Gingivitis in leukemic patient resembles:

 # Gingivitis in leukemic patient resembles:

A. Pyogenic granuloma

B. Herpetic gingivostomatitis

C. Hairy cell Leukoplakia

D. ANUG

The correct answer is D. ANUG.

Acute gingivitis and lesions that resemble necrotizing ulcerative gingivitis are more frequent and severe in patients with terminal cases of acute leukemia. The inflamed gingiva in patients with leukemia differs clinically from that found in nonleukemic individuals. The gingiva is a peculiar bluish red, it is spongelike and friable, and it bleeds persistently on the slightest provocation or even spontaneously in leukemic patients. This greatly altered and degenerated tissue is extremely susceptible to bacterial infection, which can be so severe as to cause acute gingival necrosis with pseudomembrane formation or bone exposure.

Reference: Carranza's Clinical Periodontology, 12th Edition, Page no: 194

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PUFA index in Dentistry

PUFA (pulp, ulceration, fistula, abscess) provides a measure of badly diseased and broken down teeth which have been attacked by dental decay and are causing significant problems in need of early attention. It is now advocated for use by the FDI as a tool that can help to stress the importance of tackling dental caries to planners (Benzian et  al., 2011b).  It is  interesting  to  note  that in  the  UK,  where there have been massive improvements in oral health, some 7% of dentate adults (adults with teeth) had one or more conditions. A PUFA score of one or more was more common in men than women, adults from lower social groups than more affluent, amongst adults who reported brushing less than once a day than amongst those who brushed once or twice, and amongst smokers rather than non‐smokers.

PUFA index criteria

P  –  pulp involvement is recorded when the opening of the pulp chamber is visible or when the coronal tooth structures have been destroyed by the carious process and only roots/root fragments are left

 U  –  ulceration due to trauma is recorded when sharp edges of a dislocated tooth with pulp involvement or root fragments have caused traumatic ulceration of the surrounding soft tissues, e.g. tongue or buccal mucosa 

F  –  fistula is scored when a pus‐releasing sinus tract related to a tooth with pulp involvement is present

 A  –  abscess is scored when a pus‐containing swelling related to a tooth with pulp involvement is present .

Source:  Monse  et  al., 2011;  Health  and Social  Care  Information Centre, 2011c.

The principal component of dental plaque is:

 # The principal component of dental plaque is:

A. Dextrans

B. Lactic acid

C. Materia alba

D. Microorganism

The correct answer is D. Microorganism.

Dental plaque is composed primarily of microorganisms. One gram of plaque (wet weight) contains approximately 100000000000 bacteria. The number of bacteria in supragingival plaque on a single tooth surface can exceed 1000000000 cells. In a periodontal pocket, counts can range from 1000 bacteria in a healthy crevice to more than 100000000 bacteria in a deep pocket. With the use of highly sensitive molecular techniques for microbial identification, it has been estimated that more than 500 distinct microbial phylotypes can be present as natural inhabitants of dental plaque.

Reference: Carranza's Clinical Periodontology, 12th Edition, Page no:  141

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Scaling and root planing:

# Scaling and root planing:

 A. Prevent further loss of attachment in deep pockets

B. Most effective in reducing pocket depth than surgical means

C. More successful in posterior than anterior tooth

D. Same as curettage

 

The correct answer is A. Prevent further loss of attachment in deep pockets.

Of all clinical dental procedures, subgingival scaling and root planing in deep pockets are the most difficult and exacting skills to master. It has been argued that such proficiency in instrumentation cannot be attained, and therefore periodontal surgery is necessary to gain access to root surfaces. Others have argued that although proficiency is possible, it need not be developed because access to the roots can be gained more easily with surgery. However, without mastering subgingival scaling and root-planing skills, the clinician will be severely hampered and unable to treat adequately those patients for whom surgery is contraindicated.

Scaling and root planing alone are effective for reducing pocket depths, gaining increases in periodontal attachment levels, and decreasing inflammation levels (i.e., bleeding with probing). When scaling and root planing are combined with the subgingival placement of sustained-release vehicles, however, additional clinical benefits are possible, including the further reduction of pocket depths, additional gains in clinical attachment levels (e.g., 0.39 mm with minocycline gel), and further decreases in inflammation. Improvements in clinical attachment levels also occur with the chlorhexidine chip (0.16 mm) and doxycycline gel (0.34 mm). When systemic antibiotics are used as adjuncts to scaling and root

planing, the evidence indicates that some systemic antibiotics (e.g., metronidazole, tetracycline) provide additional improvements in attachment levels (0.35 mm for metronidazole; 0.40 mm for tetracycline)

when used as adjuncts to scaling and root planing. The use of anti-infective chemotherapeutic treatment adjuncts does not result in significant patient-centered adverse effects.

Reference: Carranza's Clinical Periodontology, 12th Edition, Page no: 524

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When the flaps are not in close apposition, following suturing technique is used:

 # When the flaps are not in close apposition, following suturing technique is used:

A. Direct or loop suture

B. Sling ligation

C. Anchor suture

D. Figure of 8 suture

The correct answer is D. Figure of 8 suture.

Interdental Ligation. Two types of interdental ligation can be used: the direct loop suture and the figure-eight suture. With the figure-eight suture, thread is placed between the two flaps. This suture is used when the flaps are not in close apposition as a result of apical flap position or nonscalloped incisions. This is simpler to perform than the direct ligation. The direct suture allows for a better closure of the interdental papilla. It should be performed when bone grafts are used or when close apposition of the scalloped incision is required.

Reference: Carranza's Clinical Periodontology, 12th Edition, Page no: 586 e1

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All the following cements possess anticariogenic properties, EXCEPT:

 # All the following cements  possess anticariogenic properties, EXCEPT:

A. Silicate

B. Glass ionomer

C. Silicophosphate

D. Zinc oxide eugenol

The correct answer is D. Zinc oxide eugenol.

Anticariogenic property of cements makes the enamel (fluorapatite) resistant to acid mediated decalcification. Silica-phosphate has the highest fluoride content followed by silicate and GIC. Polycarboxylate has least fluoride content. They release fluoride throughout the life of restoration but rate of release decreases over time.

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Tarnish generally occurs in the oral cavity due to:

 # Tarnish generally occurs in the oral cavity due to:

A. Formation of hard and soft deposits

B. Pigment producing bacteria

C. Formation of their oxides, sulphides or chlorides

D. All of the above

The correct answer is D. All of the above.

Tarnish: It is the surface discoloration or alteration of the surface finish or luster. It generally occurs due to formation calculus, plaque on the surface of the metal. It also occurs due to formation of oxides, sulfides or chlorides. Tarnish is the forerunner of corrosion.

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