AGD Periodontics and Gum Disease 2 — Questions and Answers
Question 1: Which cytokine is considered the primary mediator of bone resorption in periodontitis?
- Interleukin-1β (Correct answer)
- Interleukin-10
- Transforming growth factor-β
- Interleukin-4
Correct answer: Interleukin-1β
IL-1β is a key pro-inflammatory cytokine that upregulates RANKL expression and drives osteoclast-mediated alveolar bone resorption in periodontitis.
Question 2: A patient presents with rapid, severe periodontal destruction affecting the first molars and incisors in an otherwise healthy adolescent. The most likely diagnosis is:
- Generalized aggressive periodontitis
- Localized aggressive periodontitis (Correct answer)
- Necrotizing ulcerative periodontitis
- Chronic periodontitis
Correct answer: Localized aggressive periodontitis
Localized aggressive periodontitis classically presents in adolescents with rapid bone loss around first molars and incisors, often associated with Aggregatibacter actinomycetemcomitans.
Question 3: The Widman flap procedure differs from the modified Widman flap primarily in that the original technique:
- Preserves the interdental papilla entirely
- Includes osseous recontouring as a standard step (Correct answer)
- Uses an internal bevel incision only
- Avoids suturing of the flap margins
Correct answer: Includes osseous recontouring as a standard step
The original Widman flap routinely incorporated osseous recontouring, while the modified Widman flap emphasizes root debridement with minimal osseous surgery.
Question 4: Which furcation classification indicates that a probe can pass completely through the furcation from one side to the other?
- Class I
- Class II
- Class III (Correct answer)
- Class IV
Correct answer: Class III
Class III (through-and-through) furcation involvement means the probe can pass completely through the furcation, indicating severe attachment loss.
Question 5: Systemically, which medication class is most strongly associated with drug-influenced gingival enlargement?
- ACE inhibitors
- Beta-blockers
- Calcium channel blockers (Correct answer)
- Thiazide diuretics
Correct answer: Calcium channel blockers
Calcium channel blockers, particularly nifedipine, are well-known to cause gingival enlargement by increasing collagen synthesis in gingival fibroblasts.
Question 6: During periodontal surgery, the distance from the alveolar crest to the base of the pocket that determines whether osseous surgery is indicated is typically:
- 1–2 mm
- 3–4 mm (Correct answer)
- 5–6 mm
- Greater than 6 mm
Correct answer: 3–4 mm
A distance of 3–4 mm from the alveolar crest to the base of the defect is generally the threshold at which osseous recontouring becomes beneficial.
Question 7: Which microorganism is considered a keystone pathogen in the dysbiotic shift that initiates periodontal disease?
- Streptococcus mutans
- Porphyromonas gingivalis (Correct answer)
- Fusobacterium nucleatum
- Treponema denticola
Correct answer: Porphyromonas gingivalis
P. gingivalis is recognized as a keystone pathogen that, even in low abundance, manipulates the host immune response to create a dysbiotic microenvironment promoting periodontitis.
AGD Periodontics and Gum Disease 2
Which cytokine is considered the primary mediator of bone resorption in periodontitis?