Prevotella intermedia. f. Tanerella forsythia.
899. Which of the following microorganism is not
predominant in aggressive periodontitis?
a. Actinomyctes viscosus.
b. Aggregatibacter actinomycetemcomitans.
c. Capnocytophaga spp.
d. Poprhyromonas gingivalis.
e. Prevotella intermedia.
900. Which of the following microorganisms do not cause
periodontal disease?
a. Aggregatibacter actinomycetemcomitans.
b. Porphyromonas gingivalis.
c. Prevotella intermedia. d. Streptococcus oralis.
901. Which of the following is not a sign or symptom of food
impaction?
a. Altered/foul taste in the involved area.
b. Feeling of pressure and urge to dig the material from
between the teeth.
c. Gingival ulcer.
d. Periodontal abscess formation. e. Root caries.
902. The embedding of new periodontal ligament fibers into
new cementum and the attachment of gingival
epithelium to a tooth surface previously denuded by
disease is termed as
a. Regeneration b. Repair
c. New attachment d. Epithelial adaptation
903. There is no gain in height of gingival fiber attachment
in epithelial adaptation.
a. True b. False
904. There are temperature variations between subgingival
and sublingual temperature in smokers.
a. True b. False
149
905. What is the immature connective tissue formed during
initial repair?
a. Connective tissue. b. Granulation tissue.
c. Regenerative tissue. d. Scar tissue.
906. Glucose is found in GCF. Its concentration in GCF does
not correlate with the blood glucose levels. Glucose
concentration in GCF is _________________ greater
than that in serum.
a. Four-five times. b. One-two times.
c. Three-four times. d. Two-three times.
907. Which of the following is a non-specific defence factor
in gingival crevicular fluid?
a. B and T lymphocytes. b. IgG, IgM, IgA.
c. Immunoglobulin G. d. Complement system.
908. Which of the following is a specific defence factor in
gingival crevicular fluid?
a. IgG. b. Lactoferrin.
c. Macrophages. d. Polymorphs.
909. .Which of the following is not a clinical feature of
periodontal abscess?
a. Generally dull pain/less-severe pain.
b. Non vital tooth/Apical rarefaction.
c. Periodontal pocket is present.
d. Swelling precedes pain.
910. Trauma from occlusion is generally reversible and it
does not lead to____________________.
a. Hypercementosis. b. Periodontal pocketing.
c. Root resorption.
d. Widening of periodontal ligament space.
911. Trauma from occlusion is generally ______________
and it does not lead to periodontal pocketing.
a. Irreversible.
b. Reversible.
Chapter -2 : Etiology and pathogenesis of periodontal disease
150 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
912. Trauma from occlusion in the presence of
___________________ and gingival inflammation can
lead to periodontal pocketing.
a. Dental calculus. b. Dental plaque.
c. Gingivitis. d. Herpetic ulcers.
913. Trauma from occlusion may act as a co-factor in the
etiology of the periodontal disease. Which of the
following is not its Radiographic sign?
a. Angular bone loss. b. Horizontal bone loss.
c. Hypercementosis.
d. Possible thickening of lamina dura.
e. Root resorption. f. Widening of PDL space.
914. Trauma from occlusion may act as
______________________________ in the aetiology of
the periodontal diseases.
a. Aggravating factor. b. Cofactor.
c. Contributing factor. d. Prime factor.
e. a, b and c f. b, c and d
915. What is the process of new blood vessels formation?
a. Angiogenesis. b. Osteogenesis.
c. Amelogenesis. d. Odontogenesis.
916. Can periodontopathic bacteria get transmitted within
family members?
a. Cannot say. b. Never possible.
c. No. d. Yes.
917. The host derived enzymes identified in periodontal
disease include
a. Matrix metalloproteinase
b. Tissue Inhibitors of Metalloproteinases (TIMP’s)
c. Aspartate aminotransferase
d. Alanine aminotransferase
e. Alkaline phosphatase f. Creatine kinase
g. Lactate Dehydrogenase h. Acidic phosphatase
i. Gama glutamyl transferase j. Beta-glucuronidase
k. All of the above
151
918. DSR – Digital Subtraction Radiography has
advantages over conventional radiography with the use
of positioning device during film exposure and
specialized software for image analysis.
a. True b. False
919. Ptyalism is frequently seen along with intoxication of
a. Bismuth b. Lead
c. Mercury d. Arsenic
920. Lipping refers to
a. Exostoses b. Root trunk anatomy
c. Buttressing bone formation d. Crestal angulation
921. TTV or Transfusion transmitted virus produces
a. Agranulocytosis b. Leukemia
c. Immunodeficiency d. Hepatitis
922. Advanced bone loss with Grade III furcation
involvement has
a. Fair prognosis b. Poor prognosis
c. Questionable prognosis d. Hopeless prognosis
923. An isolated, sessile or pedunculated tumor-like
enlargement of gingiva is called_________________
gingival enlargement.
a. Diffuse b. Discrete
c. Marginal d. Papillary
924. Gingival recession refers only to the location of the
gingiva and not its condition.
a. False. b. True
925. Miller’s class II recession is always associated with
dehiscence. Is this statement true?
a. It’s true. b. No it is false. c. Cannot say.
926. In inflamed gingiva, mast cells presence is proportional
to the increase in the
a. Gingival health. b. Gingival width.
c. Nutritional status. d. Severity of Inflammation.
Chapter -2 : Etiology and pathogenesis of periodontal disease
152 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
927. The lesions that are located outside the shadow of PDL
and lamina dura does not include
a. Periapical cemental dysplasia b. Condensing osteitis
c. Focal periapical osteopetrosis d. Hypercementosis.
928. Histopathologic criteria used to distinguish gingivitis
from periodontitis
a. Bone resorption b. Sulcular epithelial hyperplasia.
c. Endosteal proliferation d. Howship’s lacunae
929. Mesenteric line or black line is
a. Green stain present on the labial surface of incisors and
canines in both upper and lower jaws, which is relatively
difficult to remove.
b. Continuous bluish pigmented line on the free gingival
margin of all teeth.
c. Brown stain present on the posterior teeth,separated from
the gingival margin by an unstained band of tooth surface
1-2mm wide, which can be removed with a scaler.
d. None of the above
930. Woody sensation is seen in
a. Adult periodontitis b. Juvenile periodontitis
c. ANUG d. Desquamative gingivitis
931. Organoleptic rating is done to assess
a. Pocket depth b. Mobility
c. Halitosis d. All of the above.
932. Which of the following is not an entity in classification
of the clinical entity-desquamative gingivitis?
a. Mild b. Moderate
c. Severe. d. Advanced.
933. Desquamative gingivitis is a
__________________________:
a. Chronic condition. b. Acute condition.
c. Sub-acute condition. d. All of the above.
e. None of the above.
153
934.Which of the following statements are helpful in
differential diagnosis between Primary herpetic
gingivostomatitis (PHG) and Recurrent apthous
stomatitis (RAS)?
a. Only in RAS-a history of previous episodes.
b. Only in PHG-Diffuse erythematous involvement of
gingiva.
c. Only in PHG-Acute toxic systemic symptoms.
d. RAS heals with (larger RAS) or without (smaller) scarring
while, PHG heals without scarring.
e. All of the above. f. None of the above.
935. Which type of desquamative gingivitis is extremely
painful?
a. Mild. b. Moderate.
c. Severe. d. All of the above.
e. None of the above.
936. Which of the following is not a disease considered in
differential diagnosis of dequamative gingivitis?
a. Chronic Ulcerative Stomatitis.
b. Dermatitis Herpetiformis.
c. Erythema Multiforme.
d. Herpetic gingivostomatitis. e. Lichen Planus.
f. Linear IgA Disease. g. Lupus Erythematosus.
h. Pemphigoid. i. Pemphigus Vulgaris.
937. Slight rubbing of the gingiva/ skin can lead to a ready
exfoliation of outer layers forming a blister within
minutes in the presence of vesiculobullous disorder.
What is this sign referred to?
a. Nikolsky’s sign. b. Gorlin’s sign.
c. Hutchinson sign. d. Hippocaites sign.
938. The mild form of desquamative gingivitis is common in
_____________________.
a. 17 – 23 years aged females. b. 17-23 years aged males.
c. 30 – 40 years aged females d. 30 – 40 years aged males.
Chapter -2 : Etiology and pathogenesis of periodontal disease
154 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
939. Which of the following is not a feature of clinical
gingivitis?
a. Intrabony pocket. b. Oedematous gingiva.
c. Bleeding on probing. d. Loss of stippling.
e. Gingival pocket.
940. Small, triangular radiographic translucency can be seen
across the mesial or distal roots of maxillary 1st and 2nd
molar teeth. What are these translucencies termed?
a. Angular arrows. b. Furcation arrows.
c. Furcation shades. d. Furcation shadows.
941. Can furcation arrows be seen in Furcation involved
Mandibular 3rd molar?
a. Cannot say. b. No. c. Yes.
942. Loss of attachment will be equal to pocket depth when:
a. Epithelial attachment is at cement-enamel junction but
depth of pocket is increased.
b. Gingival margin is 2 mm apical to cement enamel junction.
c. Gingival margin is 2 mm coronal to cement enamel junction.
d. Gingival margin is at cementoenamel junction.
943. What is the best way to differentiate between acute
periapical abscess and acute periodontal abscess?
a. Palpitation. b. Percussion.
c. Radiographs. d. Vitality test.
944. Which of the following is the most important clinical
evidence that helps in differentiating acute periodontal
abscess from periapical abscess?
a. Intensity of the pain. b. Type of swelling.
c. Periodontal probing results. d. All of the above.
945. A retrospective study showed an association between
untreated occlusal discrepancies and __________ rate
of periodontitis.( Harrel & Nunn (2001))
a. increased b. unchanged
c. decreased
155
946. Which of the following is the most common predominant
pathogen found among the persons with periodontal
disease (Moore & Moore (1994))?
a. E. corrodens. b. P. intermedia.
c. F. nucleatum. d. P. gingivalis
947. In which type of periodontitis patients would you advise
bacterial culturing and sensitivity test of subgingival
plaque sample?
a. Aggressive periodontitis. b. Chronic periodontitis.
c. Necrotizing periodontitis. d. Refractory periodontitis.
948. Which of the following describes the histopathology of
chronic gingivitis?
a. Infiltration by predominately T cells.
b. Infiltration of neutrophils, lymphocytes and plasma cells.
c. Infiltration predominated by neutrophils and T cells.
d. Infiltration predominated by neutrophils.
949. What is the value of fasting plasma glucose which is a
diagnostic criterion for diabetes mellitus?
a. ≥110 mg/dl. b. ≥126 mg/dl.
c. ≥70 mg/dl. d. ≥80 mg/dl.
950. Fasting plasma glucose is used a routine test to
diagnose diabetes mellitus. What is the duration of no
caloric intake defined as fasting?
a. 16 hours. b. 2 hours.
c. 4 hours. d. 8 hours.
951. Acquired immune deficiency syndrome (AIDS) includes
all patients with CD4
+ cell counts of less than
_________________ per microliter.
a. 150. b. 200.
c. 280. d. 300.
952. Which of the following are possible oral manifestations
or have an association with hepatitis C infection?
a. Lichen planus.
b. Salivary gland disease: Sjögren-like sialadenitis.
c. All of the above. d. None of the above.
Chapter -2 : Etiology and pathogenesis of periodontal disease
156 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
953. What is the transmission of infectious agents between
patients and staff within a clinical environment called?
a. Cross infection. b. Mode.
c. Route of transmission. d. Vehicle.
954. What are individuals, who are merely recognized
because of the presence of specific antibodies in the
person’s blood and who give no history of infection as
they may have unknowingly had a non-apparent or
subclinical infection, called?
a. Asymptomatic carriers. b. Convalescent carriers.
c. Individuals in prodromal stage of infection.
955. A dentist is carrying over a periodontal procedure in a
dental clinical set-up. Which of the following can be
the modes for transmission of infection in dentistry?
a. Direct contact. b. Airborne spread.
c. Contaminated sharps. d. All of the above.
e. None of the above.
956. What is a source of infection/the person with the
infection called?
a. Index case. b. Mode.
c. Vehicle. d. Route of transmission.
957. Which of the following protective barriers a dentist,
while carrying out dental treatment, should use?
a. Gloves. b. Eye shields.
c. Face masks. d. Rubber dam isolation.
e. All of the above.
958. Which of the following has highest average risk of
transmission after percutaneous exposure?
a. HIV.
b. Hepatitis-B.
c. Hepatitis-C.
d. All of the above.
e. None of the above.
157
959. What is the process that kills or removes all the
organisms and their spores in a material or an object
termed?
a. Sterilization. b. Disinfection.
c. Antisepsis. d. Decontamination.
960. What is the process that kills or removes pathogenic
organisms in a material or an object termed?
a. Sterilization. b. Disinfection.
c. Antisepsis. d. Decontamination.
961. What is the application of a chemical agent externally
on a live surface (skin or mucosa) to destroy organisms
or to inhibit their growth termed?
a. Sterilization. b. Disinfection.
c. Antisepsis. d. Decontamination.
962. Which of the following spores are used to test the
efficacy of steam autoclaves?
a. Bacillus stearothermophilus -spores
b. Bacillus subtilis -spores
c. All of the above.
d. None of the above.
963. Which of the following spores are used to test the
efficacy of dry heat and ethylene oxide sterilization?
a. Bacillus stearothermophilus -spores
b. Bacillus subtilis -spores
c. All of the above.
d. None of the above.
964. Reprocessing/decontamination is a process by which
reusable items are rendered safe. What does it entail?
a. Cleaning.
b. Disinfection.
c. Sterilization.
d. All of the above.
e. None of the above.
Chapter -2 : Etiology and pathogenesis of periodontal disease
158 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
PERIODONTAL THERAPY
965. A patient shows signs of plaque-induced gingivitis, and
his gingiva bleeds on probing. He wants to know how
long will it take for his gingiva to stop bleeding on
probing from his commencement of continued plaque
control measures.
a. 7 days or more. b. 5 days or more.
c. 9 days or more. d. 14 days or more.
966. Which of the following is not a method to measure
adequacy of attached gingiva?
a. Rolls test. b. Measuring the width.
c. Staining with schiller’s potassium iodide solution.
d. Butterfly test.
967. Which of the following is not a part of Phase I therapy?
a. Scaling and root planing. b. Antimicrobial therapy.
c. Occlusal therapy. d. Endodontictherapy.
968. What are the other terms used to describe Phase IV
therapy?
a. Maintenance therapy. b. Periodic rechecking.
c. Supportive periodontal therapy. d. All of the above.
969. A periodontal probe is a calibrated slender instrument.
Which of the following are the uses of periodontal
probe?
a. To Measure the depth of the gingival sulcus.
b. To measure the width of attached gingiva.
c. To measure clinical attachment levels.
d. To assess for the presence of bleeding.
e. All of the above.
159Chapter -3 : Periodontal therapy
970. Which of the following are the uses of a periodontal
probe in relation to a periodontal pocket?
a. To locate the periodontal pocket.
b. To measure the depth of the periodontal pocket and
measure the loss of attachment.
c. To mark the outline of periodontal pocket.
d. To determine the configuration of a periodontal pocket
and the course of the periodontal pocket.
e. All of the above.
971. A 50 years male patient had a fixed prosthesis in his
central incisor. The crown margin is subgingival and
the patient has developed circumferential marginal
gingival inflammation-dull blue/deep red colour of the
gingival margin. What is the reason for the same?
a. Violation of attached gingiva.
b. Violation of biological width.
c. Violation of keratinized gingiva.
d. Violation of marginal gingiva.
972. What does <7% levels of Glycosylated hemoglobin
assay (Hb A1C) mean?
a. Normal.
b. Good diabetes control.
c. Moderate diabetes control.
d. Action suggested to improve diabetes control.
973. What is the common route of Hepatitis B virus among
dental health care workers?
a. IV drug abuse. b. Percutaneous injury.
c. Blood transfusion. d. Mother to child.
974. Which of the following is 10% doxycycline in a gel
system-local drug delivery?
a. Arestin.
b. Atridox.
c. Elyzol.
d. Periochip.
160 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
975. Which of the following is the available locally delivered
sustained release form of minocycline microspheres for
subgingival placement?
a. Arestin. b. Atridox.
c. Periochip. d. Elyzol.
e. All of the above.
976. What does the local drug (antiseptic) delivery system,
Perio-chip, contain?
a. Minocycline. b. Chlorhexidine.
c. Metronidazole. d. Tetracycline.
977. Which of the pregnancy trimesters is recommended for
carrying out dental treatment?
a. First trimester. b. Second trimester.
c. Third trimester. d. All of the above.
978. Which of the following drugs is not safe in pregnancy?
a. Acetaminophen. b. Cephalosporin.
c. Penicillin. d. Tetracycline.
979. A pregnant patient visiting a dentist should not be
seated reclined on the dental chair. Growing uterus may
cause partial blockage of venous return through the
vena cava, and it maybe associated with decreased
perfusion of the fetus. Name the above condition?
a. Supine hypotension syndrome.
b. Semi-reclined hypotension syndrome.
c. Supine hypertension syndrome.
d. Reclined hypertension syndrome.
980. How should a pregnant patient be seated on a dental
chair to avoid supine hypertension syndrome?
a. By placing the patient on her left side.
b. By raising patient’s right hip several inches.
c. All of the above.
981. Periodontal emergencies include:
a. ANUG b. Acute pericoronitis
c. Acute herpetic gingivostomatitis d. All of the above
161Chapter -3 : Periodontal therapy
982. Interdental brushes are used to clean large, irregular
or concave tooth surfaces.
a. True b. False
983. Subgingival irrigation with specialized tips for deep
pockets and furcation areas is also called Lavage or
Flushing of Periodontal pocket.
a. True b. False.
984. Which of the following are true about massaging the
gingiva?
a. Produces epithelial thickening
b. Increases keratinization of oral gingiva only without any
change in sulcular epithelium and col.
c. Increases mitotic activity of epithelium and connective
tissue
d. Done with tooth brush or interdental cleaning device
e. Does not restore gingival health like chemotherapeutic
mouthrinses
f. All of the above
985. Does chewing gums reduce the plaque interdentally or
at the gingival margin?
a. Yes. b. No.
986. What are the sequential steps of 4A’s in aiding smokers
to quit smoking?
a. Advise, ask, arrange and assist.
b. Ask, advice, assist and arrange.
c. Ask, assist, arrange and aid.
d. Ask, assist, manage and assist.
987. How are the smokers classified based on their desire
to quit smoking?
a. Active and passive smokers.
b. Chain, regular and irregular smokers.
c. Pre-contemplators, contemplators and active quitters.
d. Smokers and non-smokers.
162 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
988. Which of the following are considered as vibratory
techniques of tooth brushing?
a. Bass technique. b. Charter technique.
c. Stillman technique. d. All of the above.
e. None of the above.
989. Which of the following techniques involves the placing
of the tooth brush bristles at a 45o angle to the long
axis of the teeth and vibrating in the anterior-posterior
direction for plaque removal?
a. Bass method. b. Charter method.
c. Stillman method.
990. Which of the following are crystallization inhibitors seen
in toothpaste formulations to prevent calculus
formation?
a. Soluble pyrophosphates. b. Zinc citrate.
c. Polymer system (Gantez). d. All of the above.
e. None of the above.
991. Toothbrush bristles are grouped in tufts. They are
generallyarranged in three or four rows. Bristle
hardness is proportional to the _________.
a. Square of the bristle diameter.
b. Square of the bristle length.
c. Square of the tooth brush head
d. All of the above. e. None of the above.
992. Which of the following is not caused by vigorous and
harsh brushing?
a. Bacteremia. b. Gingival massage.
c. Gingival recession. d. Gingival ulceration.
e. Wedge shaped cervical tooth wear.
993. Tooth brush is the most used plaque control device.
How frequent should an individual replace the
toothbrush?
a. 3 months. b. 6 months.
c. 9 months. d. 1 month.
163
994. Powered tooth brushes are relatively new type of
toothbrushes. In which of the following groups is
powered toothbrush not of much use?
a. Children with disabilities. b. Children.
c. Chronic periodontitis patients.
d. Fixed orthodontic appliance users.
e. Institutionalized patients. f. Poor brushers.
995. Which of the following tooth brushing technique has a
rolling pattern of motion?
a. Fones technique. b. Leonard technique.
c. Modified stillman’s technique. d. Stillman’s technique.
996. Which of the following tooth brushing technique has a
rolling pattern of motion?
e. Fones technique. f. Leonard technique.
g. Roll method. h. Stillman’s technique.
997. Which of the following techniques does not have a
vibratory pattern of motion?
a. Bass technique. b. Charters technique.
c. Roll technique. d. Stillman technique.
998. Which of the following tooth brushing technique has a
circular pattern of motion?
a. Fones technique. b. Leonard technique.
c. Roll method. d. Stillman’s technique.
999. Which of the following tooth brushing technique has a
vertical pattern of motion?
a. Fones technique. b. Leonard technique.
c. Roll method. d. Stillman’s technique.
1000. Which of the following tooth brushing technique has a
horizontal pattern of motion?
a. Fones technique.
b. Leonard technique.
c. Scrub technique.
d. Stillman’s technique.
Chapter -3 : Periodontal therapy
164 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1001. Which of the following tooth brushing techniques is the
simplest and most frequently used?
a. Fones technique. b. Leonard technique.
c. Scrub technique. d. Stillman’s technique.
1002. Which of the following tooth brushing techniques is the
most recommended for the periodontal patients?
a. Bass technique. b. Fones technique.
c. Leonard technique. d. Stillman’s technique.
1003. Tooth brushing alone does not clean the interdental
plaque completely. Which of the following is not a
recommendation criterion for selecting different
interdentalcleaning aids?
a. Fixed Prosthesis. b. Furcation involvement.
c. Interdental architecture. d. Orthodontic appliance.
e. Tooth alignment. f. Tooth size.
1004. Which of the following is not a commonly used aid for
interdental cleaning?
a. Dental floss. b. Gauze piece.
c. Interdental brushes. d. Wodden/plastic tips.
1005. Which of the following is not a factor influencing the
selection of the type of dental floss?
a. Manual dexterity.
b. Roughness of proximal surfaces.
c. Size of the tooth. d. Tightness of tooth contacts.
1006. Which of the following are not among the various types
of dental floss?
a. Bonded or nonbonded. b. Soft or hard.
c. Thick or thin. d. Twisted or non-twisted.
e. Waxed or unwaxed.
1007. Irrigation in the dental office is sometimes performed
as a onetime treatment after scaling and root planning.
What is it referred to as?
a. Flushing of the periodontal pocket. b. Lavage.
c. All of the above. d. None of the above.
165
1008. What is the instrumentation of the crown and root
surfaces of the teeth to remove plaque, calculus, and
stains from these surfaces termed?
a. Scaling. b. Root planning.
c. Curettage. d. ENAP.
1009. What is the process of debriding the soft tissue wall of
a periodontal pocket termed?
a. Gingival curettage. b. Scaling.
c. Inadvertent curettage. d. Root planing.
