Periodontics Midterm 1-15

All of the following are phases of the bone remodeling cycle EXCEPT:
a) Resting phase
b) Reversal phase
c) Initial phase
d) Formation phase
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All of the following statements about bacteria are true, EXCEPT:
a) Most of the bacteria in health are gram positive
b) There can be as many as 100 million bacteria in one disease site
c) Bacteria found in chronic gingivitis are evenly divided between gram-positive and gram-negative bacteria
d) Most of the bacteria in a healthy site are very motile
Which of the following statements about disease progression is FALSE?
a) As disease progresses, the number of bacteria in a site increases
b) As disease progresses, bacteria become more motile
c) As disease progresses, the bacteria population becomes more gram-negative
d) As disease progresses, the bacteria associated with health completely disappear
b) Early lesionIn which phase of periodontal disease progression do the increasing numbers of PMNs rush to the site of the periodontal pathogens and in doing so destroy healthy gingival connective tissue and migrate through the junctional epithelium to form a "wall of cells" between the plaque biofilm and the sulcus wall?a) Initial lesionIn which phase of periodontal disease progression are PMNs the most numerous cells at the site of the periodontal infection?c) CatabasisResolution of inflammation and return to a noninflammatory state is called:d) Matrix metalloproteinases (MMPs)Which of the following is a biochemical mediator that causes extensive collagen destruction of the periodontal tissues?c) Initial phaseAll of the following are phases of the bone remodeling cycle EXCEPT:b) Gram-positive bacteriaEarly colonizers of the plaque biofilm are:b) RedSocransky grouped microorganisms into complexes and assigned each a color. Which color signifies bacterial species that are dominant in the late stages of biofilm development?a) Extracellular slime layerThe protective factor that can prevent biofilm from being killed with antibiotics, antimicrobials, or the body's immune system is called:b) Bacterial bloom is a period in which specific bacterial species grow at rapid ratesb) Bacterial bloom is a period in which specific bacterial species grow at rapid ratesd) PhagocytosisA polymorphonuclear leukocyte travels to an infection site, attaches to a bacterium, ingests, and digests the unfortunate bacterium. The process of engulfing and digesting microorganisms is termed:a) BasophilsThe immune system protects the body against all of the following, EXCEPT:a) Leukocytes that have engorged on bacteria and diedPus at a site of inflammation consists of:c) Early gingivitisWhich phase of periodontal disease progression includes bacterial colonization near gingival margins?d) All of theseCytokines function to:d) Matrix metalloproteinases (MMPs)Which of the following is a biochemical mediator that causes extensive collagen destruction of the periodontal tissues?b) Established lesionIn which phase of periodontal disease progression does PGE2 and MMPs initiate collagen destruction but cause no bone destruction?a) Responsible for collagen destruction in periodontal tissueMatrix metalloproteinases' (MMPs) functions:Alveolar mucosaWhat is the term for the apical boundary of the gingiva?Free gingival groove and MGJWhat are the two demarcations of the gingiva?Free gingival grooveWhich demarcation is a shallow linear depression that separates the free and attached gingiva?a. Allows the gingival tissue to withstand the mechanical forces created by speaking, mastication, and toothbrushing b. Prevents the free gingiva from being pulled away from the teeth when tension is applied to the alveolar mucosaList a function of the attached gingiva?Dense fibrous connective tissueWhat kind of tissue is the periodontal ligament composed of?50%-55% organic substance,and 45% inorganic contentWhat is cementum composed of?Superior alveolar nervesWhat nerves innervate the teeth and PDL of the maxillary arch?Movement and tooth positionWhat do the nerves in the PDL provide information for?ASA and PSA arteries, Infraorbital artery, and GP arteryWhere does the vascular supply to the maxillary gingiva, PDL, and alveolar bone come from?Branches of the inferior alveolar arteryWhere does the mandibular gingiva, PDL, and alveolar bone get its arterial supply?Deep cervical nodesWhat nodes drain the palatal gingiva?Jugulodigastric nodesWhat nodes drain the gingiva in the 3rd molar region?Cells that form and secrete the extracellular matrixWhat are fibroblasts?Rete PegsWhat is the name of the epithelial ridges or extensions that reach down into the connective tissue?Wavy tissue boundaryWhich tissue interface enhances the adhesion of the epithelium to the connective tissue by increasing the surfaces area?1. as a specialize epithelium, it provides attachment between the gingiva and the tooth surface 2. Barrier between the biofilm and connective tissue of the periodontium 3. Host defense by defending the periodontium from bacterial invasion 4. Forms the base of the sulcusWhat are the functions of the JE?Lamina propriaWhat is another name for gingival connective tissue?Dentogingival unit 2What is the name of the JE and the gingival fiber?FibroblastsCells of the PDL are mainly _________Dentinal tubulesCementum seals the ____________.Number of all disease cases in a given point of timeWhat does prevalence mean?a. Sex/steroid hormones - puberty, pregnancy, menstrual cycle, oral contraceptivesb. Hyperglycemia/diabetes (gingival disease modified by a systemic factor) - abnormally high blood glucose levelsc. Leukemia - exaggerated inflammatory response to the amount of plaque biofilmd. Smoking - smokers have fewer clinical symptoms than non-smokerse. Malnutrition - vitamin deficiencies, seen in infants, institutionalized elderly, addictsModifying factors that exacerbate the host response can include:a. Poorly contoured restorations b. Hyposalivation (xerostomia)Modifying factors that increase plaque retention capabilities can include:a. Direct destruction by bacteria b. Indirect destruction by the host inflammatory responseThe disease process of periodontitis includes:a. Thin periodontal biotype - individual differences in gingival anatomy and morphology b. An absence of attached gingiva - approx. 1mm of attached gingiva is desirable to maintain periodontal health c. Reduced thickness of alveolar boneRisk factors for developing recession of the gingival margin include:Assessment/preliminary phase Phase I - nonsurgical therapy (SRP) including reevaluation Phase II - surgical therapy including implant placement Phase III - restorative therapy Phase IV - maintenance (supportive periodontal therapy)Phases of Treatment:A. Actinomycetemcomitans B. Porphyromonas gingivalisFrequently detected in aggressive forms of periodontitis:TrueMotile bacteria - use flagella to swim in fluid T/FInitial attachment permanent attachment Maturation Phase I Maturation Phase II DispersionSTAGES OF POLYMICROBIAL BIOFILM FORMATIONComplement systemWhat is the second layer of defense of the immune system?chemotaxisLeukocytes migrate from blood vessels and are attracted to the infection site calledCytokinesWhat influences the behaviors of other cells; 1. Send macrophages to the site of infection 2. Initiate destruction and bone loss 3. Attracts immune cells to an infection siteTrueMatrix metalloproteinases (MMP's) - break down the connective tissue matrix T/FFalseThe warning signs of acute inflammation are PRESENT in chronic inflammation. T/FTrueLipopolysaccharides (LPS) or endotoxins - found on the cell wall of gram-negative bacteria T/F