NEET MDS Periodontology Flashcards

24 sample cards from the Periodontology deck

Sampled from the end of the deck, so these are different cards from the ones shown on the syllabus page.

1. In periodontal laser therapy, which laser wavelengths are well absorbed by water and pigment, making them useful for soft-tissue and pocket procedures?

   Diode (810-980 nm), Nd:YAG (1064 nm), and erbium lasers (Er:YAG 2940 nm, Er,Cr:YSGG 2780 nm); erbium lasers can also ablate calculus and bone.

2. What does LANAP stand for and what is its purpose?

   Laser-Assisted New Attachment Procedure, an FDA-cleared Nd:YAG protocol that selectively removes diseased pocket epithelium and bacteria while aiming to promote periodontal regeneration/new attachment.

3. What is a key advantage of erbium (Er:YAG) lasers over diode/Nd:YAG lasers in periodontal therapy?

   Erbium lasers can ablate hard tissue (calculus and bone) and are absorbed by both water and hydroxyapatite, allowing root debridement, whereas diode/Nd:YAG are primarily soft-tissue lasers.

4. What is supportive periodontal therapy (SPT) / periodontal maintenance and its typical recall interval?

   Ongoing care after active therapy involving periodic exam, reinforcement of hygiene, and professional debridement to prevent recurrence; the typical recall interval is every 3 months, adjusted by risk.

5. What does each maintenance recall visit (Ramfjord's regimen) include?

   Updated medical/dental history, plaque and bleeding assessment, full periodontal probing/charting, evaluation of mobility/furcations, radiographs as needed, oral hygiene reinforcement, and supra/subgingival debridement with polishing.

6. What is the proposed two-way relationship between periodontitis and cardiovascular disease?

   Periodontal pathogens and chronic inflammation can enter the bloodstream, contributing to endothelial dysfunction, atheroma formation, and elevated systemic inflammatory markers (e.g., CRP), increasing atherosclerotic cardiovascular risk.

7. What antibiotic prophylaxis consideration applies to periodontal procedures in at-risk cardiac patients?

   Patients with high-risk cardiac conditions (e.g., prosthetic valves, prior infective endocarditis, certain congenital defects) may require antibiotic prophylaxis (typically amoxicillin 2 g 1 hour before) to prevent infective endocarditis from bacteremia.

8. How does diabetes mellitus affect periodontal disease (the bidirectional relationship)?

   Diabetes (especially poorly controlled) is a major risk factor that worsens periodontitis via AGEs, impaired neutrophil function, and increased inflammation; conversely, periodontitis worsens glycemic control, and periodontal treatment can modestly lower HbA1c.

9. What HbA1c value generally indicates well-controlled diabetes relevant to periodontal grading?

   HbA1c <7.0% indicates good control (Grade B influence), whereas HbA1c ≥7.0% in a periodontitis patient pushes the grade toward Grade C (rapid progression).

10. What is pregnancy-associated gingivitis and the "pregnancy tumor"?

    Hormonally exaggerated gingival inflammation (raised estrogen/progesterone increase vascularity and the response to plaque); the pregnancy tumor is a pyogenic granuloma (granuloma gravidarum), a benign vascular gingival overgrowth, often on the interdental papilla.

11. Why is periodontitis a concern during pregnancy regarding birth outcomes?

    Maternal periodontal infection/inflammation has been associated with an increased risk of preterm birth and low birth weight, possibly via inflammatory mediators (PGE2, IL-6, TNF-α) and bacteremia affecting the fetal-placental unit.

12. What is the proposed link between periodontal disease and respiratory diseases such as pneumonia and COPD?

    Dental plaque can serve as a reservoir for respiratory pathogens that are aspirated into the lower airway, contributing to aspiration pneumonia (especially in the elderly/ICU) and exacerbations of COPD; improved oral hygiene reduces risk.

13. What dimensions define a successful (machined-surface) implant according to Albrektsson's criteria for osseointegration?

    Immobility, no peri-implant radiolucency, marginal bone loss <0.2 mm annually after the first year (<1.5 mm first year), and absence of pain/infection/paresthesia.

14. What is the difference between peri-implant mucositis and peri-implantitis?

    Peri-implant mucositis is reversible inflammation of soft tissue around an implant without bone loss; peri-implantitis adds progressive loss of supporting peri-implant bone.

15. What is osseointegration?

    A direct structural and functional connection between ordered living bone and the surface of a load-bearing implant, without intervening fibrous tissue (Brånemark).

16. What is the goal of periodontal plastic (mucogingival) surgery?

    To correct defects in the morphology, position, or amount of gingiva and alveolar mucosa—e.g., root coverage of recession, augmentation of keratinized tissue, ridge preservation, and esthetic crown lengthening.

17. What is the Miller classification of gingival recession (and its successor)?

    Miller Class I-IV based on recession relative to the mucogingival junction and interdental bone/soft tissue loss (Class I/II have potential for complete root coverage); the 2017 Cairo Recession Type (RT1-RT3) classification now refines this using interproximal attachment loss.

18. What is the gold-standard graft for predictable root coverage and increasing keratinized tissue?

    The subepithelial connective tissue graft (CTG), typically harvested from the palate and used with a coronally advanced flap.

19. What is a free gingival graft and its primary indication?

    A graft of epithelium and connective tissue taken from the palate and placed on a prepared recipient bed; primarily indicated to increase the width/zone of attached keratinized gingiva (less predictable for root coverage than CTG).

20. What is microsurgery in periodontics and its main advantages?

    Periodontal surgery performed with magnification (surgical microscope/loupes), microsurgical instruments, and fine sutures, allowing improved precision, atraumatic tissue handling, better wound closure/primary intention healing, enhanced blood supply, and superior esthetic outcomes.

21. What suture size and key principle characterize periodontal microsurgery?

    Use of very fine sutures (e.g., 6-0 to 9-0) with passive, tension-free, precise wound apposition under magnification to maximize primary-intention healing and minimize trauma.

22. What is the difference between repair, reattachment, and new attachment in periodontal healing?

    Repair: healing without restoration of original architecture (often long junctional epithelium); reattachment: reunion of connective tissue with a root surface that was not pathologically exposed; new attachment: formation of new cementum, PDL, and bone on a previously diseased, exposed root surface (true regeneration).

23. What is the difference between the gingival sulcus depth in health and a periodontal pocket?

    A healthy gingival sulcus probes ≤3 mm with no attachment loss; a periodontal pocket is a pathologically deepened sulcus (>3 mm) caused by gingival enlargement (pseudopocket) or apical migration of the junctional epithelium (true pocket).

24. What index measures gingival bleeding and inflammation, and what does the Löe and Silness Gingival Index score range represent?

    The Gingival Index (GI) scores 0-3: 0 = normal gingiva, 1 = mild inflammation/no bleeding on probing, 2 = moderate inflammation/bleeding on probing, 3 = severe inflammation/spontaneous bleeding.

What this deck covers

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