1010. What is the treatment procedure designed to remove
cementum or surface dentin that is rough, impregnated
with calculus, or contaminated with toxins or
microorganisms termed?
a. Root planing. b. Scaling.
c. Curettage.
1011. What is the some degree of curettage done
unintentionally when scaling and root planing are
performed called?
a. Curettage. b. Gingival curettage.
c. Inadvertent curettage. d. Subgingival curettage.
1012. Which of the following procedures can lead to transient
bacteremia in patients?
a. Scaling.
b. Subgingival irrigation-periodontitis patients.
c. Supportive periodontal therapy. d. Tooth brushing.
e. All of the above. f. None of the above.
1013. Which of the following bacteria are involved in root
caries?
a. Lactobacillus. b. Salmonella.
c. Streptococcus. d. Vibrio.
e. a and c. f. b and d.
Chapter -3 : Periodontal therapy
166 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1014. Which of the following are the localized reversible side
effects to chlorhexidine rinse?
a. Brown staining of the teeth.
b. Brown staining of tooth colored restorations.
c. Transient impairment of taste perception.
d. All of the above. e. None of the above.
1015. What is the percentage of chlorhexidine prescription
available in US?
a. 0.12% b. 0.2%
c. 0.3% d. 0.4%
1016. Which of the following are the contents of essential oil
mouth rinse?
a. Eucalyptol. b. Menthol.
c. Methyl salicylate. d. Thymol.
e. All of the above. f. None of the above.
1017. Which of the following is the vehicle used to deliver
active ingredients in case of essential oil mouth rinse?
a. Alcohol-Ethanol-Ethyl alcohol. b. Methanol.
c. Phenol. d. Propanol.
1018. Which of the following terms are used to describe the
methods used by the patient to remove plaque?
a. Home care. b. Oral hygiene.
c. Oral physiotherapy. d. Personal oral hygiene.
e. Personal plaque control. f. All of the above.
1019. In which of the following situations is Charters technique
advised?
a. Gingival message. b. Open interdental embrasures.
c. Post periodontal surgical healing phase.
d. All of the above. e. None of the above.
1020. Which of the following tooth brushing techniques is
advised during post periodontal plastic surgery and in
cases of recession?
a. Bass technique. b. Fones technique.
c. Leonard technique. d. Modified Stillman’s technique.
167
1021. Which of the following is the most widely recommended
tool for removing plaque from proximal tooth surfaces?
a. Dental floss. b. Interdental brushes.
c. Wodden picks. d. Rubber tips.
1022. Which of the following type of floss is useful under
bridges and in open embrasure spaces?
a. Non-twisted floss. b. Super floss.
c. Thin floss. d. Waxed floss.
1023. Which of the following wodden tooth picks shapes are
effective on the lingual aspects of posterior proximal
surfaces?
a. Irregular. b. Rectangular.
c. Round. d. Triangular.
1024. Chlorehexidine has bactericidal activity against
a. Gram negative bacteria. b. Gram positive bacteria.
c. All of the above. d. None of the above.
1025. Which of the following are the modes of administration
of chlorhexidine?
a. Mouth rinse. b. Gel.
c. Spray. d. All of the above.
e. None of the above.
1026. Which of the following tooth-paste ingredients interact
and inactivate chlorehexidine?
a. Anionic detergents. b. Colouring agents/pigments.
c. Flavoring agents. d. Hydrated silica.
1027. Which of the following is the gold standard in chemical
plaque control?
a. Chlorehexidine. b. Listerine.
c. Pyrophosphate. d. Triclosan.
1028. Which of the following is not a side effect of
chlorhexidine mouth rinse?
a. Brown discoloration of teeth/restoration.
b. Brown staining of the tongue.
Chapter -3 : Periodontal therapy
168 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
c. Desquamative lesions of oral mucosa.
d. Increased supragingival calculus formation.
e. Leukoplakia.
1029. Brown discolouration of teeth and fillings is a side effect
seen with chlorhexidine use, and is also seen with other
____________.
a. Anionic antiseptics. b. Cationic antiseptics.
c. Organic antiseptics. d. Synthetic antiseptics.
1030. Individuals with healthy periodontium can prevent
gingivitis by thorough plaque control every
_______________ hours.
a. 12. b. 24.
c. 36. d. 48.
1031. Which of the following is a device that resembles a
dental hand piece and is used in evaluating the tooth
mobility and the clinical success of dental implants?
a. Evaluatie. b. Fremitus test.
c. Mobilimeter. d. Periotest®.
1032. Selective grinding is the ____________ reshaping of
the occlusal surface.
a. Irreversible. b. Non-reversible.
c. Permanent. d. Reversible.
e. Temporary. f. a,b and c.
g. c and d.
1033. Bite appliance (Night guard) is ___________approach
in treatment of occlusion.
a. Irreversible. b. Reversible.
c. All of the above. d. None of the above.
1034. Which of the following is a purpose built electronic
device to evaluate tooth mobility?
a. Evaluatie. b. Fremitus test.
c. Miller’s classification. d. Periotest®
169
1035. What are the advanced devices or methods that help
in measuring tooth mobility?
a. Laser Doppler vibrometry. b. Periotest®.
c. All of the above. d. None of the above.
1036. Furcation is best detected by:
a. Marquis color coded probe. b. Naber’s probe.
c. University of Michigan ‘O’ probe. d. WHO probe
1037. The probe designed to detect furcation involvement is
a. CPITN probe. b. University of Michigan ‘O’ probe.
c. Naber’s probe. d. William’s probe
1038. Which of the following is a periodontal probe not
designed to detect furcation involvement?
a. Naber’s probe. b. Cow-horn probe.
c. ZA probe. d. UNC-15 probe.
1039. Which of the following are the most common bony
lesions described and encountered in periodontal
disease?
a. Dehiscence. b. Exostosis.
c. Interdental craters. d. Tori.
1040. What is Reverse bony architecture?
a. Fenestration. b. Funnel defect.
c. Inconsistent bony margin. d. Osseous crater.
1041. Which of the following multi rooted teeth has least
prevalence of furcation involvement?
a. Maxillary 1st molar. b. Mandibular 1st molar.
c. Mandibular 2nd molar. d. Maxillary 2nd molar.
e. Maxillary 1st premolar.
1042. Ochsenbein had classified the maxillary and mandibular
osseous craters based on their dimension from crest
of facial/lingual bone to crater base. Which of the
following is his classification?
a. Shallow crater (1-2mm), Medium crater (3-4 mm),deep
crater (≥5mm)
b. Shallow crater (1-3mm), Medium crater (4-5 mm),deep
crater (=6mm)
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c. Shallow defect (1-3mm), Medium defect (4-5 mm),deepdefect (≥6mm)
d. Initial crater (1-2mm), established crater (3-4 mm),
advanced crater (≥5mm)
1043. Which of the following periodontal instruments is useful
in the measurement of clinical attachment level?
a. Mobilimeter. b. Periodontal probe.
c. Periotron. d. Ultrasonic scaler.
1044. Which of the following are the contraindications of
ultrasonic scalers?
a. Unshielded cardiac pacemakers.
b. Patients with known communicable diseases transmitted
by aerosols.
c. Patients at risk for respiratory disorders.
d. All of the above. e. None of the above.
1045. In Glickman’s Grade I furcation involvement, one can
feel the depression of furcation opening using a Naber’s
probe. What is Grade I furcation involvement otherwise
called?
a. Cul-de-sac. b. Incipient bone loss.
c. Through and through. d. None of the above.
1046. Glickman’s Grade II furcation involvement is
characterized with partial bone loss where a probe tip
could reach the roof of the furcation. What is Grade II
furcation involvement called?
a. Cul-de-sac. b. Incipient bone loss.
c. Through and through. d. None of the above.
1047. Glickman’s Grade IV furcation involvement is
characterized by a total furcal bone loss with the
furcation entrance being visible clinically. What is this
Grade IV furcation?
a. Cul-de-sac. b. Incipient bone loss.
c. Through and through. d. None of the above.
171
1048. What are grade III furcation involvement in Glickman
(1953) and Goldman’s (1958) classification of furcation
involvement?
a. Incipient lesion. b. Cul-de-Sac.
c. Through and through lesion.
d. Through and through lesion with gingival recession.
1049. What are grade I furcation involvement in Glickman
(1953) and Goldman’s (1958) classification of furcation
involvement?
a. Incipient lesion. b. Cul-de-sac.
c. Through and through lesion.
d. Through and through lesion with gingival recession.
1050. What are grade II furcation involvement in Glickman
(1953) and Goldman’s (1958) classification of fuctaion
involvement?
a. Incipient lesion. b. Cul-de-sac.
c. Through and through lesion.
d. Through and through lesion with gingival recession.
1051. The ball of the index finger is applied along the lateral
aspect of the gingiva and pressure is applied in a rolling
motion towards the crown. The test is :
a. Known as tension test. b. Known as fremitus test.
c. Used to check the consistency of gingiva.
d. Used to check the presence or absence of exudates in
the periodontal pocket.
1052. Which of the following are tests to check blood glucose
levels?
a. Fasting blood sugar. b. Glucose tolerance test.
c. Postprandial glucose test. d. All of the above.
e. a and b only.
1053. Periodontal baseline date refers to clinical information
gathered prior to __________.
a. Maintenance phase. b. Periodontal surgery.
c. Periodontal therapy. d. Restorative phase.
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172 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1054. Which of the following are true for the use of
tetracyclines in periodontics?
a. They have the ability to concentrate in periodontal tissues.
b. They inhibit the growth o aggregatibacter
actinomycetemcomitans.
c. They exert anticollagenase effect-inhibit tissue
destruction.
d. All of the above. e. None of the above.
1055. Which of the following is the only antibiotic in
periodontal therapy to which all strains of
A.actinomycetemcomitans are susceptible?
a. Ciprofloxacin. b. Erythromycin.
c. Amoxicillin. d. Macrolides.
e. Tetracycline.
1056. Which of the following are periodontal risk factors?
a. Diabetes mellitus. b. Psychosocial stress.
c. Smoking. d. All of the above.
e. None of the above.
1057. Which of the following is the drug of choice in treatment
of ANUG?
a. Amoxicillin(500 mg every 6hours (qid) for 10 days)
b. Erythromycin(500mg qid)
c. Metranidazole (Flagyl) (500mg bd×7days/200tid×4days)
d. Tetracycline.
1058. Which brushing technique is recommended for
temporary cleaning following periodontal surgery?
a. Bass method. b. Charter’s technique.
c. Modified stillman’s method. d. Modified bass method.
1059. A patient returned to the dentist one week after supra
gingival scaling and prophylaxis. Dark, hard deposits
of calculus were noted at the gingival margin. What
does this indicate?
a. Calcified blood clots. b. Food pigments.
c. Recurrent calculus formation.
d. Shrinkage of tissue due to reduction in inflammation has
revealed subgingival calculus.
173
1060. Fremitus test is used to check
a. The frenal attachment. b. The mobility of the teeth.
c. The depth of the gingival sulcus.
d. The trauma from occlusion.
1061. What is the normal value of HbA1c?
a. 4-6%. b. 7%
c. <7.5% d. 8%
1062. What is the use of small electric current to introduce
sodium fluoride and/or corticosteroids into the dentinal
tubules?
a. Ionization. b. Iontophoresis.
c. Michigan movement. d. Oxigination.
1063. Which of the following can be a treatment for sensitive
dentine?
a. Fluorides. b. Copal varnish.
c. Potassium oxalate. d. Strontium chloride.
e. Dentine-bonding agents. f. Sealants.
g. Dental restoration. h. All of the above.
i. None of the above.
1064. Tooth with furcation involvement are difficult to treat.
Their treatment varies based on the severity. Which
among the following is not a treatment option for
furcation involvement?
a. Bone graft and Guided tissue regeneration (GTR).
b. Excisional biopsy. c. Odontoplasty.
d. Scaling and root planning. e. Tunnel preparation.
1065. Which of the following tests is no longer used in
establishing the diagnosis of diabetes?
a. Casual blood glucose.
b. Fasting blood glucose.
c. HbA1C
d. Urinary glucose analysis.
Chapter -3 : Periodontal therapy
174 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1066. Which of the following are the signs and symptoms of
undiagnosed/poorly controlled diabetes?
a. Polydipsia. b. Polyuria.
c. Polyphagia. d. Ketoacidosis.
e. All of the above. f. None of the above.
1067. Ketoacidosis is usually associated with severe
hyperglycemia and occurs primarily in
_______________________.
a. Drug induced diabetes. b. Gestational diabetes.
c. Type I diabetes. d. Type II diabetes.
1068. Which of the following laboratory methods is not
recommended for routine clinical use in diagnosing
diabetes?
a. Fasting plasma glucose.
b. Non-fasting/casual plasma glucose.
c. Oral glucose tolerance test.
d. Random plasma glucose.
1069. Which of the following are the normal fasting plasma
glucose levels?
a. <110 mg/dl. b. ≥110 mg/dl
c. <126 mg/dl d. ≤126 mg/dl.
1070. What is the best laboratory method of determining
glycemic control in a diabetic patient?
a. Casual plasma glucose.
b. Fasting plasma glucose.
c. Glycosylated, hemoglobin assay.
d. Oral glucose tolerance test.
1071. Which of the following are glycosylated, hemoglobin
assays in use?
a. Hemoglobin A1 test (HbA1) and hemoglobin A1c test
(HbA1C)
b. Hemoglobin A1c test (HbA1c) and hemoglobin B1c test
(HbB1C)
175
c. Hemoglobin B test (HbB) and hemoglobin A1c test
(HbA1C)
d. Hemoglobin B1 test (HbB1) and hemoglobin A1c test
(HbA1C)
1072. Which of the following are the major classes of oral
agents used in the management of diabetes?
a. Alpha-glucosidase inhibitors. b. Biguanides.
c. Meglitinides. d. Sulfonylureas.
e. Thiazolidine-diones. f. All of the above.
1073. ____________ HbA1c levels show that the individual
is normal.
a. 4- 6%. b. 6%.
c. ≥7%. d. <8 %.
1074. _____________ HbA1c levels show that the diabetic
patient has good glycemic control.
a. ≤ 6%. b. <7%.
c. ≥7%. d. <8 %.
1075. _____________ HbA1c levels show that the diabetic
patient has moderate glycemic control.
a. ≤ 6%. b. 7%-8%.
c. ≥7%. d. <8 %.
1076. ______________ HbA1c levels in diabetic patient
suggest action to improve glycemic control.
a. ≤ 6%. b. <7%.
c. ≥7%. d. >8 %.
1077. Which of the following are the signs and symptoms of
low blood glucose levels/hypoglycemia?
a. Confusion. b. Dizziness.
c. Loss of consciousness. d. Shaking.
e. Sweating. f. Tachycardia.
g. Tremors. h. All of theabove.
i. None of the above.
Chapter -3 : Periodontal therapy
176 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1078. A diabetic patient on oral anti-hyperglycemic visiting
dental office lost consciousness. Which of the following
are the emergency drugs for the patient?
a. 15 gm-oral carbohydrates.
b. 1mg glucagon- IV/IM/ subcutaneous.
c. 25-30ml IV-50% dextrose.
d. a or b. e. b or c.
1079. A diabetic patient on oral anti hyperglycemic visiting
dental office showed signs and symptoms of
perioperative hypoglycemia. Which of the following
should be administered to boost his blood/plasma
glucose levels?
a. 15 gm-oral carbohydrates.
b. 1mg glucagon- IV/IM/ subcutaneous.
c. 25-30ml IV-50% dextrose. d. Sugar free food.
1080. A diabetic patient on oral anti hyperglycemic visiting
dental office showed signs and symptoms of
perioperative hypoglycemia. The patient was conscious
and fit to take carbohydrates orally. Which of the
following can the patient take orally to boost his blood/
plasma glucose levels?
a. 4-6 ounce of fruit juice.
b. 4-6 ounce of sugared soda.
c. 3-4 table spoon of table sugar. d. Glucose tablets.
e. Any of the above. f. None of the above.
1081. Transgingival probing is done under local anesthesia.
What is it termed?
a. Bone sounding. b. Walking technique.
c. Probing. d. Ultrasonic probing.
1082. Which of the following is true about transgingival
probing?
a. Is refered to as bone sounding.
b. Carried out under local anaesthesia.
c. Confirms the extent and configuration of the intrabony
components of the pocket.
177
d. Confirms the extent and configuration of the intrabony
components of the furcation defects.
e. All of the above. f. None of the above.
1083. Which of the following is not a periodontal osseous
resective procedure?
a. Osteoctomy. b. Osteoplasty.
c. Gingivectomy.
1084. Which of the following is generally considered the
oldest surgical procedure developed to treat the effects
of periodontal disease?
a. Gingivectomy. b. Modified widman flap.
c. Semilunar coronally displaced flap.
d. Connective tissue regenerative procedure.
1085. Which of the following is not a procedure to increase
the width of attached gingiva?
a. Free gingival autografts.
b. Free connective tissue auto grafts.
c. Apically displaced flaps. d. Coronally displaced flap.
1086. Which of the following instrument is pivotal in marking
the pocket base on the surface while performing
gingivectomy procedure?
a. Crane-kaplan/Goldman-fox pocket marker.
b. Tweezer. c. Kirkland gingivectomy knife.
d. Orban’s interdental gingivectomy knife.
1087. Which of the following is not a use of local infiltration
(containing epinephrine) while performing a periodontal
surgery?
a. Provides extra turgor to tissues.
b. Provides transient local ischemia.
c. Reduces bleeding from the surgical site.
d. Improves healing.
Chapter -3 : Periodontal therapy
178 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1088. Peripheral buttressing bone formation occurs on the
external surface of the jaw. Which of the following terms
is used to describe?
a. Lipping. b. Intra bony defect.
c. Combined defect. d. Hemiseptum.
1089. What are the plateau-like bone margins caused by
resorption termed?
a. Ledges. b. Lipping.
c. Exostosis. d. Hemiseptum.
1090. Interdental craters are diagnosed by
a. Radiographic finding of irregular areas of reduced
radiopacity on the bone crest.
b. Clinical probing.
c. Radiographic findings of fuzziness in the bone crest.
d. a and c.
e. Using special radiographic techniques.
1091. The lingual surfaces of mandibular molars and
premolars are best accessed with
a. Plastic tips b. Wooden tips
c. Rubber tips d. Single tufted brush.
1092. Immunodiagnostic methods for periodontal pathogens
include direct & Indirect IFA, Flow cytometry/
Cytofluorography, ELISA, Membrane Assay and Latex
agglutination.
a. True. b. False.
1093. Which of the following tooth brushing techniques is most
likely to clean the gingival sulcus?
a. Bass method. b. Charter’s method.
c. Modified stillman’s method. d. Rolling stroke method.
1094. The least effect on periodontal disease is:
a. Alveolar bone loss.
b. Co-operation and motivation of the patient.
c. Furcation involvement. d. Suppuration from the pocket.
179
1095. Which of the following does not occur during soft tissue
curettage?
a. Removal of diseased cementum.
b. Removal of diseased connective tissue.
c. Removal of granulomatous tissue.
d. Removal of sulcular epithelium.
1096. Gingivoplasty is more likely to be useful in
a. Aggressive periodontitis. b. ANUG.
c. Desquamative gingivitis. d. Oral herpes infection.
1097. The initial recall schedule for patients who have been
treated for periodontitis is at the following interval.
a. 1month. b. 3 months.
c. 6 months. d. 9 months.
1098. Which of the following is not a type of absorbable/
resorbable suture?
a. Surgical gut. b. Plain gut.
c. Chromic gut. d. Polyglycolic.
e. Poly glyconate. f. Polyglecaprone.
g. Nylon.
1099. Which of the following is not a type of non-resorbable/
non-absorbable sutures?
a. Braided Silk. b. Nylon.
c. E d. e-PTFE.
e. Polyester. f. Braided polyglycolic.
1100. In mandibular distal molar surgery, faciolingual distance
between the two parallel incisions in a distal wedge
operation :
a. Depends on the depth of the pocket.
b. Depends on the underlying osseous contour.
c. Depends on the amount of fibrous tissue in the area.
d. a and b.
e. a and c.
Chapter -3 : Periodontal therapy
180 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1101. The ideal pontic design that provides the most aesthetic
appearance allows adequate hygiene procedure and
maintains the interdental papilla next to the abutment
teeth is-_______________________.
a. Ridge lap pontic. b. Sanitary pontic.
c. Ovate pontic. d. Modified ridge lap pontic.
1102. Which among the following is not a feature of Gracey
curette:
a. Curved in one plane. b. Offset blade angle.
c. Curved in two planes. d. One-cutting edge.
e. Rounded tip and back.
1103. Which of the following Gracey curettes are used only
in the anterior teeth?
a. Gracey #1-2 and 3-4 b. Gracey #5-6.
c. Gracey #7-8. d. Gracey #11-12.
e. Gracey #13-14. f. All of the above.
1104. Which of the following Gracey curettes are used in the
anterior teeth?
a. Gracey #1-2, 3-4 & 5-6. b. Gracey #7-8.
c. Gracey #11-12. d. Gracey #13-14.
e. All of the above.
1105. Which of the following Gracey curettes are used in the
premolar teeth?
a. Gracey #1-2 and 3-4 b. Gracey #5-6.
c. Gracey #7-8. d. Gracey #11-12.
e. Gracey #13-14.
1106. Which of the following Gracey curettes are used on
the facial and lingual surfaces of the posterior teeth?
a. Gracey #1-2 and 3-4 b. Gracey #5-6.
c. Gracey #7-8 and 9-10. d. Gracey #11-12.
e. Gracey #13-14. f. All of the above.
181
1107. Which of the following Gracey curettes are used on
the mesial surface of posterior teeth?
a. Gracey #1-2 and 3-4 b. Gracey #5-6.
c. Gracey #7-8 & 9-10. d. Gracey #11-12.
e. Gracey #13-14.
1108. Which of the following Gracey curettes are used only
in the anterior teeth?
a. Gracey #1-2 and 3-4 b. Gracey #5-6.
c. Gracey #7-8 & 9-10. d. Gracey #11-12.
e. Gracey #13-14.
1109. Offset blade:
a. A characteristic of Gracey curettes.
b. 60-70 degrees between the blade and the lower shank.
c. All of the above. d. None of the above.
1110. Which of the following is not a recent addition to the
gracey curette set?
a. Gracey #15-16: mesial surface of posterior teeth.
b. Gracey #17-18.distal surfaces of posterior teeth.
c. Gracey #5-6: Anterior teeth and premolars.
1111. Which of the following instruments can be used easily
in deep, narrow pockets; furcations, developmental
grooves; line angles; and deep tight facial, lingual or
palatal pockets?
a. Universal curettes. b. Gracey curettes.
c. Mini five curettes. d. Langer curettes.
1112. Which of the following curettes has a shank design of
gracey curette with a blade angle of universal curette?
a.Universal curettes. b. Gracey curettes.
c. Mini five curettes. d. Langer curettes.
