ADEX Periodontal Concepts 2 — Questions and Answers
Question 1: Which periodontal fiber group runs from the cementum to the alveolar bone in an oblique direction, resisting occlusal forces?
- Horizontal fibers
- Oblique fibers (Correct answer)
- Apical fibers
- Alveolar crest fibers
Correct answer: Oblique fibers
Oblique fibers are the most numerous PDL fiber group and primarily resist occlusal (vertical) forces by transmitting them obliquely to the bone.
Question 2: A patient presents with generalized 6-7 mm probing depths, radiographic bone loss, and a history of poor systemic control of Type 2 diabetes. How does poorly controlled diabetes most directly affect periodontal disease?
- Increases salivary buffering capacity
- Impairs neutrophil chemotaxis and phagocytosis (Correct answer)
- Accelerates cementum deposition
- Decreases prostaglandin production
Correct answer: Impairs neutrophil chemotaxis and phagocytosis
Poorly controlled diabetes impairs neutrophil function including chemotaxis and phagocytosis, reducing the host's ability to combat periodontal pathogens.
Question 3: What is the term for the distance from the cementoenamel junction (CEJ) to the base of the sulcus/pocket measured clinically?
- Attachment level (Correct answer)
- Probing depth
- Biologic width
- Osseous crest depth
Correct answer: Attachment level
Clinical attachment level (CAL) is measured from the CEJ to the base of the pocket and reflects true tissue destruction regardless of gingival position.
Question 4: Which cell is the primary mediator of alveolar bone resorption in periodontal disease?
- Osteoblast
- Osteoclast (Correct answer)
- Fibroblast
- Cementoblast
Correct answer: Osteoclast
Osteoclasts resorb mineralized bone tissue and are the primary cells responsible for the alveolar bone loss seen in periodontitis.
Question 5: Stage III Grade C periodontitis is most strongly associated with which systemic risk modifier?
- Hypothyroidism
- Osteoporosis
- Poorly controlled diabetes (HbA1c ≥7%) (Correct answer)
- Anemia
Correct answer: Poorly controlled diabetes (HbA1c ≥7%)
Grade C periodontitis indicates rapid progression and is strongly associated with poorly controlled diabetes (HbA1c ≥7%) as a systemic risk factor per the 2017 classification.
Question 6: During periodontal probing, what does a bleeding on probing (BOP) positive score primarily indicate?
- Active bone loss is occurring
- Subgingival calculus is present
- Gingival tissue inflammation is present (Correct answer)
- Pocket depth exceeds 4 mm
Correct answer: Gingival tissue inflammation is present
BOP is a reliable indicator of gingival inflammation because inflamed sulcular epithelium is ulcerated and bleeds upon gentle probing.
Question 7: Which type of bone defect has three remaining osseous walls and offers the best prognosis for regenerative therapy?
- One-wall defect
- Two-wall defect
- Three-wall (intrabony) defect (Correct answer)
- Hemiseptal defect
Correct answer: Three-wall (intrabony) defect
A three-wall intrabony defect is surrounded by bone on three sides, providing a contained environment that supports regenerative procedures with the best outcomes.
ADEX Periodontal Concepts 2
Which periodontal fiber group runs from the cementum to the alveolar bone in an oblique direction, resisting occlusal forces?