1113. Which of the following are natural abrasive stones used
for sharpeneing periodontal instruments?
a. India. b. Arkansas.
c. All of the above. d. None of the above.
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182 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1114. Which of the following is not synthetically produced
abrasive stone used for sharpening periodontal
instruments?
a. Carborundum. b. Ruby.
c. Ceramic stones. d. Arkansas oil stone.
1115. Substantivity is the intrinsic ability to bind to the soft
and the hard tissue walls of periodontal pockets. This
property is possessed by:
a. Chlorhexidine. b. Amoxicillin.
c. Povidine-iodine. d. Ciprofloxacin.
1116. What are the sites of gingival sulcus of a tooth that are
measured using a periodontal probe?
a. Disto-buccal and disto-lingual.
b. Mesio-buccal and mesio-lingual.
c. Mid-buccal and mid-lingual.
d. All of the above.
1117. Osseous resective surgery is the most predictable
pocket reduction technique. The suggested sequential
steps in osseous resective surgery are
a. Gradualizing marginal bone, radicular blending, flattening
interproximal bone and vertical grooving.
b. Horizontal grooving, Tunnenling, Radicular blending and
gradualizing marginal bone.
c. Tunneling, radicular blending, flattening interproximal bone
and gradualizing marginal bone.
d. Vertical grooving, Radicular blending, flattening
interproximal bone and gradualizing marginal bone.
1118. What is the first sequential step in osseous resection
technique?
a. Flattening inter proximal bone.
b. Gradualising marginal bone.
c. Radicular blending.
d. Vertical grooving.
183
1119. Which of the following is the most predictable pocket
reduction technique?
a. Osseous resective surgery.
b. Periodontal reconstructive surgery.
c. ENAP. d. Modified widman flap.
1120. Which of the following is not an indication of resective
osseous surgery?
a. Crown lengthening.
b. Definitive pocket reduction.
c. Exposing root caries.
d. Removal of bony exostosis and ledges.
e. Treatment of three wall defects.
1121. In which of the following situations is ossesous resective
surgery not successful?
a. 1-2 mm deep interproximal bony craters.
b. Early furcation defects.
c. Thick alveolar bone surrounding the teeth.
d. Aesthetically demanding situations.
1122. Which of the following is true about osseous resective
surgery?
a. Eliminates periodontal pocket depth.
b. Improves tissue contour.
c. Loss of attachment. d. Recession.
e. All of the above. f. None of the above.
1123. Positive architecture (Positive osseous architecture):
a. Radicular bone is apical to interdental bone.
b. Interdental bone is apical to radicular bone.
c. Both radicular bone and interdental bone are at the same
level.
1124. Negative architecture (Negative osseous architecture):
a. Radicular bone is apical to interdental bone.
b. Interdental bone is apical to radicular bone.
c. Both radicular bone and interdental bone are at the same
level.
Chapter -3 : Periodontal therapy
184 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1125. Flat architecture:
a. Radicular bone is apical to interdental bone.
b. Interdental bone is apical to radicular bone.
c. Both radicular bone and interdental bone are reduced to
the same level.
1126. What is the procedure that removes tooth-supporting
bone termed?
a. Ostectomy. b. Osteoectomy.
c. All of the above. d. None of the above.
1127. Osteoplasty:
a. Reshaping of the bone.
b. Tooth-supporting bone is not removed.
c. Non-supporting bone is removed.
d. All of the above. e. None of the above.
1128. Which of the following are among types of bone
allograft?
a. Undecalcified Freeze-Dried bone allograft
b. Decalcified Freeze- Dried allograft
c. All of the above. d. None of the above.
1129. Which of the following is not a type of alloplast bone
graft?
a. DFDBA. b. Hydroxyapatite.
c. Tricalcium phosphate. d. Perioglas.
1130. Which of the following are among the types of calcium
phosphate biomaterials used as bone grafts?
a. Hydroxyapatite. b. Tricalcium phosphate.
c. All of the above. d. None of the above.
1131. What was resorbable natural porous coralline (coral
derived) calcium carbonate marketed as?
a. Biogran.
b. Calcarle.
c. Ossifi.
d. Perioglas.
185
1132. Which of the following is a type of resorbable GTR
membrane?
a. Collagen membrane. b. Millipore.
c. PTFE. d. Rubber dam.
1133. Which of the following is not a type of non-resorbable/
non-biodegradable GTR membranes?
a. e-PTFE. b. Millipore filter.
c. PLA and PGA membranes. d. Rubber dam.
1134. Which of the following is not a substance used for root
surface biomodification?
a. Citric acid. b. Fibronectin.
c. Tetracycline. d. Hydrogen sulfide.
1135. Which of the following is a glycoprotein that is required
by fibroblasts to attach to root surfaces?
a. Citric acid. b. Fibronectin.
c. Tetracycline. d. Emdogain.
1136. Which of the following is not a type of resorbable/
biodegradable membrane?
a. Poly lactic acid and Poly glycolic membranes.
b. Collagen membrane.
c. Autogenous periosteum.
d. Polytetrafluoroethylene membrane.
1137. Which of the following is the protein content of
Emdogain?
a. Amelogenin (90%) & Proline-rich non-amelogenin.
b. Tuftelin & Tuft protein.
c. Ameloblastin, Amelin & serum proteins.
d. All of the above. e. None of the above.
1138. Which of the following is true about enamel matrix
derivative?
a. Promotes bone cells attachment and cell spreading;
osteopromotor.
b. Enhance human fibroblast cell wound healing.
Chapter -3 : Periodontal therapy
186 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
c. Could enhance periodontal regeneration.
d. All of the above. e. None of the above.
1139. What is the origin of Enamel matrix derivative
marketed under the name Emdogain?
a. Murine. b. Porcine.
c. Bovine. d. Feline.
1140. What is the formation or development of new bone by
cells contained in the graft refered?
a. Osteogenesis. b. Osteoinduction.
c. Osteoconduction.
1141. What is the chemical process by which molecules
contained in the graft convert the neighboring cells into
osteoblasts, which in turn form bone?
a. Osteogenesis. b. Osteoinduction.
c. Osteoconduction.
1142. What is a physical effect by which the matrix of the
graft forms a scaffold that favors outside cells to
penetrate the graft and form new bone termed?
a. Osteoinduction. b. Osteoconduction.
c. Osteogenesis.
1143. Which of the following is a type of alloplastic bone graft
referred to as hard tissue replacement?
a. Polyhydroxyethylmethacrylate (PHEMA).
b. DFDBA.
c. Biogran d. Tricalcium phosphate.
1144. Which of the following is the flap technique best suited
for grafting purposes?
a. Papilla preservation flap. b. Modified widman flap.
c. Conventional flap. d. Apically displaced flap.
1145. Which of the following are the autogenous sources of
bone for periodontal bone grafting procedures?
a. Bone from healing extraction wounds.
b. Bone from edentulous ridges.
187Chapter -3 : Periodontal therapy
c. Bone trephined from within the jaw without damaging
the roots.
d. Bone removed during osteoplasty and osteoctomy.
e. All of the above. f. None of the above.
1146. Bioactive glasses are a type of alloplastic bone graft
material. Which of the following are the types of
bioactive glasses?
a. Perioglas and biogran.
b. Hydroxyapatite and tricalcium phosphate.
c. PTFE and e-PTFE. d. Bio-oss and HTR.
1147. Free gingival grafting is a procedure for increasing the
width of attached gingiva. The ideal thickness of the
graft is:
a. 1.0 to 1.5 mm. b. 0.1 to 1.0 mm.
1148. What is spontaneous migration of the gingival margin
coronally after successful free gingival grafting over
due course of time is called?
a. Creeping reattachment. b. Rebound attachment.
c. Gingival regrowth. d. Gingival rebound.
1149. ___________ is the aesthetic non-surgical treatment
for the gingival recession in anterior region:a. Gum veneer. b. Night guard.
c. Occlusal splints. d. Connective tissue graft.
1150. What is the surgical excision of gingiva termed?
a. Gingivectomy. b. Gingivoplasty.
c. Modified widman flap.
d. Excisional new attachment procedure.
1151. _________________________ is a definitive
subgingival curettage procedure performed with a knife,
developed and used by the US Dental Corps.
a. Excisional new attachment procedure (ENAP).
b. Curettage. c. Modified widman flap.
d. Fiberotomy.
188 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1152. ENAP was developed by
a. Indian Dental Corps. b. Australian Dental Corps.
c. US Dental Corps. d. German Dental Corps.
1153. Which of the following clinical finding influences the
type of incision to be given in periodontal flap surgery?
a. Probing depth b. Amount of attached gingiva
c. Frenal attachment d. Depth of vestibule
1154. Lasers which are applicable for both soft and hard
tissues and can ablate all biological tissues
a. Solid state laser b. Gas lasers
c. Excimer laser d. Diode laser
1155. The high suction tip absorbs fluids at the rate of
a. 150ml per sec b. 150 litres per hour
c. 15 litres per minute d. 150 ml per 10 sec
1156. According to Melcher concept,the regeneration of new
attachment is from
a. Gingival connective tissue b. Junctional epithelium
c. Alveolar bone d. Periodontal ligament.
1157. What is the surgical reshaping or recontouring of
gingiva termed?
a. Gingivectomy. b. Gingivoplasty.
c. Modified widman flap.
d. Excisional new attachment procedure.
1158. Which of the following is a contraindication for
gingivectomy?
a. Acutely inflamed gingiva. b. Gingival enlargement.
c. Suprabony periodontal abscess. d. Suprbony pockets.
1159. Which of the following is an indication for gingivectomy?
a. Need for bone surgery.
b. Pocket reaching beyond the mucogingival junction.
c. Esthetic considerations-Anterior maxilla.
d. Acutely inflamed gingiva.
e. Gingival enlargement.
189Chapter -3 : Periodontal therapy
1160. Which of the following instruments are not used to
perform gingivectomy?
a. Electrodes. b. Files.
c. Laser beams. d. Chemicals.
1161. Grafts taken from different individuals within the same
species are known as:
a. Allografts. b. Autografts.
c. Fillers. d. Xenografts.
1162. Graft procured from same individual is known as:
a. Allograft. b. Autograft.
c. Bone filler. d. Xenograft.
1163. Autograft is tisue transferred from one position to
another within the same individual. Which of the
following is not a type of autogenous bone graft?
a. Bone blend. b. Bone swaging.
c. DFDBA. d. Osseous coagulum.
1164. What is osseous coagulum?
a. Cancellous bone marrow transplants.
b. Iliac autograft.
c. Bone dust and blood.
d. Autogenous bone with hydroxyapatitie bone graft.
1165. Who described the technique of osseous coagulum?
a. R.Earl Robinson. b. Nabers and O’Leary.
c. Glickman. d. Shulger.
1166. Where can the cancellous bone marrow transplant be
obtained from?
a. Maxillary tuberosity. b. Edentulous defects.
c. Healing sockets. d. All of the above.
1167. Which of the following is not an autogenous bone graft
procured from intraoral site?
a. Iliac autograft. b. Osseous coagulum.
c. Bone blend.
d. Cancellous bone marrow transplant. e. Bone swaging.
190 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1168. Which of the following is autogenous bone grafting
procedure from intraoral sites, is technically difficult
and has limited usefulness?
a. Bone swaging. b. Osseous coagulum.
c. Bone blend. d. Cancellous bone marrow transplant.
1169. Kiel bone:
a. Calf or Ox bone denatured with 20% hydrogen peroxide,
dried with acetone, and sterilized with ethylene oxide.
b. DFDBA. c. Bio-oss.
d. PerioGlas.
1170. A cell binding poly peptide/A synthetic analog of a 15
amino acid sequence of type-I collagen when used in
combination with Bio-Oss seems to enhance the bone
regeneration of the matrix alone in periodontal defects.
What is the cell-binding polypeptide marketed as?
a. Pepgen-15. b. BMP-3.
c. Emdogain. d. PRP.
1171. Bone morphogenetic protein-3 (BMP-3) is a bone
inductive protein isolated from the extra cellular matrix
of human bones. What is BMP-3 termed?
a. Osteogenin. b. Pepgen-15.
c. Osteopontin. d. Osteocalcin.
1172. After gingivectomy, surface epithelization normally
requires:
a. 2 to 4 days: b. 5-14 days.
c. 2 to 3 weeks. d. One month.
1173. In a 40 year old patient clenching and bruxism can be
controlled by
a. Occlusal equilibration. b. Occlusal guard.
c. Psychological counseling. d. All of the above.
1174. Lateral food impaction occurs mainly due to
a. Open gingival embrasure. b. Open proximal contact.
c. Uneven alteration of occlusal surface.
d. All of the above.
191Chapter -3 : Periodontal therapy
1175. Gingivectomy helps:
a. To eliminate all types of infra-bony pockets.
b. To treat any type of gingival enlargement.
c. To manage any type of periodontal abscess.
d. All of the above. e. None of the above.
1176. Perio-chip
a. Contains 2.5mg of chlorehexidine.
b. Is controlled release of chemotherapeutic agent
c. Is placed in periodontal pockets following root planing.
d. All of the above.
1177. Name an electronic instrument used to measure
gingival crevicular fluid.
a. Periocheck. b. Perioscan.
c. Periotemp. d. Periotron.
1178. What is the blotting paper used to measure gingival
crevicular fluid employing an electronic transducer-
Periotron called?
a. Absorbing paper strip. b. Filter paper.
c. Litmus paper. d. Periopaper.
1179. Which of the following is not the side effect of
chlorehexidine?
a. Discrete desquamation of the oral mucosa.
b. Extrinsic staining of teeth.
c. Intrinsic staining of teeth.
d. Trainsent impairnment of taste perception.
1180. Successful scaling and root planning is best evaluated
by absence of
a. Bleeding on probing. b. Residual calculus.
c. Residual plaque. d. Tooth mobility.
1181. Scaling and root planning form the ______ treatment
for periodontal inflammation.
a. Primary.
b. Secondary. c. Tertiary.
192 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1182. What is the most frequently used periodontal therapy?
a. Excisional new attachment procedure.
b. Gingival curettage.
c. Polishing. d. Scaling and root planing.
1183. What is not among the common clinical changes seen
following scaling and root planning?
a. Periodontal regeneration.
b. Reduction in gingival inflammation.
c. Reduction in pocket depth.
d. a and b. e. b and c.
1184. Restorative phase of periodontal therapy concerns
with:
a. Correction of faulty restorations.
b. Permanent restoration of carious and missing teeth.
c. Surgical treatment of bony pockets.
d. Temporary restoration of carious teeth.
1185. Which among the following is not the use of Curettes?
a. Calculus removal. b. Curettage.
c. Flap elevation. d. Root planning.
e. Subgingival calculus detection.
1186. Which of the following instruments has a highly
magnetized end, designed to retrieve broken
instruments?
a. Columbia curettes. b. Gracey curettes.
c. Rizt magnetized forceps. d. Schwartz Periotrievers.
1187. Hoe scalers:
a. The blade is bent at 99-degree angle.
b. Cutting edge is beveled at 45 degrees.
c. Used with a two point contact.
d. Used for removal of ledge or rings of calculus.
e. All of the above.
f. None of the above.
193Chapter -3 : Periodontal therapy
1188. Which of the following instruments has a series of
blades and primarily fractures or crushes large deposits
of calculus or burnishes sheets of calculus?
a. Files. b. Hoes.
c. Gracey curettes. d. Chisels.
1189. Which of the following instruments are actually hoes?
a. Quétin furcation curettes. b. Gracey curettes.
c. Universal curettes. d. Langer curettes.
1190. Which of the following instrument is used with a push
stroke?
a. Chisel scalers. b. Gracey curettes.
c. Hoe scalers. d. Sickle scaler.
1191. Which of the following is the most effective and stable
grap for all periodontal instruments?
a. Modifiedpen grasp. b. Standardized pen grasp.
c. Palm and thumb grasp. d. All of the above.
e. None of the above.
1192. Which of the following grasps are useful for stabilizing
instruments during sharpnening?
a. Palm and thumb grasp.
b. Modified pen grasp. c. Standardized pen grasp.
1193. Which of the following are different variation of the
intraoral finger rest used while periodontal
instrumentation?
a. Conventional. b. Cross arch.
c. Opposite arch. d. Finger on finger.
e. All of the above. f. None of the above.
1194. What is the most effective pattern of use of strokes in
performing root planing?
a. Ending with harder strokes.
b. Ending with lighter strokes.
c. Longer strokes followed by shorter strokes.
d. Shorter strokes followed by longer strokes.
e. a and c. f. b and d.
194 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1195. The outcome of results of laterally positioned flap are
dictated by
a. Presence of sufficient bone support at donor site.
b. Thickness of attached gingiva at donor site.
c. Width of attached gingiva at donor site.
d. All of the above. e. None of the above.
1196. What are the incision angle and the direction of incision
in external bevel gingivectomy?
a. 45 degrees towards the tooth in an apical direction.
b. 45 degrees towards the tooth in a coronal direction.
c. 90 degrees towards the tooth in an apical direction.
d. 90 degrees towards the tooth in a coronal direction.
1197. A 6 mm pocket is measured in which the junctional
epithelium lies apical to the cement-enamel junction.
How it is correctly described?
a. Pseudo pocket. b. Relative pocket.
c. Suprabony pocket. d. True pocket.
1198. A 5 mm pocket is measured on the distobuccal site of
canine in which the junctional epithelium lies coronal
to the cement-enamel junction. How is it properly
described?
a. True pocket. b. Pseudo pocket.
c. Infrabony pocket. d. Intrabony pocket.
1199. Which of the following drugs has been found to have
twice its concentration in GCF compared to its plasma
levels?
a. Acetaminophen. b. Cephalosporins.
c. Metronidazole. d. Penicillin.
1200. Which of the following is not an absorbable hemostatic
agent?
a. Absorbable gelatin sponge. b. Oxidized cellulose.
c. Microfibrillar collagen. d. Thrombin.
e. Heparin.
195
1201. Which of the following drugs has 10 times higher
concentration in GCF compared to its plasma levels?
a. Penicillin. b. Acetaminophen.
c. Tetracycline. d. Erythromycin.
1202. Which of the following hemostatic agents may possibly
prove fatal if injected into tissues or vasculature?
a. Absorbable gelatin sponge. b. Oxidized cellulose.
c. Both a & b d. Microfibrillar collagen.
1203. Which of the following hemostatic agent has been
associated with increased pain?
a. Absorbable gelatin sponge. b. Oxidized cellulose.
c. Microfibrillar collagen. d. Thrombin.
1204. This hemostatic agent may produce fatal outcome, if
injected into tissues or vasculature:
a. Absorbable gelatin sponge.
b. Oxidized cellulose. c. Thrombin.
1205. What among the following is not the use of periodontal
pack?
a. Controls post operative bleeding.
b. Has curative properties.
c. Prevents surface trauma during mastication.
d. Protects against induced by food contact with the wound.
1206. Which of the following are the components of ward
periodontal pack?
a. Zinc oxide + eugenol. b. Cyanoacrylate.
c. Methacrylic gels. d.Metallic oxide +fatty acids.
1207. Which of the following are types of non-eugenol
containing periodontal dressings/ periodontal packs?
a. Coe-pak.
b. Periocare.
c. Barricaid VLC.
d. All of the above.
e. None of the above.
Chapter -3 : Periodontal therapy
196 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1208. Which of the following are the disadvantages of
electrosurgery?
a. Possible heat damage.
b. Relatively Increased instrumentation time.
c. Unpleasant odor.
d. Contraindicated in unshielded cardiac pace maker users.
e. May result in delayed wound healing.
f. Results in bone necrosis and sequestration /cemental burn
on contact.
g. All of the above. h. None of the above.
1209. What is the rationale of using periodontal dressings?
a. Make the patient comfortable after periodontal surgery.
b. Prevent overgrowth of granulation tissue by acting as a
matrix.
c. Protect the wound from local environmental changes.
d. All of the above.
1210. Which of the following agents were used for chemical
gingivectomy?
a. Paraformaldehyde. b. Potassium hydroxide.
c. All of the above. d. None of the above.
1211. What is the inverse bevel distal wedge procedure
otherwise called?
a. Widman flap. b. Modified widman procedure.
c. Mohawk procedure. d. Trapdoor procedure.
1212. Who is considered as the father of osseous resective
surgery?
a. Schluger. b. GV.Black.
c. PD.Miller. d. NP.Lang.
1213. Which one of the following is a better candidate for
root resection?
a. A molar with fused roots.
b. A molar with long root trunk length.
c. A molar with short root trunk length.
d. All of the above.
197
1214. Tunnel preparation of Mandibular 1st and madibular
2nd molars can be successful only when the degree of
divergence is larger than
a. 100 b. 300
c. 50 d. 900
1215. Guided tissue regeneration (GTR) is used mainly in
the treatment of______________?
a. Class I furcation. b. Class II furcation.
c. Class III furcation. d. Class IV furcation.
1216. Guided tissue regeneration membranes are barrier
membranes used to treat osseous defects. Which
among the following statements is not correct?
a. They allow time for the periodontal cells to repopulate.
b. They are available in different shapes and sizes.
c. They contain alveolar bone cells within them.
d. They prevent the formation of long junctional epithelium.
e. They prevent the epithelial migration along the cemental
wall of the pocket.
1217. Which of the following is an alloplastic material?
a. Bone blend. b. Iliac crest graft.
c. Osseous coagulum. d. Tricalcium phosphate.
1218. What is the main aim of restoration of carious lesion in
phase I therapy?
a. To reduce microbial source. b. To restore form of tooth.
c. To restore function of tooth. d. All of the above.
1219. Which root is commonly extracted during hemisection
or root resection of maxillary first molar?
a. Disto buccal root b. Lingual root
c. Mesio buccal root. d. Palatal root.
1220. Which of the following is not an indication of root
resection?
a. Vertical root fracture. b. Fused roots.
c. Uncorrectable root dehiscence.
d. Abutment tooth with hopeless prognosis associated with
one root.
Chapter -3 : Periodontal therapy
198 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1221. What does local drug delivery system “Elyzol” contain?
a. Metronidazole. b. Penicillin.
c. Sanguinarine. d. Tetracycline.
1222. After placement of free gingival graft, first it undergoes
a. Degeneration. b. Dysplasia.
c. Hyperplasia. d. Metaplasia.
1223. Gracey curette no 11-12 are for
a. Anterior teeth. b. Posterior teeth.
c. Posterior teeth-distal.
d. Posterior teeth-facial and lingual.
1224. What should be the waiting period before periodontal
therapy in a patient after stroke?
a. For 3 months. b. For 6 months.
c. For 9 months. d. For 12 months.
1225. What is the relationship between the working edge of
the instrument and the tooth surface called?
a. Angulation. b. Access.
c. Adaptation. d. Activation.
1226. What is the angle between the face of a bladed
instrument and the tooth surface called?
a. Tooth-blade relationship. b. Angulation.
c. All of the above. d. None of the above.
1227. What is the pressure that is created when force is
applied against the surface of a tooth with the cutting
edge of a bladed instrument?
a. Lateral pressure. b. Vertical pressure.
1228. What are the basic strokes used during periodontal
instrumentation?
a. Exploratory stroke.
b. Scaling stroke and Root-planing stroke.
c. All of the above.
d. None of the above.
199
1229. Which of the following strokes are used most frequently
during periodontalinstrumentation?
a. Vertical and oblique strokes. b. Horizontal strokes.
c. All of the above. d. None of the above.
1230. What is the area to which scaling and root planing
strokes (area of calculus and altered cementum
presence) are confined known as?
a. Instrumentation zone. b. Zone of co-destruction.
c. Biological zone. d. Scaling zone.
1231. Which of the following bacteria have been found in
dental aerosols?
a. Pneumococci. b. Staphylococci.
c. á-hemolytic streptocci.
d. Mycobacterium tuberculosis. e. All of the above.
1232. Which of the following viruses can be presented in the
dental aerosols?
a. Herpes simplex virus. b. Hepatitis virus.
c. Influenza virus. d. Common cold viruses.
e. Epstein-Barr virus. f. Cytomegalovirus.
g. All of the above.
1233. The finger rest that is established on tooth surface on
the opposite side of the same arch is known as:
a. Conventional finger rest. b. Cross arch finger rest.
c. Finger-on-finger rest. d. Opposite arch finger rest.
1234. Which of the following is not a characteristic of a sickle
scaler?
a. Triangular shape in cross-section. b. Pointed tip.
c. Double-cutting edge. d. Offset blade angle.
1235. Which of the following is not a characteristic of a
curette?
a. Semicircular in cross section. b. Rounded toe.
c. Heavier than scalers.
d. No sharp points or corners. e. Curved blade.
Chapter -3 : Periodontal therapy
200 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1236. Which of the following are the characteristics of a
universal curette?
a. Two parallel cutting edges.
b. Blade-lower shank angulation: 90-degree.
c. Semi circular in cross section. d. Rounded tip.
e. Curved in one plane. f. All of the above.
1237. Which of the following are heavy instruments used to
remove subgingival calculus?
a. Sickle scalers. b. Gracey curettes.
c. Hoe. d. Chisels.
e. File scalers.
1238. Which of the following are fine instruments used for
subgingival scaling, root planing, and removal of the
soft tissue lining the pocket?
a. Curettes. b. Sickle scalers.
c. Files. d. Tarnow scalers.
1239. Which one of the following instruments is used to
visualize deeply into subgingival pockets and furcation,
allows the detection of deposits?
a. Periodontal endoscope. b. Periotest.
c. Periotriever. d. Periotron.
1240. Which of the following is used most commonly in the
manufacture of periodontal instruments?
a. Stainless steel. b. High-carbon-content-steel.
c. Titanium. d. Alumunium.
1241. Which among the following instruments is used with a
two-point contact?
a. Hoe. b. Sickle scaler.
c. Chisel. d. Cumine scaler.
1242. Root surface biomodification/ root conditioning with
citric acid helps in:
a. Accelerating healing and new cementum formation.
b. Removal of endotoxin. c. Removal of smear layer.
d. Inhibits the down growth of oral epithelium.
e. All of the above.
201
1243. What is the separation of a two-rooted tooth into two
separate portions termed?
a. Hemisection. b. Bicuspidization.
c. Separation. d. All of the above.
e. None of the above.
1244. When is hemisection most commonly likely performed?
a. Mandibular molars-Class II or Class III furcation
involvement.
b. Mandibular molars-Class IV furcation involvement.
c. Maxillary molars-Class II or class III furcation
involvement.
d. Maxillary molars-Class IV furcation involvement.
1245. Which of the following is not an objective of furcation
therapy?
a. Facilitate mainanence.
b. Prevent further attachment loss.
c. Obliterate the furcation defects as a periodontal
maintenance problem.
d. Reduce the grade of furcation involvement.
1246. Which of the following procedure is not used in
treatment of Class I furcation involvement?
a. Scaling. b. Root planing.
c. Odontoplasty. d. Osseous grafting.
1247. Which type of bone defects hasthe highest chance of
success when treated with GTR membranes?
a. Horizontal defects. b. One-walled defects.
c. Osseous craters. d. Tri-walled defects.
1248. Osteoplasty is reshaping or reconturing of the bone.
In periodontal osseous surgery it is done to alter the
shape of ____________________________.
a. Basal bone.
b. Bundle bone.
c. Non supportive bone.
d. Supporting alveolar bone
Chapter -3 : Periodontal therapy
202 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1249. What therapy do clinicians prefer to do before
performing hemisection?
a. Fluoride application. b. Inlay crown placement.
c. Prosthetic crown placement. d. Root canal therapy.
1250. What are the surgical procedures performed to correct
or eliminate anatomic, developmental, or traumatic
deformities of the gingiva or alveolar mucosa called?
a. Periodontal plastic surgery.
b. Osseous resective surgery.
c. Mucogingival surgery.
d. Periodontal regenerative surgery.
1251. Who introduced the term mucogingival surgery?
a. Friedman. b. Miller.
c. Shulger. d. Glickman.
1252. Who proposed the term periodontal plastic surgery?
a. Miller. b. Friedman.
c. Shulger. d. Glickman.
1253. Which is the common site for harvesting donor
connective tissue graft in periodontal plastic surgery?
a. Buccal tissue. b. Palate.
c. Retromolar pad. d. Skin.
1254. Which of the following is not among techniques of free
gingival graft?
a. The classic technique. b. Accordion technique.
c. Strip technique. d. Combination technique.
e. Trap-door technique.
1255. Use of soft tissue autografts is common in periodontics.
Which of the following is not true about the grafts
procured from the palate?
a. Grafts tend to re-establish their original epithelial structure.
b. Mucous glands may occur.
c. Free gingival grafts- creeping reattachment.
d. Rugae may form at the grafted site.
203
1256. Which of the following is the correct sequence of
changes seen on the first day after placement of a free
gingival graft?
a. Connective tissue Oedema, epithelial degeneration.
b. Epithelial proliferation, connective tissue new blood vessel
formation.
c. Connective tissue-granulation tissue formation, epithelium-
new epithelium formation.
d. Epithelial Oedema, connective tissue-degeneration.
1257. Which of the following is not an advantage with free
connective tissue autografts?
a. Better esthetics. b. Less patient discomfort.
c. Primary closure of surgical sites. d. Single surgical site.
1258. Sullivan and Atkins classified the field of gingival
recessions based on the morphology of gingival
recession. Which of the following are categories of their
classification?
a. Shallow-narrow. b. Shallow-wide.
c. Deep-narrow. d. Deep-wide.
e. All of the above. f. a, b &c.
1259. Which of the following is true about the free gingival
graft placement directly on the bone tissue?
a. Less postoperative mobility of the graft.
b. Less swelling. c. Better hemostasis.
d. Less shrinkage (1.5-2 times).
e. Initial healing lag. f. All of the above.
1260. What are the different tissue layers present in the full
thickness mucoperiosteal flap?
a. Epithelium and basement membrane.
b. Connective tissue and periosteum.
c. All of the above.
d. None of the above.
Chapter -3 : Periodontal therapy
204 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1261. Full-thickness flap which denude the bone result in
superficial necrosis. What is the average resultant loss
of bone when the remaining bone is not thin?
a. About 1 mm. b. About 2 mm.
c. About 1-2 mm. d. About 0.5 mm.
1262. Which of the following are types of flaps based on the
bone exposure after reflection?
a. Full-thickness flaps & partial thickness flaps.
b. Nondisplaced flaps & displaced flaps.
c. Conventional flaps & papilla preservation flaps.
1263. Which of the following are types of flaps based on the
flap placement after surgery?
a. Full-thickness flaps & partial thickness flaps.
b. Nondisplaced flaps & displaced flaps.
c. Conventional flaps & papilla preservation flaps.
1264. Which of the following are types of flaps based on the
management of the papilla?
a. Full-thickness flaps & partial thickness flaps.
b. Nondisplaced flaps & displacedflaps.
c. Conventional flaps & papilla preservation flaps.
1265. Split thickness flap is also called:
a. Partial thickness flap. b. Nondisplaced flap.
c. Conventional flap.
1266. Which of the following types of flap constitute the
conventional flap?
a. The modified widman flap.
b. The apically displaced flap.
c. The flap for reconstructive procedure. d.All of the above
1267. Which of the following is true about internal bevel
incision?
a. First incision/reverse bevel incision.
b. Removes the pocket lining.
c. Conserves the outer gingiva.
d. Produces thin flap margin for adaptation.
e. All of the above.
205
1268. What is the flap where no vertical incisions are made
called?
a. Envelope flap. b. Modified widman flap.
c. Widman flap. d. Apically displaced flap.
1269. Which of the following flap procedures do not employ
vertical incisions?
a. Envelope flap. b. Pouch technique.
c. Semilunar coronally displaced flap.
d. Pouch and tunnel technique. e. All of the above.
1270. Which of the following flap procedures mandate sharp
dissection?
a. Full thickness flap. b. Partial thickness flap.
c. Conventional flap. d. Nondisplaced flap.
1271. Which of the following suturing techniques is used to
hold in place apically displaced partial thickness flaps?
a. Holding mattress-periosteal suture.
b. Anchor suture.
c. Closed anchor suture. d. Sling suture.
1272. Which of the following is not true?
a. Direct loop suture-bone grafting.
b. Horizontal mattress suture-diastema.
c. Continuous, Independent sling suture- maxillary arch.
d. Anchor suture-distal wedge procedures.
e. Holding mattress-periosteal suture-Modified widman flap.
1273. Which of the following is true about the internal bevel
incision in various periodontal procedures?
a. Modified widman flap- Internal bevel incision to the
alveolar bone crest starting 0.5 to 1 mm away from the
gingival margin.
b. Undisplaced flap- Internal bevel incision is carried out to
a point apical to the alveolar crest.
c. Apically displaced flap- Internal bevel incision to the
alveolar bone crest no more than about 1 mm from the
crest of the gingiva.
d. All of the above.
Chapter -3 : Periodontal therapy
206 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1274. Which of the following complicate the surgical
treatment of periodontal pockets on the distal surface
of terminal molars?
a. Bulbous fibrous tissue- maxillary tuberosity.
b. Prominent retromolar pads-Mandible.
c. All of the above. d. None of the above.
1275. What is the most important reason for performing
periodontal flap surgery?
a. Access. b. Aesthetics.
c. Biopsy. d. Periodontal regeneration.
1276. Which of the following is not a problem associated with
frenum?
a. Ankyloglossia. b. Localized gingival recession.
c. Midline diastema. d. Pericoronitis.
e. Trouble with denture fabrication and retention.
1277. When is the surgical treatment of the maxillary frenum
preferred?
a. After Canine and lateral incisors eruption.
b. After Orthodontic therapy.
c. All of the above. d. None of the above.
1278. Frenectomy is a mucogingival surgical procedure where
in
a. Alveolar bone is removed.
b. Frenum is only partially removed.
c. Frenum is completely removed.
d. Gingiva is removed.
1279. Frenotomy is a a periodontal plastic surgical procedure
where in
a. Fenum is completely removed.
b. Frenum is incised and relocated.
c. PDL ligament fibers are severed.
d. Alveolar bone ledges are removed.
207Chapter -3 : Periodontal therapy
1280. Patient compliance is an important factor in success of
periodontal therapy. Treated patients who do not attend
regular recall are at _______________for tooth loss.
a. Greater risk. b. Lesser risk.
c. No extra risk. d. No risk.
1281. Is there a possibility of progression of periodontal
disease after appropriate periodontal therapy?
a. Cannot say. b. Never possible.
c. No. d. Yes.
1282. Can scaling, root planing and flap surgery completely
eliminate the intra gingival bacteria in all the areas?
a. Cannot say. b. No.
c. Surely yes. d. Yes.
1283. Which of the following types of periodontal healing is
weaker and could easily revert back to periodontal
pocket?
a. Ankylosis. b. Long junctional epithelium.
c. Normal periodontal healing. d. Periodontal regeneration.
1284. Which of the following methods can determine the
resultant type of attachment following periodontal
reconstruction?
a. Clinic methods: periodontal probing, bone sounding.
b. Standardized radiographs.
c. Surgical reentry. d. Histologic methods.
1285. Which of the following are results seen after
reconstructive periodontal therapy?
a. Healing with long junctional epithelium.
b. Ankylosis with resultant root resorption.
c. Recession.
d. Recurrence of pocket.
e. Combinations of the above.
f. All of the above.
208 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1286. Does subgingival scaling alter the microflora of
periodontal pocket?
a. Cannot say. b. Never.
c. No. d. Yes.
1287. Which of the following chemical agents were used in
the past to remove pocket epithelium?
a. Sodium sulfide. b. Phenol.
c. Camphor. d. Antiformin.
e. Sodium hypochlorite. f. All of the above.
1288. What are the three parts of periodontal maintenance
recall procedure?
a. Disucussion. b. Examination.
c. Report, cleanup and scheduling. d. Treatment.
e. a,b and c. f. b,c and d.
1289. What is the correct sequence of the three parts of
periodontal maintenance recall procedure?
a. Discussion, treatment, report, cleanup and scheduling.
b. Discussion, report, cleanup, scheduling and treatment.
c. Examination, treatment, report, cleanup and scheduling.
d. Treatment, report, cleanup, scheduling and examination.
1290. Which one of the following instruments is preferred by
most clinicians for subgingival scaling and root planing?
a. Sickle scalers. b. Hoes.
c. Files. d. Curettes.
1291. Which of the following procedures removes plaque,
calculus and endotoxins from cemental surface?
a. Scaling. b. Root planing.
c. Curettage.
1292. What can repeated subgingival scaling and root
planning at sites with normal periodontium lead to?
a. Loss of attachment.
b. Maintains the clinical attachment level.
c. No loss of attachment. d.Prevents periodontal disease.
209
1293. Which of the following is not a characteristic feature of
a periodontally treated failing case?
a. Apical periodontitis.
b. Increasing gingival sulcus depth.
c. Progressive alveolar bone loss.
d. Progressive mobility.
e. Recurring inflammation.
1294. What is the proper duration of recall interval for first
year, periodontal post treatment patients?
a. Longer than 3months.
b. Not longer than 3 months.
c. Longer than 6 months. d. Not longer than 6 months.
1295. What gives the most accurate indication of loss of
attachment?
a. Comparison of bleeding on probing.
b. Comparison of consecutive periotron readings.
c. Comparison of dental sensitivity measurements.
d. Comparison of sequential probing measurements.
1296. What is the minimum distance between two implants
to prevent bone loss (Tarnow)?
a. 2 mm b. 3 mm
c. 4 mm d. 5 mm
1297. Studies evaluating 0.12% chlorhexidine gluconate
mouthrinses showed a decrease in plaque scores of
approximately:
a. 35%. b. 55%.
c. 75%. d. 95%.
1298. According to Lowenguth and Greenstein (1995), the
greatest changes in probing depth reduction and gains
in clinical attachment occur within ____ weeks following
scaling and root planing.
a. 2 b. 4
c. 6 d. 8
Chapter -3 : Periodontal therapy
210 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1299. When free gingival grafts are used to increase the zone
of attached gingiva, the ideal graft thickness is ______
mm.
a. 0.25-0.75 b. 1.0-1.5
c. 2.0-2.5 d. 3
1300. According to Sherman et al (1990), periodontists can
routinely remove up to _____% of microscopically
detectable calculus from the root surfaces of teeth.
a. 10-20 b. 25-40
c. 50-75 d. 80-95
1301. What are the overall results of periodontal treatment?
a. Prevents andreduces loss of attachment.
b. Prevents, resolves and treats gingivitis.
c. Reduces tooth mortality. d. All of the above.
e. None of the above.
1302. What are the terms used to describe periodontal Phase
I therapy?
a. Cause related therapy. b. Hygienic phase.
c. Initial therapy. d. Nonsurgical therapy.
e. All of the above. f. a and b only.
1303. What is the goal of maintanence therapy?
a. Prevent bone loss. b. Prevent calculus.
c. Prevent recurrence. d. Reduce pocket depth.
1304. Which of the following are the dental therapeutic uses
of fluoride?
a. Inhibition of growth of plaque microorganisms.
b. Prevention of demineralization of the tooth structures.
c. Remineralization of the tooth structures.
d. All of the above.
1305. There is an apparent reduction in inflammation and
possibly certain amount of healing following periodontal
debridement. What type of healing takes place after
periodontal debridement?
a. Ankylosis. b. Long junctional epithelium.
c. New attachment. d. Periodontal regeneration.
211
1306. Which of the following is most appropriate for cleaning
the Type I embrasure?
a. Dental floss. b. Gauze.
c. Interdental brush. d. Toothpicks.
1307. Which of the following are appropriate for cleaning a
Type II embrasure?
a. Dental floss. b. Interdental brush.
c. Tooth pick. d. a and b only.
e. b and c only.
1308. Which of the following are effective plaque control tools
for Type III embrasure?
a. End-tuft brushes. b. Interdental brushes.
c. Tooth pick. d. a and b only.
e. b and c only
1309. Which of the following is not an effective tool in
cleaning root concavities and grooves?
a. Dental floss. b. End-tuft brush.
c. Interdental brush. d. Marquis perio-aid.
1310. Repair is healing with _______________ formation.
a. Fibroma. b. Granuloma.
c. New tissue. d. Scar.
1311. What does healing by repair following periodontal flap
surgery result?
a. Long junctional epithelium. b. New attachment.
c. Reattachment. d. Regeneration.
1312. How many wounds result in the oral cavity while
performing connective tissue graft and free gingival
graft procedures?
a. None.
b. One.
c. Two.
d. Three.
Chapter -3 : Periodontal therapy
212 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1313. Which of the following procedures is carried out in case
of gummy smile?
a. Connective tissue graft. b. Coronally displaced flap.
c. Crown lengthening. d. Free gingival graft.
1314. Which of the following is known as toothpick tree?
a. Mastix tree (Pistacia lenticus)
b. Taban tree (Isonandra percha)
c. Acacia tree (Acacia senegal)
d. Cedarwood tree (Cedrus atlantica)
1315. Downward growth of epithelium at surgical sites is
referred as ________________.
a. Epithelization. b. Marsupialization.
c. New attachment. d. Regeneration.
1316. Which of the following is an extracellular bone matrix
protein which modulates apatite crystal growth?
a. Amelogenin. b. Cementoblastin.
c. Interleukin 1. d. Osteocalcin.
1317. Which of the following is the minimal amount of root/
crown ratio to maintain the stability of the tooth root in
the alveolar bone?
a. 1:1. b. 2:1.
c. 1:2 d. 1:3
1318. Which of the following is not an indication of surgical
crown lengthening?
a. Subgingival caries. b. Subgingival fracture.
c. Tooth is poor restorative risk.
d. Unequal gingival heights.
1319. Which of the following is not a use of surgical crown
lengthening procedures?
a. Adjust gingival levels for esthetics.
b. Placement of restorative margin.
c. Provide resistance form.
d. Provide retention form.
213
1320. Which of the following is not a contraindication of
surgical crown lengthening?
a. Deep caries that would require excessive bone removal.
b. Inadequate clinical crown length for retention.
c. Tooth is poor restorative risk.
d. Unaesthetic outcome.
1321. Which of the following is true about semilunar coronally
repositioned flap?
a. It was described by Tarnow.-hence called Tarnow’s flap.
b. Simple and easy to perform.
c. Predictable 2-3 mm root coverage.
d. Indicated in maxillary teeth.
e. Not recommended in mandibular teeth.
f. All of the above.
1322. Which of the following is not a procedure used to treat
gingival recession?
a. Free gingival autograft. b. Modified widman flap.
c. Semilunar coronally positioned flap.
d. Free connective tissue autograft.
1323. Who is considered the father of oral hygiene? Who is
considered the inventor of dental floss?
a. Levi Spear Parmly. b. Gracey.
c. Robert genco. d. Walter Cohen.
1324. Which one of the following is not a use of Mouthrinses?
a. Anti plaque agents.
b. Anti gingivitis. c. Anti periodontitis.
1325. What is the use of alcohol present in some mouth
rinses?
a. Active ingredient. b. Anti plaque agent.
c. Antimicrobial. d. Vehicle.
1326. Which part of the day is preferred for dental
appointments in hypertensive patients?
a. Afternoon. b. Around awakening.
c. Mid-morning. d. Mid noon.
Chapter -3 : Periodontal therapy
214 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1327. At what levels of blood pressure values in a
hypertensive patient should the dental/periodontal
treatment be limited only to emergency care?
a. Systolic pressure≥180 mm Hg Diastolic pressure≥110 mm
Hg.
b. Systolic pressure=120 mm Hg Diastolic pressure=70 mm
Hg.
c. Systolic pressure>120-139 mm Hg Diastolic pressure 80-
89 mm Hg.
d. Systolic pressure 140-159 mm Hg Diastolic pressure 90-
99 mm Hg.
1328. Which one of the following statements is not true about
carrying out periodontal procedure in a hypertensive
patient?
a. Local anaesthesia containing epinephrine concentration
of <1:100,000 should not be used.
b. Pain should be minimized to avoid increase in endogenous
epinephrine secretion.
c. Intra ligamentary injection is generally contraindicated.
d. Conscious sedation is never warranted.
e. Dental treatments are generally safe if the stress is
minimized.
1329. What is the temporary myocardial ischemia resulting
due to myocardial demand exceeding supply that occurs
irregularly or on multiple occasions without
predisposing factors termed?
a. Stable angina.
b. Unstable angina.
1330. What is the temporary myocardial ischemia resulting
due to myocardial demand exceeding supply that occurs
infrequently, is associated with excretion or stress, and
is easily controlled with medication and rest termed?
a. Stable angina.
b. Unstable angina.
215
1331. A 60 years old male patient had an angina episode in
the dental chair. Which of the following is not the
emergency medical treatment that he is supposed to
receive?
a. Discontinue the periodontal procedure.
b. Administer one tablet 0.3-0.6 mg nitroglycerine
sublingually. Repeat the medication every 3 min if required
three times.
c. Oxygen administration in reclined position.
d. Administer one tablet 250 mg Acetaminophen orally to
relieve and reduce anxiety.
1332. Dental treatment is generally deferred for at least 6
months after ___________________ because peak
mortality occurs during this time.
a. Hypertension. b. Myocardial infarction.
c. Stable angina. d. Unstable angina.
1333. Which of the following are the common surgical
procedures carried out in patients with ischemic heart
disease?
a. Angioplasty. b. Cardiac (aortocoronary) bypass.
c. Endarterectomy. d. Femoral artery bypass.
e. All of the above.
1334. What is the inability to breathe except in an upright
position termed?
a. Orthopnea. b. Paroxysymal nocturnal dyspnea.
c. Both a & b d. None of the above
1335. Which of the following are not dental equipment’s that
can disrupt older unipolar pacemakers?
a. Equipments that generate electromagnetic fields.
b. Ultrasonic scalers.
c. Electrocautery units.
d. Composite Light cure units.
Chapter -3 : Periodontal therapy
216 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1336. Which of the following periodontal procedures require
antibiotic prophylaxis in certain heart conditions
associated with infective endocarditis?
a. Procedures associated with significant bleeding from hardor soft tissues.
b. Periodontal surgery.
c. Scaling and root planning procedures.
d. All of the above. e. None of the above.
1337. In which of the following patients with heart conditions
associated with infective endocarditis, is antibiotic
prophylaxis not recommended?
a. Major congenital heart disease.
b. Mitral valve prolapse without valvular regurgitation.
c. Previous history of Infective endocarditis.
d. Prosthetic heart valves.
1338. In which of the following patients with heart conditions
associated with infective endocarditis, is antibiotic
prophylaxis not recommended?
a. Hypertrophic cardiomyopathy.
b. Mitral valve prolapse with valvular regurgitation.
c. Mitral valve prolapse without regurgitation.
d. Rheumatic heart disease.
1339. A patient ABC and a patient XYZ, both with heart
conditions associated with infective endocarditis visited
your dental clinic. ABC has mitral valve prolapse with
valvular regurgitation and XYZ has mitral valve
prolapse without valvular regurgitation. Which of the
following statements is true in relation to their
periodontal treatment?
a. Endocarditis prophylaxis is recommended for ABC while
it is not recommended for XYZ.
b. Endocarditis prophylaxis is recommended for both ABC
and XYZ.
c. Endocarditis prophylaxis is recommended for XYZ while
it is not recommended for ABC.
d. Endocarditis prophylaxis is not recommended for both
ABC and XYZ.
217
1340. Which of the following is a standard oral regimen
recommended as antibiotic prophylaxis for periodontal
procedures in adults at risk for infective endocarditis?
a. Amoxicillin 2g, 1 hour before the procedure.
b. Azithromycin 500mg, 1 hour before procedure.
c. Clarithromycin 500mg. 1 hour before procedure.
d. Clindamycin 600mg, 1 hour before the procedure.
1341. Which of the following is an alternate regimen
recommended as antibiotic prophylaxis for periodontal
procedures in adults at risk for infective endocarditis
who are allergic to amoxicillin/penicillin?
a. Azithromycin 500mg, 1 hour before procedure.
b. Cefadroxil 2 g 1 hour before the procedure.
c. Cephalexin 2 g 1 hour before the procedure.
d. Clarithromycin 500mg. 1 hour before procedure.
e. Clindamycin 600mg, 1 hour before the procedure.
f. All of the above.
1342. Which of the following is not an alternate regimen
recommended as antibiotic prophylaxis for periodontal
procedures in adults at risk for infective endocarditis
who are allergic to amoxicillin/penicillin?
a. Ampicillin 2 g IM /IV 30 min before the procedure.
b. Azithromycin 500mg, 1 hour before procedure.
c. Cefadroxil 2 g 1 hour before the procedure.
d. Cephalexin 2 g 1 hour before the procedure.
e. Clarithromycin 500mg. 1 hour before procedure.
f. Clindamycin 600mg, 1 hour before the procedure.
1343. Which of the following is recommended as antibiotic
prophylaxis for periodontal procedures in adults at risk
for infective endocarditis who are unable to take oral
medications?
a. Ampicillin 2 g IM /IV 30 min before the procedure.
b. Azithromycin 500mg, 1 hour before procedure.
c. Cefadroxil 2 g 1 hour before the procedure.
d. Cephalexin 2 g 1 hour before the procedure.
Chapter -3 : Periodontal therapy
218 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1344. Which of the following is recommended as antibiotic
prophylaxis for periodontal procedures in adults at risk
for infective endocarditis who are unable to take oral
medications and are allergic to penicillin?
a. Ampicillin 2 g IM /IV 30 min before the procedure.
b. Azithromycin 500mg, 1 hour before procedure.
c. Cefadroxil 2 g 1 hour before the procedure.
d. Cephalexin 2 g 1 hour before the procedure.
e. Clindamycin 600mg IV / Cefazolin 1.0g IM/IV within 30
min before procedure.
1345. Which of the following antibiotics should not be used in
patients with immediate-type hypersensitivity reactions
like urticaria, angioedema, anaphylaxis to penicillins?
a. Azithromycin. b. Cephalosporins.
c. Clarithromycin. d. Erythromycin.
1346. Which of the following tests may provide an indication
of the potential response to periodontal therapy in a
diabetic mellitus patient?
a. Fasting plasma glucose.
b. Glycosylated hemoglobin assay (Hb A1C).
c. Non-fasting plasma glucose.
d. Two-hour postprandial glucose.
1347. Which of the following sequence shows the correct risk
levels of patients having antiglycemic agents to have
hypoglycemic episodes?
a. Biguanides/Thiazolidinediones >Insulins >sulfonylureas
b. Insulins =sulfonylureas=Biguanides/Thiazolidinediones.
c. Insulins >sulfonylureas>Biguanides/Thiazolidinediones.
d. Insulins>Biguanides/Thiazolidinediones>sulfonylureas.
1348. Which of the following is not a sulfonylurea type of
antiglycemic drug; rather is a biguanide- antiglycemic
drug?
a. Chloropropamide. b. Glimepiride.
c. Glipizide. d. Metformin.
219
1349. Which of the following is not a sulfonylurea type of
antiglycemic drug; rather is á-glucosidase inhibitor -
antiglycemic drug?
a. Acarbose. b. Chloropropamide.
c. Glimepiride. d. Glipizide.
1350. Which of the following is not a sulfonylurea type of
antiglycemic drug; rather is a thiazolidinediones -
antiglycemic drug?
a. Chloropropamide. b. Glimepiride.
c. Glipizide. d. Rosiglitazone.
1351. Which of the following is not a manifestation of acute
adrenal insufficiency or adrenal crisis?
a. Coma. b. Hunger pangs.
c. Hypertension. d. Loss of consciousness.
e. Mental confusion, fatigue and weakness.
f. Nausea and vomiting. g. Syncope.
1352. Which of the following are the primary modes of
Hepatitis B transmission?
a. Percutaneous. b. Per mucosal.
c. Sexual. d. All of the above.
e. None of the above.
1353. Which of the following are the primary known modes
of Hepatitis C transmission?
a. Percutaneous. b. Per mucosal.
c. All of the above. d. None of the above.
1354. Which of the following are the known modes of HIV
transmission?
a. Exposure to infectious blood or blood products.
b. Illicit use of injectable drugs.
c. Mother to infant.
d. Unprotected Sexual contact.
e. All of the above.
f. None of the above.
Chapter -3 : Periodontal therapy
220 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1355. Can a dentist contract Hepatitis B/C/HIV from his
patients if he/she does not use proper barrier
techniques?
a. Yes. b. No
1356. A dentist can transmit Hepatitis B/C/HIV to their
patients if he/she does not use proper barrier
techniques.
a. True. b. False.
1357. Does shaking hands transmit the following HIV/
hepatitis B/Hepatitis-C?
a. Yes. b. No.
1358. Does using public toilets transmit the following HIV/
Hepatitis-B/ Hepatitis-C?
a. Yes. b. No.
1359. Contaminated needle stick injury can transmit the
following diseases Hepatitis-C/ Hepatitis-B /HIV.
a. True. b. False.
1360. A shaving razor sharing can transmit the following
diseases Hepatitis-C/ Hepatitis-B /HIV.
a. True. b. False.
1361. A human bite can transmit the following Hepatitis-C/
Hepatitis-B /HIV.
a. True. b. False.
1362. Can a contaminated blood soaked gauze transmit the
Hepatitis-C/ Hepatitis-B /HIV
a. Yes. b. No.
1363. Which of the following population groups are at high
risk of contracting Hepatitis?
a. Female prostitutes.
b. Health care workers. Eg Surgeons.
c. Injecting drug users.
d. Migrants from developing countries.
e. Promiscuous homosexual men.
f. All of the above. g. None of the above.
221
1364. Intra orally, the greatest concentration of HBV is at
the gingival sulcus as a result of the continuous serum
exudate. In which of the following diseases the viral
presence increases significantly in mixed saliva?
a. Dental caries. b. Periodontitis.
c. Ranula. d. Trauma from occlusion.
1365. Which of the following viruses does not have a safe
vaccine available yet?
a. Hepatitis A virus. b. Hepatitis B virus.
c. Hepatitis C virus.
1366. A dentist accidently had a needle stick injury/
percutaneous injury while treating a Hepatitis B virus
carrier. Which of the following would you prefer to do
for the injured individual?
a. Hepatitis B immunoglobulin
b. HepatitisB vaccine administration if not received earlier.
c. All of the above. d. None of the above.
1367. Which of the following mouth rinse use is
contraindicated in immunocompromised individuals?
a. Chlorhexidine. b. Hydrogen peroxide.
c. Povidine-iodine. d. Sanguinarine.
e. Sodium fluoride.
1368. Which of the following is not a common systemic
antifungal drug used for oral candidiasis?
a. Ketoconazole. b. Fluconazole.
c. Itraconazole. d. Metronidazole.
1369. Which of the following is not a common tropical
antifungal therapeutic agent for oral candidiasis?
a. Amphotericin B oral suspension 100 mg qid for 2 weeks.
b. Chlorhexidine ointment.
c. Clotrimazole 10mg dissolvable tablet.
d. Miconazole 2% ointment
e. Nystatin 500000 U dissolvable tablet.
Chapter -3 : Periodontal therapy
222 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1370. Which of the following are the uses of chlorhexidine in
dentistry?
a. Antiseptic.
b. Antiplaque agent/plaque controlling agent/antigingivitis
agent.
c. Denture disinfectant. d. All of the above.
e. None of the above.
1371. How is the removable dental appliance, usually
constructed of acrylic that covers a dental arch and
designed to minimize the damaging effects of bruxism
and other occlusal habits referred?
a. Bite guard. b. Mouth guard.
c. Night guard. d. Occlusal guard.
e. All of the above. f. None of the above.
1372. Smokers are not benefitted from periodontal treatment.
a. True. b. False.
1373. Which of these groups among non-smokers and
smokers demonstrate diminished response to
periodontal treatment?
a. Non smokers demonstrate diminished response to
periodontal treatment.
b. Smokers demonstrate diminished response to periodontal
treatment.
1374. With selective grinding, the forces are directed along
_____________________ of the tooth.
a. Horizontal axis. b. Lateral surface.
c. Long axis. d. Proximal surfaces.
1375. Which of the following is not true about the use of dental
lasers in periodontics?
a. Excimer lasers- Argon-fluoride lasers: Gingivectomy.
b. Gas lasers-Argon (Ar)-subgingival curettage.
c. Gas lasers- Carbon di oxide-subgingival curettage.
d. Diode lasers: Gallium-aluminium-arsenide: subgingival
curettage, gingival depigmentation.
e. Solid state lasers: Neodymium-yttrium-aluminium-granet
(Nd: YAG): Subgingival curettage, gingival
depigmentation.
223Chapter -3 : Periodontal therapy
f. Solid state lasers: Erbium group: Subgingival curettage,
gingival depigmentation, Dentinal hypersensitivity
treatment.
1376. Which of the following is the antibiotic of choice in
treatment of Aggregatibacter actinomycetemcomitans
in aggressive periodontitis?
a. Metronidazole-amoxicillin.
b. Metronidazole-ciprofloxacin. c. Tetracycline.
d. All of the above. e. None of the above.
1377. One stage-full mouth disinfection protocol consists of
full mouth debridement ie removal of all plaque and
calculus, scaling and root planing, tongue brushing with
chlorhexidine gel (1%), mouth rinsing with a
chlorehexidine solution (0.2%) for 2 min and periodontal
pockets are irrigated with a chlorehexidine solution
(1%) all with a 24 hour period. Who described this
concept of full-mouth disinfection?
a. Quiryen et al. b. Lang et al.
c. Glickman and co-workers.
1378. Which of the following is first aid after sharp injuries?
a. Thorough wash of the puncture site with soap and warm
water.
b. Encourage bleeding from the injured site.
c. Dry antiseptically. d. Proceed for further action.
e. All of the above. f. a and b.
1379. A dentist was performing a periodontal surgical
procedure; he sustained an accidental injury with a
sharp instrument. He took his regular first aid. What
further actions should he pursue?
a. Review hepatitis-B/C and HIV status of the patient.
b. Arrange venesection of the patient.
c. If unvaccinated for hepatitis B commence immediately
along with hepatitis B immunoglobulin IM.
d. Follow up antibody testing.
e. All of the above. f. None of the above.
224 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1380. Titanium plasma-sprayed (TPS) and hydroxyapatite
(HA) surfaces are considered smooth-surface implants.
a. True. b. False.
1381. Which of the following have a negative effect on the
dental implant after its placement?
a. Compromised blood supply.
b. Compromised oxygen supply. Eg after radiotherapy,
hyperbaric oxygen therapy.
c. Loss of blood clot stability.
d. Microbial contamination of the surgical site.
e. Temperature of more than 47°c for a minute.
f. All of the above.
1382. The critical temperature for the bone cells bearing a
thermal insult is ________ at an exposure time of 1
minute.
a. 47°c. b. 40°c.
c. 56°c. d. 51°c.
1383. Which of the following instruments can be used to
measure the surface roughness of dental implants?
a. Florida probe. b. Mobilimeter.
c. Periodontometer. d. Profilometer.
1384. Which of the following devices are used to clinically
assess the implant biomechanics-rigidity of bone-
implant interface?
a. Periotest.
b. Resonance frequency analysis: ostell.
c. All of the above. d. None of the above.
ORAL IMPLANTOLOGY
225Chapter -4 : Oral implantology
1385. Which of the following researcher’s was responsible
for the historical break through- osseointegeration?
a. Brånemark. b. Glickman.
c. Linkow. d. Tarnow.
1386. Blade shaped endosseous dental implants are
associated with __________________.
a. Brånemark. b. Glickman.
c. Linkow. d. Masters and Hopkins.
1387. Which of the following is not a type of endosseous
dental implants?
a. Bladelike implants. b. Cylindrical implants.
c. Screw shaped implants. d. Transmandibular implants.
1388. Which of the following endosseous dental implants are
most commonly used once?
a. Screw-shaped threaded implants.
b. Cylindrical implants.
c. Disk implants. d. Blade like implants.
1389. Which of the following implant types require a
submandibular skin incision and general anesthesia for
their placement?
a. Blade like implants. b. Cylindrical implants.
c. Screw-shaped threaded implants.
d. Transmandibular implants.
1390. Which of the following are types of transmandibular
implants?
a. Bosker implants.
b. Staple-bone implants by Small.
c. All of the above. d. None of the above.
1391. Which of the following materials is a gold standard for
endosseous implants both in orthopedics and in
periodontics?
a. Ceramics. b. Commercially pure titanium.
c. Iron. d. Noble metals.
226 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1392. Which of the following is not an additive process that
is used to modify the nature of implant surface?
a. Calcium phosphates: Hydroxyapatite.
b. Fluoride integrated into titanium oxide layer.
c. Increased titanium oxide layers. d. Sandblasting.
1393. Which of the following is not a subtractive process that
is used to modify the surface of implants?
a. Acid etching. b. Calcium phosphate coating.
c. Sandblasting. d. Turning.
1394. Dental implants are lately of common use. What are
the types of instruments used for their maintenance?
a. Irregular instruments. b. Metallic instruments.
c. Plastic-tipped instruments. d. Stainless steel instruments.
1395. Which of the following implant types have more chances
of having periimplantitis?
a. Rough surface implants.
b. Hydroxy apatite coated implants.
c. Titanium plasma-sprayed coated implants.
d. All of the above.
1396. Which of the following is not a type of incision used in
implant surgery?
a. Circular/punch incision. b. Crestal incision.
c. Crevicular incision. d. Remote incision.
1397. In case of implants, what does the probing penetration
depth reveal?
a. Loss of attachment. b. Thickness of connective tissue.
c. Thickness of mucoperiosteum.
d. Width of junctional epithelium.
1398. With endosseous dental implants, after a few months
certain amount of sensitivity develops. What is it
refered to as?
a. Osseointegeration. b. Osseoperception.
c. Osteoid formation. d. Tactile reception.
227
1399. Which of the followingpatients are usually not treated
with dental implants?
a. Patients after radiation therapy-60 Gy.
b. Immunocompromised patients.
c. All of the above. d. None of the above.
1400. Which of the following dental implants are more
vulnerable to implant fracture?
a. Larger implants. b. Smaller implants.
c. Wider implants. d. All of the above.
1401. Which of the following is not an absolute
contraindication for treatment using dental implants?
a. Diabetes. b. Mental instability.
c. Psychiatric syndromes. d. Radiation therapy.
e. Substance abuse (e.g alcohol, drugs)
1402. Which of the following is a relative contraindication for
treatment using dental implants?
a. Atophic mandible. b. Bone metabolic disorders.
c. Diabetes. d. Immunosuppressive drugs.
e. Periodontal disease. f. Psychiatric syndromes.
g. Smoking; tobacco use.
1403. Which of the following is not an anatomic structure
pertinent to treatment planning of the implant patient
for placing an implant in maxilla?
a. Canine fossa. b. Incisive foramen.
c. Maxillary sinus. d. Mental foramen.
e. Nasal cavity.
1404. Which of the following is not an anatomic structure
pertinent to treatment planning of the implant patient
for placing an implant in mandible?
a. Anterior extension of mandibular canal.
b. Anterior loop of mandibular canal. c. Incisive foramen.
d. Lingual inclination of alveolar ridge.
e. Mandibular canal. f. Mental foramen.
g. Submandibular gland.
Chapter -4 : Oral implantology
228 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1405. Dental implant should be placed _______________
superior to the roof of the alveolar canal.
a. 0-1 mm. b. 1-2 mm.
c. 2-3 mm. d. 3-4 mm.
1406. Which of the following is not a type of quantity of bone?
a. A: Most of the alveolar ridge is present.
b. B: Moderate residual ridge resorption has occurred.
c. C: Advanced residual ridge resorption has occurred and
only basal bone remains.
d. D: Minimal to moderate resorption of basal bone has
occurred.
e. E: Extreme resorption of the basal bone has occurred.
f. B: A thin layer of cortical bone surrounds a core of low
density trabecular bone.
1407. Which of the following is not a group in bone quality
index?
a. Type I; almost the entire jaw comprises homogenous
cortical bone.
b. Type II; a thick layer of cortical bone surrounds a core of
dense trabecular bone.
c. Type III; a thin layer of cortical bone surrounds a core of
dense trabecular bone of favourable strength.
d. Type IV; a thin layer of cortical bone surrounds a core of
low-density trabecular bone.
e . Type IV: Extreme resorption of the basal bone has
occurred.
1408. Which of the following is not a criterion for evaluating
the success of dental implants?
a. Absence of clinical signs and symptoms of pain, bleeding,
infection and paraesthesia and involvement of anatomic
structures.
b. Biological width should be 3-4 mm.
c. Implant should be immobile.
d. Minimum success rate of 85% at 5 years and 80 % at 10
years of observation.
e. No peri-implant radiolucency should be seen on the
radiograph.
229Chapter -4 : Oral implantology
1409. What is the process of preparing the bone with a series
of burs and drills to place the dental implant directly
into a socket?
a. Cavitation.
b. Osseous preparation.
c. Socketing.
d. Trephning.
1410. Inflammatory changes, involving the soft tissue and
bone surrounding an implant, are diagnosed as.
a. Peri-implant mucositis.
b. Peri-implantitis.
c. Peri-implant gingivitis.
d. Peri-implant periodontitis.
1411. Which of the following are the differences in
maintenance of implants when compared to natural
tooth?
a. No acidic fluoride prophylactic agents.
b. Non abrasive prophylactic paste.
c. Use Plastic coated instruments.
d. Use Sharp stainless instruments.
e. a, b and c.
f. b, c and d.
1412. Which of the following when used on dental implants
will damage their surface?
a. Acidic fluoride agents.
b. Gold-plated curettes.
c. Plastic instruments.
d. Rubber cup with pumice
230 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
SELF-ASSESSMENT
PICTURE TEST
1413. Identify the parts of the gingiva.
a. Mucogingival junction, Attached gingiva, Interdental papilla,
 Free gingiva.
1414. An otherwise healthy dark-complexioned male adult
has gingiva with pigmentation. The male adult is not a
smoker. What is the most probable reason?
1415. A 60 years old male patient reported with mobility of
his teeth. Examination revealed poor oral hygiene,
generalized bleeding on probing, multiple periodontal
pockets, generalized moderate to severe loss of
attachment. The patient has no history of smoking and
has no systemic ailments.What is the diagnosis?
a. Melanin pigmentation.
231Chapter -5 : Self-assessment Picture test
a. Generalized chronic moderate to severe periodontitis.
1416. A 25 years old male patient reported with poor oral
hygiene, with plaque and calculus. A significant
difference in amount of plaque and calculus was seen
between the two sides.The amount of local deposits was
more on the left side than on the right side. The patient
reported of using only the right side and rarely
performs any oral hygiene measuresWhich of the
following is the most probable cause for this disparity
in local factor accumulation?
a. Non-working side is not cleaned by the fibrous foods that the patient
 takes.
1417. A young female patient reported with a gingival polyp
in her lower anterior tooth region. The lesion was
excised. Histopathologic examination revealed chronic
inflammatory cells and dense collagen fibers in the
connective tissue. The lesions showed no signs of
recurenceWhat is the diagnosis?
232 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1418. An otherwise healthy pregnant female patient in her
first trimester complained of a painful mushroom-like
mass in gingiva, which readily bled when disturbed.
What is your possible diagnosis?
a. Pregnancy induced pyogenic granuloma- Pregnancy tumor.
a. Inflammatory fibrous hyperplasia.
1419. A patient with a recent amalgam restoration in his
mandibular 2nd and 3rd molar reported with gingival
inflammation, pain and discomfort. What does the
radiograph reveal? What is the reason for the
discomfort and gingival inflammation?
a. Overhanging restoration-violation of biologic width.
b. Loss of the 1st molar-mesial drift.
c. Dental caries with pulpal involvement
233Chapter -5 : Self-assessment Picture test
1420. A57-year-old female patient reported with sensitivity
in her maxillary anterior teeth. The patient had an
excessive overbite.What is the diagnosis and the
possible cause of her ailment?
a. Excessive overbite-recession in palatal area-dentinal hyper sensitivity.
b. Dental erosion
c. Myofascial Pain Dysfunction Syndrome
1422. The following picture shows a periodontal probe.
Identify the probe and its markings.
a. Dental abrasion and hypersensitivity.
1421. A 23-years-old female reported with severe sensitivity
to cold food. Clinical examination revealed a wedge
shaped defect in the cervical region of maxillary molar.
What is the probable diagnosis?
234 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1423. The following picture shows a periodontal instrument.
Identify the instrument.
1424. The following picture shows a periodontal instrument.
Identify the instrument.
1425. The following picture shows a periodontal instrument,
a flat bladed knife that is sharp on all its edges. Identify
the instrument.
a. Orban’s interdental knife
a. Hoe
a. Kirkland knife.
a. CPITN-Clinical(0.5, 3.5,5.5,8.5 and 11.5 mm)
235Chapter -5 : Self-assessment Picture test
1426. The following picture shows a periodontal instrument.
Identify the instrument.
1427. The following picture shows a periodontal instrument.
Identify the instrument.
a. Jacquette scaler.
a. Goldman fox scaler.
1429. The following picture shows a dental instrument.
Identify the instrument.
a. Williams Probe.(1,2,3,5,7,8,9,10mm)a. Periosteal elevator
1428. The following picture shows a periodontal instrument.
Identify the instrument.
236 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1430. The following picture shows a periodontal instrument.
Identify the instrument.
1431. The following picture shows a periodontal instrument.
Identify the instrument.
a. Pocket marker.
a. Toothed tissue forceps
1432. The following picture shows periodontal instruments.
Identify them.
a. Universal curettes.
237Chapter -5 : Self-assessment Picture test
1433. The following picture shows a periodontal instrument.
Identify the instrument.
1434. The following picture shows a set of periodontal curettes
with offset blade. Identify them.
a. Towner -U15/30-Sickle scalers.
a. Gracey curettes.
1435. The following picture shows a periodontal scaling
instrument. Identify the instrument.
a. Chisel.
1436. The following picture shows a periodontal furcation
probe. Identify the instrument.
a. Nabers probe.
238 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1438. The following picture shows a periodontal furcation
probe. Identify the instrument.
a. Cowhorn probe.
1439. The following picture shows a commonly used dental
instrument used for indirect vision, illumination and
retraction. Identify the instrument.
a. Mouth mirror.
1440. The following picture shows a dental instrument.
Identify the instrument.
a. Dental tweezer with lock.
1437. The following picture shows a periodontal instrument
whose spoon shaped end is for stain removal and the
other sickle shaped is for supragingival scaling. Identify
the instrument.
a. Cumine scaler.
239Chapter -5 : Self-assessment Picture test
1441. The following picture shows a periodontal probe.
Identify the probe and its markings.
a. CPITN -Epidemiological (0.5,3.5,5.5)
1442. The following is an interdental aid used for plaque
removal from the interdental areas. Identify the same.
a. Interproximal brush.
1443. The following is an interdental aid used for plaque re-
moval from the interdental areas. Identify the same
a. Dental floss.
240 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1444. The following is part of barrier protection used for
infection control. Identify the same.
a. Protective eyewear.
1445. When the upper lip is pulled upwards and outwards,
the papilla between the central incisors blanches and
moves. What does this observation infer?
a. High labial frenum:
1446. How would you describe the bony architecture seen in
this picture?
a. Negative architecture.
1447. A child of 9 years age has melanin pigmented gingiva.
He had unerupted central incisors. The area of incisors
showed a non inflammatory firm bulge. Whatare the
findings in the gingiva?
241Chapter -5 : Self-assessment Picture test
a. Pre -eruptive bulge in gingiva.
1448. A child with 9 years with unerupted central incisors
reported. A surgical exposure of incisor edges of teeth
was done. Name the procedure.
a. Operculectomy.
1449. A child patient aged 9 years reported with pain and
difficulty in mastication in relation to right back tooth
region. On examination, a partially erupted molar was
found. What is your diagnosis?
a. Pericoronitis
242 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1450. Child patient aged 9 years complained of pain during
mastication in lower incisors. On examination there was
inflammation in mandibular anteriors with edge to egde
relationship with lower laterals.
a. Acute gingivitis.
1451. A child of 7 years reported with erupting central incisor
with thick frenum inserting into the interdental papilla.
What is the condition of frenum called?
a. High labial frenal attachment
1452. A 21 years old male patient reported to a dental clinic.
History revealed his Type I diabetic status. The patient
was a previous smoker. He also had stains in his teeth.
Periodontal examination revealed multiple periodontal
pockets and generalized mild loss of attachement. What
is your diagnosis?
243
a. Chronic generalized mild periodontitis.
1453. A young patient undergoing an orthodontic treatment
reported with poor oral hygiene, gingival inflammation
and gingival enlargement. History revealed nothing of
significance. The patient underwent scaling. Gingival
inflammation subsided significantly. What is your
probable diagnosis and treatment of choice?
a. Chronic inflammatory gingival enlargement-gingivectomy.
Chapter -5 : Self-assessment Picture test
1454. Gingivitis is gingival inflammation without concomitant
loss of attachment. A young patient reported with gin-
gival inflammation confined largely to papillae of the
maxillary anterior teeth. Clinical examination showed
bleeding on probing and no loss of attachment. What is
your diagnosis?
a. Papillary gingivitis:
244 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1455. Identify the dental anomaly in this section of
orthopantomograph.
a. Supernumerary teeth
b. Localized periodontitis
c. Calculus .
d. All of the above.
1456. An apparently healthy male patient reported with a pain-
ful ulcer in the lateral border of the tongue for two weeks
duration. There was associated history of biting the
tongue occasionally and the symptoms were gradually
subsiding.
a. Traumatic ulcer
b. Aphthous ulcer
c. Squamous cell carcinoma
Fod. liate papillitis
245
1457. In a moderately deep periodontal pocket in the left cen-
tral incisor of the patient tetracycline fibers were
placed. Does this tetracycline fibers-local drug deliv-
ery induce tetracycline resistance among periodontal
pathogens?
a. No -it does not induce.
Chapter -5 : Introduction
1458. Which of the following is true about the mandibular
central incisors of the presented case?
a. Millers Class IV recession in the central incisors.
b. They have a poor prognosis.
c. All of the above.
1459. Mesio buccal site of a maxillary molar records 7 mm
pocket depth. The gingival margin is at the level of the
Cemento enamel junction.What is the loss of
attachment?
246 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1460. Which of the following is true about the left canine of
this presented case? The radiograph showed severe
interdental bone loss and the roots of lateral incisor
and canine were close to each other.
a. Millers class IV recession in relation to left maxillary canine.
b. Dehiscence in relation to canine.
c. Buccally placed canine.
d. Prognosis is very poor.
e. All of the above.
1461. A 26 year old female complains of a soft tissue growth
inside her left lower molars with occasional bleeding.
The associated tooth was carious for a long period of
time and not associated with any other complaints.
What is the probable differential diagnosis?
a. 7 mm. b. 4 mm.
c. 3 mm. d. 8 mm.
247
a. Pulp polyp
b. Gingival polyp
c. Squamous cell carcinoma
d. All of the above.
1462. What does the following picture show outrightly in
relation to the 1st molar?
Chapter -5 : Self-assessment Picture test
a. Plaque and calculus.
1463. An 18-years-oldfemale reported with unsatisfactory
gingival appearance due to coloration in his upper and
lower gums. The probable diagnosis is
a. Mild – gingival melanin pigmentation
248 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1464. A chlorehexidine chip (Periochip)-local antiseptic
delivery was used to treat a moderately deep
periodontal pocket.How long does it take for the chip
to degrade?
a. -2 days.
b. 3-4 days.
c. 7-10 days.
d. 8-10 days
1465. Radiographs revealed interdental bone levels in
relation to central incisors as normal. How would you
describe the periodontal status of mandibular left
central incisor?
a. Miller’s class II marginal recession -31.
b. Diastema.
c. Frenal pull -31.
d. Prognosis of 31 is good.
e. All of the above.
249Chapter -5 : Self-assessment Picture test
1466. A 49 years old male patient presented with a dome like
ovoid elevationof gingiva in his lower left back tooth
region. The patient reported of discomfort and fever.
Clinical examination revealed furcation involvement
and regional lymphadenopathy. What is your
diagnosis?
a. Acute periodontal abscess.
b. Gingival abscess.
c. Chronic periodontal abscess.
d. Pericoronal abscess.
1467. A 31 year old male reported with a history of fractured
crown replacement and intra oral examination revealed
a. Remaining implants
250 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1468. Identify the surgical procedure performed on this pa-
tient.
a. Crown lengthening
b. Gingival curettage
c. Oral prophylaxis 
1469. Clinical examination showed gingival sulcus depth to
be between 2-3 mm in realtion to 13. Intraoral
periapical radiographs showed no interdental bone loss.
How would you describe the status of right maxillary
canine?
a. Wide Millers class I recession -31.
b. Dehescinece -31.
c. Good prognosis -31.
d. All of the above.
251Chapter -5 : Self-assessment Picture test
1470. Identify the treatment provided to reduce the mobility
of periodontally involved teeth.
a. Extra coronal splinting
.
1471. Identify the variation in gingival anatomy
a. Stillmans cleft
.
a. Midline diastema.
1473. A patient complains of tooth mobility and receded
gums. Identify the clinical presentation.
a. Chronic generalized severe periodontitis
1472. The patient complains of unesthetic appearance due to
spacing between teeth. Identify the clinical condition.
252 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1474. A 55 years old diabetic patient reported to the clinic
with complaints of bleeding on probing, tooth mobility
and bad breath. Identify the clinical presentation.
a. Chronic periodontitis associated with diabetes.
1475. A 60 years old diabetic patient complained of a slowly
growing gingival overgrowth in relation to his lower
molars. It is associated with bleeding and mild pain.
Clinical examination revealed gingival recession,
pocket formation and tooth mobility. The differential
diagnosis is
a. Gingival epulis in association with Chronic periodontits
b. Squamous cell carcinoma
c. Pyogenic granuloma
d. Ossifying fibroma
e. All of the above.
253Chapter -5 : Self-assessment Picture test
1476. Identify the plaque control procedure.
a. Chemical p laque control using Chlorhexide.
1477. Identify the active ingredient and mention its use:
a. Povidine -iodine: pre procedural rinse.
1478. A patient with recession in his lower anteriors reported.
A complete connective graft procedure carried out is
presented. Identify the steps of the procedure.
254 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
a. Pre operative pic with recession, b-a papilla preservation flap elevated,
c-citric acid root surface biomodification carried over, d- emdogain
(enamel matrix derivative) applied, e-double incisions carried over at the
donor site, f- removal of connective tissue graft, g-connective tissue
autograft, h- procured connective tissue autograft, h-placed in the
recipient bed and sutured, i- post healing.
255
1479. A surgical flap has been elevated for carrying out a
bone grafting procedure. Identify the type of the flap
shown in the picture?
a. Papilla preservation flap.
b. Conventional flap.
c. Laterally displaced flap.
d. Coronally displaced flap.
1480. Identify what is seen bilaterally in the mandibular molar
region in the orthopantamograph (OPG).
Chapter -5 : Self-assessment Picture test
a. Endosseous implants.
b. Zygomatic implants.
c. Transmandibular implants.
d. Blade shaped implants.
256 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1481. Identify the dental anomaly in this orthopantomograph.
a. Taurodontism in relation to mandibular 3rd molar.
1482. The following radiographs showsradiopaque objects
other than the normal anatomic structures. Identify
them.
a. Artifacts.
b. Dental implants.
c. Ligature wires.
d. Orthodontic bands.
1483. Write the diagnosis of the radiographic presentation.
257Chapter -5 : Self-assessment Picture test
a. Chronic generalized gingivitis
b. Chronic generalized periodontits
1484. Identify the condition and prognosis of lower right first
premolar
a. Chronic generalized periodontitis and poor prognosis.
1485. Identify the anomaly.
a. High frenal attachment
258 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1486. A patient complains of enlarged tongue. Clinical
examination revealed numerous fissures on dorsal
tongue. Identify the clinical condition.
a. Macroglossia associated with fissured tongue
1487. A patient complained of restricted mobility of tongue
and disturbances in speech and swallowing. Identify the
clinical condition.
a. Tongue tie/ Partial ankyloglossia
1488. Intra-oral examination revealed enamel hypoplasia.
Periodontal status revealed bleeding on probing with
no loss of attachment. Identify the clinical condition.
259Chapter -5 : Self-assessment Picture test
a. Chronic marginal gingivitis with dental fluorosis.
1489. A dark coloured individual reported to the dental clinic
for a check-up. Identify the clinical condition.
a. Severe gingival melanin pigmentation.
1490. A female patient complains of burning sensation in
tongue. History of anemia and she is not under any
treatment. Examination revealed atrophy of papillae.
Identify the clinical condition.
a. Bald tongue - Glossitis with atrophy of papillae
260 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1491. A female patient complains of bleeding gums and mobile
lower teeth. Identify the clinical condition.
a. Chronic generalized periodontitis
1492. Examination in the following case revealed gingival
bleeding on probing and no loss of attachment. Medical
history was non-significant. Identify the clinical
condition.
a. Chronic marginal gingivitis
1493. A patient had extracted the upper molar many years
ago. Clinical examination revealed this clinical
condition. What is the probable diagnosis?
a. Supra -eruption of lower molar and malocclusion.
261Chapter -5 : Self-assessment Picture test
1494. A patient had extracted the upper molar many years
ago. Clinical examination revealed this clinical condition.
What is the probable diagnosis?
1495. The patient complains of severe burning sensation in
the maxillary gingiva after applying topical gel. What
is the probable differential diagnosis?
1496. A patient complained of painful, soft tissue swelling in
relation to the lower third molar. Identify the clinical
condition.
a. Chemical burn
b. Hypersentivity reaction
c. All of the above.
a. Fracture d crown
a. Partially erupted third molar with pericoronitis.
262 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1497. A patient complained of deposits and discoloration in
his lower teeth. Identify the clinical condition.
a. Calculus and Extrinsic stains.
1498. A female patient reported with burning sensation in
tongue. Examination revealed numerous fissures, at-
rophy of dorsal papillae and erythematous areas sur-
rounded by a white border. Identify the clinical condi-
tion.
a. Glossitis associated with Geographic tongue and fissured tongue.
1499. An old male reported with reduced vertical dimension
and hypersensitivity. Examination revealed extensive
loss of occlusal tooth structure. Identify the clinical
condition.
a. Generalized -severe dental attrition.
263Chapter -5 : Self-assessment Picture test
1500. A patient reported with a gingival overgrowth of recent
occurence. He had no history of drug intake. Medical
history was non-significant. Identify the clinical
condition.
a. Inflammatory Gingival enlargement.
1501. A young boy reported with a history of trauma to his
front teeth region. Clinical examination revealed
gingival trauma with no mobility or fracture of the
teeth.Identify the clinical condition.
a. Acute / Traumatic gingivitis.
1502. A patientis a chronic smoker and complained of
discoloration in the tongue. Identify the clinical
condition.
a. Hairy tongue.
264 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1503. A patient complained of recent trauma and injury to
his anterior teeth. Identify the clinical condition.
a. Fracture crown with traumatic gingivitis.
1504. A patient complained of a slow growing, asymptomatic
swelling in the mandibular gingiva. Give the differential
diagnosis for this clinical condition.
a. Gingival epulis
b. Ossifying fibroma
c. Gingival abscess
d. Fibro -epithelial polyp
e. All of the above.
1505. Clinical examination revealed bleeding on probing with
no loss of attachment. Oedema was restricted only to
the interdental papilla and adjacent attached gingiva.
Identify the clinical condition.
a. Localized papillary gingivitis.
265Chapter -5 : Self-assessment Picture test
1506. The patient complained of a bluish swelling in the
maxillary alveolus accompanied with mild discomfort.
Radiographic examination revealed an erupting
premolar. Identify the clinical condition.
a. Eruption cyst.
1507. The patient complained of dark and unesthetic gingival
colour. History revealed that pigmentationwas present
from childhood and was alsoseen among her family
members. Identify the clinical condition.
1508. The patient had used a medication to relieve oral
discomfort. Identify the clinical condition.
a. Extrinsic pigmentation 
a. Severe – Racial gingival melanin pigmentation
266 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1509. An old male reported with hypersensitivity of his teeth.
He was using a hard toothbrush with vigorous brushing.
Intra oral examination revealed exposed roots with loss
of tooth structure. Identify the clinical condition.
a. Dental abrasion with gingival recession
1510. A patient reported with unesthetic gingival pigmentation.
The following are the case photos, which reveal a plastic
surgical procedure, carried out to alter the colour of
the gingiva. Name the procedure.
a. Gingival depigmentation.
267Chapter -5 : Self-assessment Picture test
1511. A young adult who had undergone a recent organ
transplant reported complaining of gingival
enlargement. He had a history of cyclosporine intake.
How do you categorize his gingival enlargement?
a. Drug -induced gingival enlargement.
1512. The patient presented with a slow growing, firm, painless
gingival growth. Histopathology revealed dense fibrous
connective tissue stroma with stretched overlying
surface epithelium. What is the diagnosis?
a. Fibrous epulis / Fibroma 
1513. The following picture shows a graft being harvested
from the palate. The procured graft consisted of both
epithelium and connective tissue. The graft is to be used
in the same patient in periodontal plastic procedure
without any alteration. Name the graft.
268 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
a. Free gingival autograft.
1514. A patient reported with gingival overgrowth since
childhood. Medical and drug history revealed nothing
of significance. Clinical examination revealed diffuse,
firm, symmetrical maxillary and mandibular gingival
enlargement with minimal local factors. What is your
diagnosis?
a. Idiopathic gingival fibromatosis. 
1515. The following two cases show areas of plaque
accumulation and gingival overgrowth. They bleed
easily on probing. History revealed nothing of
significance. What is the most probable diagnosis?
a. Inflammatory gingival enlargement.
269Chapter -5 : Self-assessment Picture test
1516. Modified widman flap procedure is a commonly used
pocket reduction procedure. What is the first incision
employed in this procedure?
a. Internal bevel incision. 
1517. The following case shows a type of wasting disease,
which arises from tooth to tooth contact. What is it?
a. Attrition. 
1518. Splinting of teeth is done to comfort patient by
stabilizing mobile teeth. Identify the type of splint used
in the following case.
a. Extracoronal splint. 
270 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
NORMAL PERIODONTIUM
1. a. Cementum, alveolar bone, periodontal ligament and the
gingiva.
2. e. All of the above.
3. a. True.
4. b. Cementum and alveolar bone.
5. c. All of the above.
6. c. Fibroblasts.
7. b. Fibroblasts.
8. b. Periodontal ligament
9. a. Trauma
10. c. Both a and b
11. b. Dental plaque
12. d. Fibroblast.
13. c. Both are true.
14. c. 2-3 mm.
15. a. Keratinocyte.
16. c. All of the above.
17. a. Acid phosphatase.
18. d. Occluding junctions (zonula occludens).
19. c. Lymphocyte.
20. c. All of the above.
21. c. All of the above.
22. d. Present in unerupted teeth.
23. d. Malassez.
24. a. Hertwigs epithelial root sheath.
25. c. Vitamin C.
26. c. Both a and b.
27. d. All of the above.
28. d. Fullmer.
29. b. Tensional viscoelastic and thixotropic theory.
30. c. Viscoelastic theory.
31. a. True.
32. d. Only statements a and b are true.
271
33. b. Acellular extrinsic fiber cementum.
34. a. Cementoblasts.
35. a. Cementoblasts & fibroblasts.
36. e. Intermediate cementum.
37. a. Acellular afibrillar cementum- coronal cementum:
Acellular extrinsic fiber cementum-cervical third:
Cellular mixed stratified cementum-apical third,
Cellular intrinsic fiber cementum-resorption lacunae -
furcation areas
Intermediate cementum-cementodentinal junction.
38. c. Cementum..
39. d. Sharpey”s fibers.
40. a. Connective tissue.
41. a. 1.08 mm
42. b. Dentogingival fibers.
43. b. Incompletely formed roots.
44. b. Roots of multi-rooted teeth.
45. c. Indifferent fiber plexus.
46. d. All the above statements are true.
47. b. Masticatory forces.
48. c. Both a and b are true.
49. a. Adhesion molecule.
50. a. Cementum attachment protein (CAP).
51. b. Hyaline layer of Hopewell-smith.
52. a. Incremental lines of Saltier.
53. b. Cementum.
54. d. Periodontal ligament.
55. a. Reversal line.
56. c. 28,000.
57. a. Pagets disease.
58. a. Amelo-cemental junction.
59. a. Because it lacks neural component.
60. a. Cementoblasts.
61. b. Middle area.
62. a. True.
63. a. Basal bone.
64. c. All of the above.
Answer key
272 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
65. a. Bundle bone.
66. b. Double fiber orientation.
67. b. 100 to 200μm.
68. c. Their origin is unknown.
69. b. Statement a is true and b is false.
70. c. Active osteoclasts.
71. d. All of the above.
72. b. Osteoblast.
73. a. Osteocytic osteolysis.
74. c. Coupling.
75. b. Part of the immune defense system.
76. a. True.
77. c. Fiery red.
78. c. Epithelium and connective tissue.
79. b. Parakeratinized.
80. a. Type I collagen.
81. c. Supra-crestal connective tissue fibers.
82. c. Tooth with the adjacent tooth.
83. a. Cell to cell connection between two epithelial cells.
84. b. Epithelial cell to basal lamina.
85. d. All of the above.
86. d. Interradicular fibers.
87. c. Rete pegs.
88. b. 1.8 mm.
89. b. Cementum overlaps enamel.
90. b. Non-keratinized epithelium.
91. e. All of the above.
92. a. True.
93. a. True.
94. a. Stippling.
95. a. (a) Mucogingival junction,
(b) Gingival sulcus/Periodontal pocket.
96. a. Distance between the crest of the gingival margin and the
mucogingival junction – the depth of the gingival sulcus/
pocket.
273
97. a. (a) Incisor region,
(b) 3.5-4.5 mm
(c) 3.3-3.9mm
98. b. (a) 1st Premolar
(b) 1.9mm
(c)1.8mm.
99. b. Only a is true.
100. a. Free gingiva +attached gingiva.
101. b. Masticatory mucosa.
102. d. a and b.
103. d. Transforming growth factor-â
104. e. All of the above.
105. c. All of the above.
106. c. All of the above.
107. b. No.
108. a. True.
109. c. QO2 1.6 ± 0.37.
110. a. Between 1 to 6 days.
111. a. Does not permit any substance to pass through.
112. a. Both 1 and 2 are correct.
113. a. 33.9± 0.4 ºC.
114. b. Pale yellow.
115. b. Attached gingiva.
116. b. Directly attached to the tooth (DAT cells).
117. e. It is also permeable to particulate matter.
118. b. Molars.
119. d. Gingiva.
120. b. Junctional epithelium.
121. e.b and c.
122. c. All of the above.
123. d. All of the above.
124. b. No.
125. a. Collagen.
126. a. Non-fibrillar collagens.
127. a. Type I
128. b. Type III.
129. d. Basement membrane.
Answer key
274 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
130. d. Type V
131. c. Hydroxyproline
132. a. Keratohyalin granules.
133. c. Fillaggrin.
134. a. Orthokeratinized stratified epithelium.
135. c. Non-keratinized stratified epithelium.
136. a. Polymorpho nuclear leukocyte.
137. a. Neural crest origin.
138. b. 1 cm.
139. d. All of the above statements are true.
140. d. All of the above.
141. c. Hemidesmosome.
142. a. Intramembraneous ossification.
143. b. Clear cells.
144. c. Keratohyaline granules.
145. d. 41 to 57 days.
146. a. Basal cell layer and prickle cell layer.
147. a. Circadian periodicity.
148. c. Produce melanin pigmentation.
149. c. Malphigian layer.
150. d. All of the above.
151. b. Non-keratinocytes
152. a. Supra basal layers.
153. a. Basal layer.
154. a. Basal and spinous layers.
155. c. Sulcular epithelium.
156. c. Keratinized gingiva.
157. a. g-specific granules /Birbeck granules.
158. a. Neural crest origin.
159. b. Clear cells.
160. a. High level clear cells.
161. a. Macrophages.
162. d. 64%
163. a. 0.25-1.35 mm.
164. c. 4 times.
165. d. It originates only from the reduced enamel epithelium.
275
166. d. Thickness of the sulcular epithelium.
167. a. Junctional epithelium.
168. d. 3000.
169. d. All of the above.
170. c. Dental sac proper.
171. a. 15 to 100μm.
172. b. Apico-coronal direction.
173. a. The alveolar mucosa has an accumulation of
intraepithelial glycogen and this is the basis of its staining.
While it is not present in the gingiva.
174. a. 0.6 to 1.4 mm.
175. c. Presence of Long and thick gingival fibers.
176. d. Yes.
177. a. 5-6 years.
178. d. Geriatrics
179. c. They are present on the buccal aspect.
180. b. No.
181. b. 2 weeks.
182. d. Transseptal fibers.
183. c. Transseptal fibers.
184. a. Junctional epithelium.
185. b. Yes.
186. c. Dentogingival unit.
187. a. Decreases.
188. a. Firm and resilient.
189. a. Hour glass.
190. b. Type III.
191. a. Type I.
192. d. Production of neutrophils.
193. d. Provides gingival pigmentation.
194. d. Both a & b
195. b. Volkmann’s canals
196. e. All of the above
197. a. Maxilla
198. d. All of the above
199. a. Sharpey’s fibers
200. c. Both a & b
Answer key
276 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
201. e. Both a & b
202. d. Old age
203. c. Hypo-phosphatasia
204. b. Cementicles
205. b. Middle third of roots
206. c. Oblique group
207. c. 20
208. c. Apical third
209. d. 19
210. d. Sensation
211. a. Both statements are True
212. b. Ankylosis
213. a. Interleukins
214. a. Red marrow is not evident in embryo and newborn.
215. a. True
216. b. Knife-edged and arcuate
217. b. Dehiscence
218. c. Epithelial diaphragm
219. a. True
220. a. All statements are true.
221. a. True
222. a. Associated factor
223. a. True
224. b. Periodontal ligament.
225. a. Superior constrictor, temporalis and buccinator muscle.
226. c. 5 mm.
227. d. Rolled free gingival margin.
228. d. All of the above.
229. f. c & d.
230. a. McCall Festoon’s and Stillman’s clefts
231. e. All of the above.
232. d. Tooth dependent.
233. b. Fibroblasts.
234. c. Soft tissue only.
235. b. Maxilla.
236. b. Cementoenamel junction (CEJ).
237. a. No.
277
238. b. Krause-type end bulbs.
239. a. 0.69 mm.
240. a. Eosinophil’s are in abundance.
241. a. Type I.
242. c. Both a and b.
243. c. All of the above.
244. a. Constant.
245. a. 1.07 mm.
246. b. Constant /stationary.
247. a. 2 mm.
248. b. Junctional epithelium.
249. a. B.W (2.04) = (0.97mm) J.E+ (1.07mm)C.T.A
250. c. Free nerve endings-treelike configuration-pain sensation,
ruffini-like mechano receptors-primarly present in apical
area, coiled Meissner’s corpuscles-mechano receptors-Mid
root region, spindle like pressure & vibration endings-apex.
251. c. Solid foods.
252. b. Exudate.
253. a. Löe and Holm-Pedersen.
254. b. 1000 kD.
255. b. 1:3
256. b. Gingival sulcus.
257. a. Root trunk.
258. a. Type I embrasure.
259. b. Type II embrasure.
260. c. Type III embrasure.
261. b. 1.5mm-2.0mm.
262. a. Cavite bodies.
263. a. Induce acellular cementum formation.
Answer key
278 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
264. a. Probing depth.
265. d. Rhamnose.
266. a. Gingival ablation.
267. c. Increased gingival crevicular flow.
268. e. Trauma from occlusion.
269. a. Trauma from occlusion.
270. d. Polymorpho nuclear leukocytes.
271. a. Lymphocytes.
272. c. Plasma cells.
273. c. 4-7 days.
274. a. 14-21 days.
275. a. Lymphocytes.
276. c. Plasma cell.
277. c. a & b.
278. d. Neutrophils.
279. a. Class-I.
280. b. Class-II.
281. c. Class-III.
282. d. Class-IV.
283. a. Extrusive movement.
284. b. Laterotrusion.
285. c. Protrusion.
286. d. Retrusion.
287. c. All of the above.
288. c. Balancing side.
289. c. All of the above.
290. b. Physiologic occlusion.
291. c. Therapeutic occlusion.
ETIOLOGY AND
PATHOGENESIS OF
PERIODONTAL DISEASE
279
292. c. All of the above.
293. b. Traumatic occlusion.
294. d. Dental caries.
295. a. Bruxism.
296. b. Crepitus.
297. a. Clenching.
298. c. All of the above.
299. d. All of the above.
300. e. All of the above.
301. c. All of the above.
302. d. All of the above.
303. e. All of the above.
304. c. All of the above.
305. d. Solitary bacteria.
306. a. Final stable community of bacteria.
307. d. At the time of birth.
308. a. 10 times.
309. d. Yeast infections.
310. d. Plaque/dental biofilm.
311. c. Teeth.
312. b. Obligate periphyte.
313. b. Matrix.
314. b. Materia Alba.
315. e. All of the above.
316. f. Streptococcus sanguis.
317. a. Porphyromonas gingivalis.
318. d. All of the above.
319. a. Gram negative bacteria.
320. c. Gram positive bacteria
321. b. Marginal plaque.
322. a. Marginal plaque.
323. f. b and d.
324. c. Tissue associated subgingival plaque.
325. c. Non motile, gram positive.
326. a. Epithelial-attached plaque.
327. c. Fluid channels.
Answer key
280 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
328. b. No.
329. b. Long cone paralleling technique.
330. e. All of the above.
331. a. Clinically.
332. a. It shows the amount of remaining bone.
333. a. Fibrous dysplasia.
334. a. Infrared light examination.
335. d. All of the above.
336. c. All of the above.
337. b. Histologically.
338. a. Clinical attachment level.
339. a. Clinical attachment level.
340. a. Biologic depth / histologic depth.
341. a. Histologic sections.
342. a. True.
343. c. Porphyromonas gingivalis.
344. c. Prevotella intermedia.
345. b. Calculus.
346. c. ½ Liter.
347. b. Leucotoxin.
348. a. Gingival enlargement.
349. a. Destruction of periodontium.
350. a. Complex pocket.
351. b. Furcation areas.
352. d. Localized pain.
353. d. Gingival bleeding on gentle probing.
354. a. Careful probing along the gingival crevice.
355. b. Circulatory stagnation.
356. e. Suppurative inflammation of inner pocket wall.
357. d. All of the above.
358. c. 80%.
359. b. Secondary sign, Objective sign.
360. a. Horizontal bone loss.
361. b. Vertical bone loss.
362. b. Vertical bone loss.
363. c. Horizontal bone loss.
281
364. b. Infra-bony pocket
365. d. Root caries.
366. a. Langerhans cells.
367. c. Loss of attachment.
368. d. Chronic inflammation.
369. b. Elastase.
370. c. Chloramines and Hypochlorous acid.
371. d. Yes.
372. c. Leucocytes.
373. d. Solely salivary origin.
374. e. All of the above.
375. c. Plaque.
376. a. True.
377. d. True pocket.
378. a. Gingival enlargement.
379. b. Interproximal surface.
380. f. a, c, d and e.
381. c. Lateral wall of periodontal pocket.
382. d. All of the above.
383. e. All of the above.
384. a. Lipoxin A4.
385. d. All of the above.
386. b. Adults.
387. d. No bleeding on probing.
388. c. Periodontitis.
389. a. < 30%
390. b. >>>>> 30%
391. a. 1 or 2 mm.
392. b. 3 or 4 mm.
393. c. >>>>> 5mm.
394. f. All of the above.
395. a. Ascorbic acid-deficiency gingivitis.
396. c. Ascorbic acid-deficiency gingivitis.397. c. All of the above.
398. b. Primary herpetic gingivostomatitis.
399. a. Linear gingival erythema.
Answer key
282 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
400. b. Hereditary gingival fibromatosis.
401. e. All of the above.
402. d. All of the above.
403. d. All of the above.
404. a. Necrotizing ulcerative periodontitis.
405. f. All of the above.
406. b. Porphyromonas gingivalis
407. b. Oxidative and non-oxidative killing
408. c. Bacterial culture
409. c. Streptococcus
410. d. A. Actinomycetemcomitans
411. d. Trypsin like enzyme
412. d. Quorum sensing
413. c. Orange complex
414. a. Prevotella intermedia.
415. a. Entamoeba gingivalis.
416. f. All of the above.
417. f. All of the above.
418. l. Consuming acidic juice.
419. e. All of the above.
420. d. All of the above.
421. d. Periodontal pocket.
422. e. All of the above.
423. d. Rapid periodontal attachment loss.
424. f. All of the above.
425. c. All of the above.
426. b. Cicatricial pemphigoid.
427. a. Acute necrotizing ulcerative gingivitis (ANUG).
428. c. Necrotizing ulcerative gingivitis.
429. d. Purulent exudate.
430. d. All of the above.
431. f. b and d.
432. c. Established lesion.
433. a. Advanced lesion.
434. c. Initial lesion.
435. c. All of the above.
283
436. c. Vascular proliferation.
437. d. Vascular proliferation plus blood stasis.
438. a. Gingival anoxemia.
439. f. All of the above.
440. f. All of the above.
441. a. Actinobacillus actinomycetemcomitans.
442. c. Papillon-lefe’vre syndrome.
443. e. Paracetamol and Ibuprofen.
444. f. a and d.
445. d. Lamina dura.
446. b. Vertical bone loss.
447. b. Two dimensional image.
448. a. Class IV furcation involvement (Mandibular molars).
449. b. Late effects of the disease.
450. d. Prevalence
451. a. Extent.
452. d. Severity.
453. c. Exposure.
454. d. Risk factor.
455. b. Risk indicator.
456. d. Prevalence
457. c. All of the above.
458. d. All of the above.
459. a. Validity.
460. c. Incidence.
461. d. All of the above.
462. b. Prognosis.
463. b. Prognosis.
464. d. Risk factors.
465. b. Different host response.
466. c. All of the above.
467. c. All of the above.
468. a. Bluish-purple hue.
469. c. Amount of melanin pigmentation of the gingiva.
470. e. Tension test.
471. g. All of the above.
Answer key
284 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
472. e. Recession.
473. d. All of the above.
474. d. b and c.
475. a. Aerobe.
476. b. Anaerobe.
477. c. Capnophilic.
478. c. Facultative anaerobes.
479. d. Saccharolytic.
480. f. b and d.
481. a. Actinobacillus actinomycetemcomitans.
482. d. All of the above.
483. a. S.sanguis and P.gingivalis.
484. d. All of the above.
485. d. All of the above.
486. d. Loesche.
487. a. All plaque microorganisms are pathogenic.
488. c. Only certain plaque microorganisms are pathogenic.
489. b. Dextran.
490. c. Increase.
491. d. Ameloblasts.
492. d. All of the above.
493. d. All of the above.
494. c. All of the above.
495. f. None of the above.
496. d. All of the above.
497. e. All of the above.
498. d. All of the above.
499. d. All of the above.
500. e. All of the above.
501. c. Interdental papilla.
502. b. Macrophage rich zone.
503. d. Localized aggressive periodontitis.
504. d. All of the above.
505. a. Two permanent teeth.
506. a. Localized aggressive periodontitis.
285
507. a. LAP has 3-4 times faster bone loss than in chronic
periodontitis.
508. e. Periodontal pocket.
509. b. Burn out phenomenon.
510. c. All of the above
511. c. II-IV stages of HIV infection.
512. c. All of the above.
513. a. Coaggregation.
514. a. Streptococci +Bacterionema Matruchotii/Actinomyces
species.
515. b. Filamentous bacteria+ gram-negative rods.
516. c. Red complex.( P.gingivalis, Tannerella forsythia &
Treponema Denticola)
517. a. Yellow complex. (streptococcus sp).
518. a. 20-30 ìm.
519. b. Night.
520. d. P.gingivalis.
521. b. P.gingivalis.
522. c. S.sanguis.
523. f. All of the above.
524. a. A. actinomycetemcomitans.
525. a. Treponema denticola.
526. d. All of the above.
527. c. Universally prevalent in adult population.
528. a. 6 years.
529. b. Refractory periodontitis.
530. d. Lateral periodontal abscess.
531. b. Painless.
532. f. Typhoid fever.
533. d. Pyogenic granuloma.
534. d. 7 mm.
535. b. Heamorrhage and thrombosis of blood vessels in periodontal
ligament.
536. b. Fenestration.
537. d. All of the above.
538. b. 50 grams.
Answer key
286 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
539. c. 0.25 N.
540. d. Vitamin C deficiency.
541. c. 6 mm.
542. b. Periodontal pocket.
543. a. Neutrophils.
544. d. Interleukin-9 (IL-9).
545. d. PGE2 was earlier referred to as “osteoclastic-activating
factor”.
546. a. Maxillary right 1st molar, maxillary left central incisor,
maxillary left 1st premolar, mandibular left 1st molar,
mandibular right central incisor and mandibular right 1st
premolar.
547. c. Extent and severity index.
548. a. Russell’s periodontal index.
549. d. Score-3: Severe inflammation.
550. d. Gingivitis with pocket formation.
551. c. All of the above.
552. e. All of the above.
553. e. Score-4.
554. f. Score-5.
555. c. Gingival area is covered with a thin to moderately thick layer
of plaque; deposit is visible to naked eye.
556. b. Matrix metalloproteinases.
557. f. All of the above.
558. e. All of the above.
559. d. All of the above.
560. a. Neutrophils.
561. a. Optimal periodontal health.
562. d. All of the above.
563. e. All of the above
564. a. 50%
565. f. All of the above.
566. d. Facultative, gram-positive.
567. a. Bacteriodes gingivalis.
568. b. Bacteroides forsythus.
569. a. Aggregatibacter actinomycetemcomitans.
287
570. c. Exotoxin.
571. d. Tannerella forsythia, Treponema denticola
Porphyromonas gingivalis.
572. c. Porphyromonas gingivalis.
573. a. S.mitis, S.oralis, S.sangius, S.gordonii, S.intermedia and
Streptococcus sp.
574. b. V.parvula and A.odontolyticus.
575. b. E.corrodens, C.gingivalis, C.sputigena, C.ochracea,
c.condsus and A.actinomycetemcomitans.
576. d. P.intermedia, P.nigrescens, P.micros, F. nucleatum,
Camplylobacter.
577. b. Gingival margin, attached gingiva and interdental papilla.
578. b. Gingival margin and part of attached gingiva.
579. b. Interdental papilla and adjacent marginal gingiva.
580. d. Prevotella intermedia.
581. d. N-acetyl muramic acid.
582. d. All of the above.
583. b. Methyl mercaptan.
584. f. All of the above.
585. a. Periodontitis.
586. d. Regurgitation esophagitis.
587. f. Xerostomia.
588. a. Trimethyaminuria-heridatary metabolic disorder.
589. c. All of the above.
590. a. Eucalyptus.
591. b. Rotten onions.
592. d. All of the above.
593. a. Acidic malodor.
594. d. All of the above.
595. a. More inflammation than smokers.
596. a. A mature B cell.
597. d. Amylase.
598. a. Collagenase.
599. d. Leukocidins.
600. c. Gram positive cocci and rods.
601. b. Bacteria and polymer matrix.
Answer key
288 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
602. d. Metalloproteinases.
603. d. Compound lipids.
604. a. Increased tooth mobility.
605. e. Staphylococcus aureus.
606. b. Neutrophil abnormalities.
607. c. Palatogingival groove.
608. d. Parapulpal lines.
609. b. Macrophage.
610. c. Can influence or aggravate the severity of periodontal
disease.
611. b. Anaerobic proteolytic gram-negative bacterial community.
612. e. All of the above.
613. d. a and b only.
614. c. Porphyromonas gingivalis.
615. d. Supra gingival plaque.
616. d. Traumatic occlusion.
617. b. Secondary trauma from occlusion.
618. c. Trauma from occlusion can cause gingivitis.
619. c. All of the above.
620. d. Tobacco smokers.
621. d. Osseous crater.
622. c. Pregnancy tumor.
623. d. All of the above.
624. a. It accentuates bone loss in Periodontitis.
625. d. Widening of PDL.
626. e. All of the above.
627. b. Gingival hyperplasia.
628. c. Gingival hypertrophy.
629. a. Antonie van Leeuwenhoek.
630. d. Grade III.
631. c. Gingival abscess/periodontal abscess.
632. d. Surface dehydration.
633. a. Marginal and papillary gingivitis-maxillary anterior sextant.
634. a. Cyclosporine.
635. c. Drug-induced gingival enlargement.
636. c. False gingival enlargement.
289
637. d. All of the above.
638. d. All of the above.
639. a. Clinical picture.
640. a. Blacks/negroids.
641. c. Localized aggressive periodontitis.
642. c. Three permanent teeth.
643. d. Severe gingival inflammation.
644. a. Chemical process.
645. d. All of the above.
646. e. All of the above.
647. c. Gingival tissues.
648. d. Periodontium.
649. c. Necrotizing ulcerative periodontitis.
650. a. True
651. c. Osseous defects.
652. a. Gingival abscess.
653. b. Mandibular canine-premolar area.
654. e. All of the above.
655. b. Loss of attachment.
656. d. All of the above.
657. c. Gingivitis.
658. h. All of the above.
659. d. All of the above.
660. e. All of the above.
661. b. Periapical abscess.
662. d. a and b.
663. e. All of the above.
664. a. Kaposi’s sarcoma.
665. c. Gingival recession.
666. a. True.
667. c. Gingivostomatitis.
668. e. All of the above.
669. b. P.gingivalis.
670. e. b and c.
671. d. All of the above.
672. b. Diffuse gingivitis.
Answer key
290 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
673. b. Bone loss.
674. d. All of the above.
675. a. Aggressive periodontitis.
676. c. Periodontitis.
677. c. Mucogingival junction.
678. a. Mandibular lateral incisor.
679. a. One-walled defect.
680. a. Absorbing paper strips placed within the sulcus.
681. b. Sharp radiating pain.
682. b. Periapical abscess.
683. c. Systemic diseases aggravate the response of the tissues to
local irritants.
684. c. Smoking.
685. b. Pale pink.
686. a. 2.1 mm (±0.2 mm).
687. c. Eruption cyst.
688. a. Chronic marginal gingivitis.
689. d. All of the above.
690. d. All of the above.
691. d. All of the above.
692. g. All of the above.
693. c. 123±23days.
694. c. All of the above.
695. a. Greater.
696. d. All of the above.
697. d. All of the above.
698. c. Yes.
699. a. Clinical attachment loss.
700. b. No.
701. b. Indicates the nature of inflammatory changes in the pocket
wall.
702. d. Wegener’s granulomatosis.
703. b. Kindler syndrome.
704. e. All of the above.
705. c. All of the above.
706. d. All of the above.
707. d. Frothing.
291
708. c. All of the above.
709. e. All of the above.
710. e. All of the above.
711. d. Tooth mobility.
712. d. Triangulation.
713. d. Occlusal forces.
714. c. Histologically.
715. d. All of the above.
716. d. All of the above.
717. a. Centric relation.
718. d. All of the above.
719. c. Centric occlusion.
720. h. All of the above.
721. d. Demastication.
722. e. Dental stains.
723. a. Abrasion + attrition.
724. a. Abfraction.
725. d. a and c.
726. b. Cemento-enamel junction.
727. a. Maxillary arch + Buccal side.
728. d. Socransky.
729. c. Must demonstrate a host response, in the form of an alternation
in the host cellular or humoral immune response.
730. e. Must be recovered from lesions in a diseased laboratory
animal.
731. c. Dense, Dark- brown or greenish-black in colour.
732. a. Hydroxyapatite & Octacalcium phosphate.
733. b. Brushite.
734. c. Magnesium whitlockite.
735. e. White - yellowish white in colour.
736. c. Calculocementum.
737. d. Reversal phenomenon.
738. c. All of the above.
739. b. Abrasion.
740. d. Proximal surface of 1st molar.
741. d. Every 48 hours.
Answer key
292 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
742. c. Interdental locations.
743. a. Cementum.
744. b. No.
745. f. All of the above.
746. b. Gingival inflammation.
747. c. Enlargement of the marginal gingiva.
748. b. Improper tooth brushing.
749. d. Necrotizing ulcerative gingivitis.
750. c. All of the above.
751. b. Primary herpetic gingivostomatitis.
752. c. Periocoronitis.
753. a. Mandibular third molar area.
754. d. All of the above.
755. a. Tzanck cells.
756. a. Epithelial cells.
757. a. COPD patient.
758. d. Trauma from occlusion.
759. b. Chronic periodontitis.
760. c. Linear, random burst model.
761. b. Periodontitis is an age-associated disease.
762. a. Abnormality in phagocyte function.
763. d. All of the above
764. a. Yes.
765. c. All of the above.
766. a. Labially prominent canines.
767. c. All of the above.
768. d. Periodontal regeneration.
769. c. Systemic disease.
770. e. a and d.
771. a. Bleeding on probing.
772. f. b and c.
773. d. All of the above.
774. a. 2 days.
775. b. Angiogranuloma.
776. a. Pathogen-associated molecular patterns.
777. c. Gold.
778. b. Bismuth.
293
779. b. Linear.
780. c. Carbon monoxide.
781. d. Tuberculosis.
782. d. Silver.
783. b. Hemochromatosis.
784. b. Bluish black to brown.
785. d. All of the above.
786. c. All of the above.
787. c. Glickman.
788. b. Secondary herpes.
789. b. Furcation.
790. c. All of the above.
791. b. Exposed dentine.
792. c. All of the above.
793. a. Modifiable risk factor.
794. a. Current smokers.
795. c. Current smokers.
796. a. Smoking.
797. a. Chronic periodontitis.
798. d. Smokers.
799. d. Cushing’s diabetes.
800. a. Advanced glycation end products (AGEs).
801. b. No.
802. a. During pregnancy.
803. a. Angiogranuloma.
804. e. Stress.
805. d. Risk factor.
806. b. Years.
807. c. Hemosiderin-hemolysis of RBCs.
808. c. Salivary calculus.
809. d. Serumal calculus.
810. a. Apical to the gingival margin.
811. a. Systolic <120 Diastolic <80.
812. b. Systolic 120-139 Diastolic 80-89.
813. c. Systolic 140-159 Diastolic 90-99.
814. d. Systolic ≥160 Diastolic ≥100.
815. a. Essential/primary hypertension.
Answer key
294 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
816. a. Secondary hypertension.
817. a. Angina pectoris.
818. a. Depression.
819. g. All of the above.
820. d. Nutritional challenges: eg: marasmus, Vit C deficiency.
821. c. Infective endocarditis.
822. a. á-hemolytic streptococcus (Streptococcus viridans).
823. b. Dane particle.
824. b. Hepatitis B virus.
825. f. All of the above.
826. l. All of the above.
827. b. Microflora of periodontitis.
828. a. Candida dubliniensis.
829. b. Hepatitis-B.
830. b. Leukoplakia.
831. a. Prevotella intermedia
832. d. Gingival mast cells.
833. c. Infiltrating cell type in gingiva-independent of type of
leukemia.
834. a. Leukemia cutis.
835. a. Bleeding gingiva.
836. d. Sickle cell anaemia.
837. b. Healthy periodontium.
838. f. All of the above.
839. d. Ossified cartilages.
840. a. Burtonian line.
841. a. Gram-positive.
842. a. Acetaminophen.
843. a. Tuberous sclerosis.
844. g. All of the above.
845. a. Bacterial plaque.
846. b. Drug-induced gingival enlargements are a type of conditioned
enlargements.
847. a. Chronic inflammatory gingival enlargement.
848. c. All of the above.
849. a. Epulis.
850. d. Wegener’s granulomatosis.
295
851. b. Drug induced gingivitis (cyclosporine, sodium valproate. etc)
852. a. Suprabony pocket.
853. d. Phoenix abscess.
854. a. 1.5-2.5mm.
855. a. Trauma from occlusion.
856. e. Exostosis.
857. a. Mesial surface of molars.
858. c. Three walls.
859. b. Grade II
860. a. Undermining resorption.
861. g. All of the above.
862. b. Fusobacterium nucleatum.
863. d. Peptostreptococcus micros.
864. b. Leukotoxin.
865. a. Campylobacter rectus and Peptostreptococcus micros.
866. c. Premolars.
867. c. 30% or more sites.
868. b. 3-4 mm.
869. d. Fluoridated toothpaste.
870. a. Periodontal pocket.
871. e. Deep interdental osseous craters.
872. d. Kaposi’s sarcoma.
873. a. Occlusal wear facets.
874. c. All of the above.
875. d. All of the above.
876. d. Scar.
877. d. Sjögren-Larsson syndrome
878. d. Langerhans cell histiocytosis.
879. d. Leukocyte adhesion deficiency syndrome.
880. d. Papillon-Lefèvre syndrome.
881. e. All of the above.
882. c. Buccal surface-mandibular 2nd molar.
883. e. All of the above.
884. d. Pulp.
885. a. Everett.
886. c. First molar.
Answer key
296 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
887. d. Maxillary lateral incisors.
888. c. Parapulpal lines.
889. c. 25 years
890. a. Extrusion.
891. a. Pathological migration.
892. c. Pathologic migration.
893. e. All of the above.
894. d. Plunger cusps.
895. d. Allof the above.
896. d. Tanerella forsythia.
897. f. Veilonella spp.
898. a. Actinomyces viscosus.
899. a. Actinomyctes viscosus.
900. d. Streptococcus oralis.
901. c. Gingival ulcer.
902. c. New attachment
903. a. True
904. a. True
905. b. Granulation tissue.
906. c. Three-four times.
907. d. Complement system.
908. a. IgG.
909. b. Non vital tooth/Apical rarefaction.
910. b. Periodontal pocketing.
911. b. Reversible.
912. b. Dental plaque.
913. b. Horizontal bone loss.
914. e. a, b and c
915. a. Angiogenesis.
916. d. Yes.
917. k. All of the above
918. a. True
919. c. Mercury
920. c. Buttressing bone formation
921. d. Hepatitis
922. c. Questionable prognosis
923. b. Discrete
297
924. b. True
925. a. It’s true.
926. d. Severity of Inflammation.
927. d. Hypercementosis.628. a. Bone resorption
929. c. Brown stain present on the posterior teeth,separated from
the gingival margin by an unstained band of tooth surface 1-
2mm wide, which can be removed with a scaler.
930. c. ANUG
931. c. Halitosis
932. d. Advanced.
933. a. Chronic condition.
934. e. All of the above.
935. c. Severe.
936. d. Herpetic gingivostomatitis.
937. a. Nikolsky’s sign.
938. a. 17 – 23 years aged females.
939. a. Intrabony pocket.
940. b. Furcation arrows.
941. b. No.
942. d. Gingival margin is at cementoenamel junction.
943. d. Vitality test.
944. c. Periodontal probing results.
945. a. increased
946. c. F. nucleatum.
947. d. Refractory periodontitis.
948. b. Infiltration of neutrophils, lymphocytes and plasma cells.
949. b. ≥126 mg/dl.
950. d. 8 hours.
951. b. 200.
952. c. All of the above.
953. a. Cross infection.
954. a. Asymptomatic carriers.
955. d. All of the above.
956. a. Index case.
957. e. All of the above.
958. b. Hepatitis-B.
Answer key
298 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
959. a. Sterilization.
960. b. Disinfection.
961. c. Antisepsis.
962. a. Bacillus stearothermophilus -spores
963. b. Bacillus subtilis -spores
964. d. All of the above.
299
PERIODONTAL THERAPY
965. a. 7 days or more.
966. d. Butterfly test.
967. d. Endodontic therapy.
968. d. All of the above.
969. e. All of the above.
970. e. All of the above.
971. b. Violation of biological width.
972. b. Good diabetes control.
973. b. Percutaneous injury.
974. b. Atridox.
975. a. Arestin.
976. b. Chlorhexidine.
977. b. Second trimester.
978. d. Tetracycline.
979. a. Supine hypotension syndrome.
980. c. All of the above.
981. d. All of the above
982. a. True
983. a. True
984. f. All of the above
985. b. No.
986. b. Ask, advice, assist and arrange.
987. c. Pre-contemplators, contemplators and active quitters.
988. d. All of the above.
989. a. Bass method.
990. d. All of the above.
991. a. Square of the bristle diameter.
992. b. Gingival massage.
993. a. 3 months.
994. c. Chronic periodontitis patients.
995. c. Modified stillman’s technique.
996. c. Roll method.
Answer key
300 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
997. c. Roll technique.
998. a. Fones technique.
999. b. Leonard technique.
1000. c. Scrub technique.
1001. c. Scrub technique.
1002. a. Bass technique.
1003. f. Tooth size.
1004. b. Gauze piece.
1005. c. Size of the tooth.
1006. b. Soft or hard.
1007. c. All of the above.
1008. a. Scaling.
1009. a. Gingival curettage.
1010. a. Root planing.
1011. c. Inadvertent curettage.
1012. e. All of the above.
1013. e. a and c.
1014. d. All of the above.
1015. a. 0.12%
1016. e. All of the above.
1017. a. Alcohol-Ethanol-Ethyl alcohol.
1018. f. All of the above.
1019. d. All of the above.
1020. d. Modified Stillman’s technique.
1021. a. Dental floss.
1022. b. Super floss.
1023. d. Triangular.
1024. c. All of the above.
1025. d. All of the above.
1026. a. Anionic detergents.
1027. a. Chlorehexidine.
1028. e. Leukoplakia.
1029. b. Cationic antiseptics.
1030. d. 48.
1031. d. Periotest®.
1032. f. a,b and c.
301
1033. b. Reversible.
1034. d. Periotest®
1035. c. All of the above.
1036. b. Naber’s probe.
1037. c. Naber’s probe.
1038. d. UNC-15 probe.
1039. c. Interdental craters.
1040. c. Inconsistent bony margin.
1041. e. Maxillary 1st premolar.
1042. a. Shallow crater (1-2mm), Medium crater (3-4 mm),deep
 crater (≥5mm)
1043. b. Periodontal probe.
1044. d. All of the above.
1045. b. Incipient bone loss.
1046. a. Cul-de-sac.
1047. c. Through and through.
1048. c. Through and through lesion.
1049. a. Incipient lesion.
1050. b. Cul-de-sac.
1051. d. Used to check the presence or absence of exudates in the
 periodontal pocket.
1052. d. All of the above.
1053. c. Periodontal therapy.
1054. d. All of the above.
1055. a. Ciprofloxacin.
1056. d. All of the above.
1057. c. Metranidazole (Flagyl) (500mg bd×7days/200tid×4days)
1058. b. Charter’s technique.
1059. d. Shrinkage of tissue due to reduction in inflammation has
 revealed subgingival calculus.
1060. d. The trauma from occlusion.
1061. a. 4-6%.
1062. b. Iontophoresis.
1063. h. All of the above.
1064. b. Excisional biopsy.
1065. d. Urinary glucose analysis.
1066. e. All of the above.
Answer key
302 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1067. c. Type I diabetes.
1068. c. Oral glucose tolerance test.
1069. a. <110 mg/dl.
1070. c. Glycosylated, hemoglobin assay.
1071. a. Hemoglobin A1 test (HbA1) and hemoglobin A1c test
 (HbA1C)
1072. f. All of the above.
1073. a. 4- 6%.
1074. b. <7%.
1075. b. 7%-8%.
1076. d. >8 %.
1077. h. All of the above.
1078. e. b or c.
1079. a. 15 gm-oral carbohydrates.
1080. e. Any of the above.
1081. a. Bone sounding.
1082. e. All of the above.
1083. c. Gingivectomy.
1084. a. Gingivectomy.
1085. d. Coronally displaced flap.
1086. a. Crane-kaplan/Goldman-fox pocket marker.
1087. d. Improves healing.
1088. a. Lipping.
1089. a. Ledges.
1090. c. Radiographic findings of fuzziness in the bone crest.
1091. d. Single tufted brush.
1092. a. True.
1093. a. Bass method.
1094. d. Suppuration from the pocket.
1095. a. Removal of diseased cementum.
1096. b. ANUG.
1097. b. 3 months.
1098. g. Nylon.
1099. f. Braided polyglycolic.
1100. e. a and c.
1101. c. Ovate pontic.
303
1102. a. Curved in one plane.
1103. a. Gracey #1-2 and 3-4
1104. a. Gracey #1-2, 3-4 & 5-6.
1105. b. Gracey #5-6.
1106. c. Gracey #7-8 and 9-10.
1107. d. Gracey #11-12.
1108. e. Gracey #13-14.
1109. c. All of the above.
1110. c. Gracey #5-6: Anterior teeth and premolars.
1111. c. Mini five curettes.
1112. d. Langer curettes.
1113. c. All of the above.
1114. d. Arkansas oil stone.
1115. a. Chlorhexidine.
1116. d. All of the above.
1117. d. Vertical grooving, Radicular blending, flattening
 interproximal bone and gradualizing marginal bone.
1118. d. Vertical grooving.
1119. a. Osseous resective surgery.
1120. e. Treatment of three wall defects.
1121. d. Aesthetically demanding situations.
1122. e. All of the above.
1123. a. Radicular bone is apical to interdental bone.
1124. b. Interdental bone is apical to radicular bone.
1125. c. Both radicular bone and interdental bone are reduced to
 the same level.
1126. c. All of the above.
1127. d. All of the above.
1128. c. All of the above.
1129. a. DFDBA.
1130. c. All of the above.
1131. b. Calcarle.
1132. a. Collagen membrane.
1133. c. PLA and PGA membranes.
1134. d. Hydrogen sulfide.
1135. b. Fibronectin.
1136. d. Polytetrafluoroethylene membrane.
Answer key
304 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1137. d. All of the above.
1138. d. All of the above.
1139. b. Porcine.
1140. a. Osteogenesis.
1141. b. Osteoinduction.
1142. b. Osteoconduction.
1143. a. Polyhydroxyethylmethacrylate (PHEMA).
1144. a. Papilla preservation flap.
1145. e. All of the above.
1146. a. Perioglas and biogran.
1147. a. 1.0 to 1.5 mm.
1148. a. Creeping reattachment.
1149. a. Gum veneer.
1150. a. Gingivectomy.
1151. a. Excisional new attachment procedure (ENAP).
1152. c. US Dental Corps.
1153. b. Amount of attached gingiva
1154. a. Solid state laser
1155. c. 15 litres per minute
1156. d. Periodontal ligament.
1157. b. Gingivoplasty.
1158. a. Acutelyinflamed gingiva.
1159. e. Gingival enlargement.
1160. b. Files.
1161. a. Allografts.
1162. b. Autograft.
1163. c. DFDBA.
1164. c. Bone dust and blood.
1165. a. R.Earl Robinson.
1166. d. All of the above.
1167. a. Iliac autograft.
1168. a. Bone swaging.
1169. a. Calf or Ox bone denatured with 20% hydrogen peroxide,
 dried with acetone, and sterilized with ethylene oxide.
1170. a. Pepgen-15.
1171. a. Osteogenin.
1172. b. 5-14 days.
305
1173. d. All of the above.
1174. a. Open gingival embrasure.
1175. e. None of the above.
1176. d. All of the above.
1177. d. Periotron.
1178. d. Periopaper.
1179. c. Intrinsic staining of teeth.
1180. a. Bleeding on probing.
1181. a. Primary.
1182. d. Scaling and root planing.
1183. a. Periodontal regeneration.
1184. b. Permanent restoration of carious and missing teeth.
1185. c. Flap elevation.
1186. d. Schwartz Periotrievers.
1187. e. All of the above.
1188. a. Files.
1189. a. Quétin furcation curettes.
1190. a. Chisel scalers.
1191. d. All of the above.
1192. a. Palm and thumb grasp.
1193. e. All of the above.
1194. f. b and d.
1195. d. All of the above.
1196. b. 45 degrees towards the tooth in a coronal direction.
1197. d. True pocket.
1198. b. Pseudo pocket.
1199. c. Metronidazole.
1200. e. Heparin.
1201. c. Tetracycline.
1202. d. Microfibrillar collagen.
1203. c. Microfibrillar collagen.
1204. c. Thrombin.
1205. b. Has curative properties.
1206. a. Zinc oxide + eugenol.
1207. d. All of the above.
1208. g. All of the above.
Answer key
306 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1209. d. All of the above.
1210. c. All of the above.
1211. c. Mohawk procedure.
1212. a. Schluger.
1213. c. A molar with short root trunk length.
1214. b. 30Ú
1215. b. Class II furcation.
1216. c. They contain alveolar bone cells within them.
1217. d. Tricalcium phosphate.
1218. a. To reduce microbial source.
1219. a. Disto buccal root
1220. b. Fused roots.
1221. a. Metronidazole.
1222. a. Degeneration.
1223. b. Posterior teeth.
1224. b. For 6 months.
1225. c. Adaptation.
1226. c. All of the above.
1227. a. Lateral pressure.
1228. c. All of the above.
1229. a. Vertical and oblique strokes.
1230. a. Instrumentation zone.
1231. e. All of the above.
1232. g. All of the above.
1233. b. Cross arch finger rest.
1234. d. Offset blade angle.
1235. c. Heavier than scalers.
1236. f. All of the above.
1237. a. Sickle scalers.
1238. a. Curettes.
1239. a. Periodontal endoscope.
1240. a. Stainless steel.
1241. a. Hoe.
1242. e. All of the above.
1243. d. All of the above.
1244. a. Mandibular molars-Class II or Class III furcation
 involvement.
307
1245. d. Reduce the grade of furcation involvement.
1246. d. Osseous grafting.
1247. d. Tri-walled defects.
1248. c. Non supportive bone.
1249. d. Root canal therapy.
1250. a. Periodontal plastic surgery.
1251. a. Friedman.
1252. a. Miller.
1253. b. Palate.
1254. e. Trap-door technique.
1255. d. Rugae may form at the grafted site.
1256. a. Connective tissue Oedema, epithelial degeneration.
1257. d. Single surgical site.
1258. e. All of the above.
1259. f. All of the above.
1260. c. All of the above.
1261. a. About 1 mm.
1262. a. Full-thickness flaps & partial thickness flaps.
1263. b. Nondisplaced flaps & displaced flaps.
1264. c. Conventional flaps & papilla preservation flaps.
1265. a. Partial thickness flap.
1266. d. All of the above
1267. e. All of the above.
1268. a. Envelope flap.
1269. e. All of the above.
1270. b. Partial thickness flap.
1271. a. Holding mattress-periosteal suture.
1272. e. Holding mattress-periosteal suture-Modified widman flap.
1273. d. All of the above.
1274. c. All of the above.
1275. a. Access.
1276. d. Pericoronitis.
1277. c. All of the above.
1278. c. Frenum is completely removed.
1279. b. Frenum is incised and relocated.
1280. a. Greater risk.
Answer key
308 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1281. d. Yes.
1282. b. No.
1283. b. Long junctional epithelium.
1284. d. Histologic methods.
1285. f. All of the above.
1286. d. Yes.
1287. f. All of the above.
1288. f. b,c and d.
1289. c. Examination, treatment, report, cleanup and scheduling.
1290. d. Curettes.
1291. b. Root planing.
1292. a. Loss of attachment.
1293. a. Apical periodontitis.
1294. b. Not longer than 3 months.
1295. d. Comparison of sequential probing measurements.
1296. b. 3 mm
1297. b. 55%.
1298. b. 4
1299. b. 1.0-1.5
1300. c. 50-75
1301. d. All of the above.
1302. e. All of the above.
1303. c. Prevent recurrence.
1304. d. All of the above.
1305. b. Long junctional epithelium.
1306. a. Dental floss.
1307. e. b and c only.
1308. d. a and b only.
1309. a. Dental floss.
1310. d. Scar.
1311. a. Long junctional epithelium.
1312. c. Two.
1313. c. Crown lengthening.
1314. a. Mastix tree (Pistacia lenticus)
1315. b. Marsupialization.
1316. d. Osteocalcin.
309
1317. a. 1:1.
1318. c. Tooth is poor restorative risk.
1319. c. Provide resistance form.
1320. b. Inadequate clinical crown length for retention.
1321. f. All of the above.
1322. b. Modified widman flap.
1323. a. Levi Spear Parmly.
1324. c. Anti periodontitis.
1325. d. Vehicle.
1326. a. Afternoon.
1327. a. Systolic pressuree”180 mm Hg Diastolic pressuree”110 mm
 Hg.
1328. d. Conscious sedation is never warranted.
1329. b. Unstable angina.
1330. a. Stable angina.
1331. d. Administer one tablet 250 mg Acetaminophen orally to
 relieve and reduce anxiety.
1332. b. Myocardial infarction.
1333. e. All of the above.
1334. a. Orthopnea.
1335. d. Composite Light cure units.
1336. d. All of the above.
1337. b. Mitral valve prolapse without valvular regurgitation.
1338. c. Mitral valve prolapse without regurgitation.
1339. a. Endocarditis prophylaxis is recommended for ABC while it
 is not recommended for XYZ.
1340. a. Amoxicillin 2g, 1 hour before the procedure.
1341. f. All of the above.
1342. a. Ampicillin 2 g IM /IV 30 min before the procedure.
1343. a. Ampicillin 2 g IM /IV 30 min before the procedure.
1344. e. Clindamycin 600mg IV / Cefazolin 1.0g IM/IV within 30
 min before procedure.
1345. b. Cephalosporins.
1346. b. Glycosylated hemoglobin assay (Hb A1C).
1347. c. Insulins >sulfonylureas>Biguanides/Thiazolidinediones.
1348. d. Metformin.
Answer key
310 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1349. a. Acarbose.
1350. d. Rosiglitazone.
1351. b. Hunger pangs.
1352. d. All of the above.
1353. c. All of the above.
1354. e. All of the above.
1355. a. Yes.
1356. a. True.
1357. b. No.
1358. b. No.
1359. a. True.
1360. a. True.
1361. a. True.
1362. a. Yes.
1363. f. All of the above.
1364. b. Periodontitis.
1365. c. Hepatitis C virus.
1366. c. All of the above.
1367. b. Hydrogen peroxide.
1368. d. Metronidazole.
1369. b. Chlorhexidine ointment.
1370. d. All of the above.
1371. e. All of the above.
1372. b. False.
1373. a. Non smokers demonstrate diminished response to
 periodontal treatment.
1374. c. Long axis.
1375. a. Excimer lasers- Argon-fluoride lasers: Gingivectomy.
1376. d. all the above
1377. a. Quiryen et al.
1378. e. All of the above.
1379. e. All of the above.
311
ORAL IMPLANTOLOGY
1380. b. False.
1381. f. All of the above.
1382. a. 47°c.
1383. d. Profilometer.
1384. c. All of the above.
1385. a. Brånemark.
1386. c. Linkow.
1387. d. Transmandibular implants.
1388. a. Screw-shaped threaded implants.
1389. d. Transmandibular implants.
1390. c. All of the above.
1391. b. Commercially pure titanium.
1392. d. Sandblasting.
1393. b. Calcium phosphate coating.
1394. c.Plastic-tipped instruments.
1395. d. All of the above.
1396. c. Crevicular incision.
1397. c. Thickness of mucoperiosteum.
1398. b. Osseoperception.
1399. c. All of the above.
1400. d. All of the above.
1401. a. Diabetes.
1402. f. Psychiatric syndromes.
1403. d. Mental foramen.
1404. c. Incisive foramen.
1405. b. 1-2 mm.
1406. f. A thin layer of cortical bone surrounds a core of low density
 trabecular bone.
1407. e. Type IV: Extreme resorption of the basal bone has occurred.
1408. b. Biological width should be 3-4 mm.1409. d. Trephining.
1410. b. Peri-implantitis.
Answer key
312 Perio-quest: Mcqs and self- assessment pictorial testsin periodontics.
1411. e. a, b and c.
1412. a. Acidic fluoride agents.
313
REFERENCES AND
SUGGESTED FURTHER
READING:
References and suggested further reading:
David M.Williams et al; Pathology of periodontal disease1992:
Oxford medical publications.
Glossary of Periodontal terms 4th edition 2001: The American
Academy Of Periodontology
Hallmon.WW & Harrel.SK: Occlusal analysis, diagnosis and
management in periodontics: periodontology 2000, vol 34,2004,151-
164
Newman et al: Carranza’s Clinical periodontology 10th edition,
2006: Elsevier
Nield-Gehrig, Jill S: foundations of periodontics for dental hygienist
2nd edition 2007: Lippincott Williams & Wilkins.
Portnof JE, Leung T: NBDE II: Aboutabl Longlife learning.
Schroeder.HE: Oral Structural Biology: embryology, structure, and
function of normal hard and soft tissues of the oral cavity and
temperomandibular joints. 1991:Thieme
Rose.L.F et al: Periodontics: Medicine, Surgery and Implants 2004:
Elsevier Mosby
Samaranayake.L: Essential Microbiology for dentistry 4th edition
2012: Churchill Livingstone.
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