Multiple Choice Questions Test - II (Basic Periodontology).

This is a self assessment test consisting of ten questions. Click evaluate to get result.

1. Structurally bone morphogenetic proteins are related members of,

Bone Morphogenetic Proteins (BMPs) are potent growth factors belonging to the Transforming Growth Factor-β superfamily. To date over 20 members have been identified in humans with varying functions during processes such as embryogenesis, skeletal formation, hematopoiesis and neurogenesis. Though their functions have been identified, less is known regarding levels of regulation at the extracellular matrix, membrane surface, and receptor activation.

Reference: A. H. Reddi. Bone Morphogenetic Proteins: From Basic Science to Clinical Applications. J Bone Joint Surg Am, 2001 Mar 01;83(1 suppl 1):S1-S6.

TGF-β superfamily .
Immunoglobulin superfamily.
Toll-like receptor superfamily.
TNF- receptor superfamily.
Correct Answer - option 1

2. The mean pH of saliva is between pH 6.75 and 7.25 but during inflammation in gingivitis and periodontal disease it is,

Saliva plays a major role in maintaining the integrity of teeth by clearing food and by buffering the potentially damaging acids produced by dental plaque following the metabolism of dietary carbohydrates. Bicarbonate is the major buffering system in saliva, but phosphates, peptides and proteins are also involved. The mean pH of saliva is between pH 6.75 and 7.25, although the pH and buffering capacity will vary with the flow rate. The mean pH during health is approximately 6.90 and this can rise during inflammation in gingivitis and periodontal disease to between pH 7.25 and 7.75.

Reference: Professor Philip D Marsh. Oral Microbiology. Fifth Edition. Chapter 2. The mouth as a microbial habitat.

Between pH 6.25 and 6.75
Between pH 6.75 and 7.25
Between pH 7.25 and 7.75
Between pH 7.75 and 8.25
Correct Answer - option 3

3. Width of basal lamina is reported to be in the vessinity of

Basement membrane is specialised extracellular matrix that is interposed between connective tissue and the epithelium. It is thought to play the role in compartmentalisation (physical barrier function), filtration (selective permeability barrier function), cell polarisation, migration, adhesion and differentiation. It usually consists of lamina lucida (also known as lamina rara) towards the epithelium, lamina densa towards the connective tissue and a lamina fibroraticularis (also known as subbasal lamina). The lamina fibro-reticularis is a discontinuous layer consisting of reticular and anchoring fibrils and face the connective tissue site from which it is supposed to originate. The width of basal lamina is reported to be in the vessinity of 800 A° -1200 A°.

600 A° -800 A°.
800 A° -1200 A°.
200 A° -600 A°.
1200 A° -1600 A°.
Correct Answer - option 2

4. Which of the following is not a stromelysin,

MMP-3.
MMP-10.
MMP-11.
MMP-13.
Correct Answer - option 4

5. Constant region on heavy and light chains determine the

Human immunoglobulins are made up of LIGHT and HEAVY chains. Genetically these are encoded by a total of 14 constant region genes which are organized into three gene families, namely

  • 1 KAPPA gene
  • 4 LAMBDA genes
  • 9 HEAVY CHAIN genes.


Allelic variation is present only for kappa locus and six of the nine heavy chain loci. The nine heavy chains of the antibodies form CLASSES and SUBCLASSES of human immunoglobulin.  Together with the five different light chains, these genes represent 14 distinct ISOTYPES which can be identified in all normal human sera.  ALLOTYPES are the allelic variations within the constant regions that exist for some of these isotypes, and are inherited in a Mendelian co-dominant fashion.  IDIOTYPES consist of the unique combination of VH and VL which characterize a particular immunoglobulin's combining sites.

So, in summary we can infer that

  • Constant region on heavy chain determines the Immunoglobulin class.
  • Constant region on heavy and light chains determine the allotypes.
  • Variable region of light and heavy chains determine idiotypes.
Immunugobulin class.
Allotypes.
Idiotypes.
None of above
Correct Answer - option 2

6. Hypophosphatasia is characterized by,

Serum alkaline phosphatase (AP) activity is markedly reduced in hypophosphatasia, while urinary phosphoethanolamine (PEA) is increased. However, AP activity is only a helpful diagnostic indicator as other conditions may also show this finding: early pregnancy, drug administration, hypothyroidism, anemia, celiac disease etc. It must be also noticed that serum AP dramatically varies with age and sex.

Reference: Etienne Mornet. Hypophosphatasia. Orphanet J Rare Dis. 2007; 2: 40.

High levels of acid phosphatase and alkaline phosphatase.
High levesl of serum alkaline phosphatase and phosphoethanolamine.
Low levels of serum alkaline phosphatase and high level of phosphoehtanolamine.
Low levels of serum alkaline phosphatase and low level of phosphoethanolamine.
Correct Answer - option 4

7. Which of the following histologic structures are generally absent within the periodontal ligament?

Predominant Periodontal ligament fibers: The predominant collagens of the periodontal ligament are type I, III, and XII, with individual fibrils having a relatively smaller average diameter than tendon collagen fibrils, a difference believed to reflect the relatively short half-life of ligament collagen, and hence less time for fibrillar assembly. The vast majority of collagen fibrils in the periodontal ligament are arranged in definite and distinct fiber bundles, and these are termed principal fibers.

Elastic fibers: There are three types of elastic fibers: elastin, oxytalan, and elaunin. Only oxytalan fibers are present within the periodontal ligament; however, elaunin fibers may also be found in association with fiber bundles in the gingival ligament.

Reference: Antonio Nanci & Dieter D. Bosshardt. Structure of periodontal tissues in health and disease. Periodontology 2000, Vol. 40, 2006, 11–28.

Mylenated nerve fibers.
Mature elastin fibers.
Interstitial spaces
Fibronectin.
Correct Answer - option 2

8. Which of the following is also known as Erythropoetic factor

Insulin like Growth Factor (IGF-I) is found in substantial levels in platelets and is released during clotting along with the other growth factors present in platelets. It is a potent chemotactic agent for vascular endothelial cells. It promotes migration of vascular endothelial cells into the wound area resulting in increased neovascularization. It stimulates mitosis of many cells in vitro such as fibroblasts, osteocytes and chondrocytes.

Platelet Derived Growth Factor (PDGF).
Insulin like Growth Factor-I (IGF-I).
FDGF (Fibroblast Derived Growth Factor).
All of above.
Correct Answer - option 2

9. Which of the following is a BANA (benzoyl-arginyl-napthylamide) based chairside diagnostic kit

Periocheck:

This system detects the presence of neutral proteinases such as collagenase in GCF.A paper strip is used to obtain a GCF sample. This strip is then placed in contact with a collagen gel to which a blue dye has been covalently bonded. This is then incubated at 43°C. If the neutral proteinases are present in the sample they will attack the collagen gel and release the blue dye. The released blue dye produces a blue color in the strip, the intensity of which is proportional to the amount of enzyme present in the sample. The intensity and the area of the blue color is then scored on a scale of 0 to 2 by comparing it with three standards on a color card which is provided with the test kit.

Perioscan:          

It is BANA (benzoyl-arginyl-napthylamide) based test which acts as hydrolase for nonspecific proteases with trypsin like activity (only bacteria Porphyromonas gingivalis, Bacteroid forsythus, Trep Denticola and possibly capnocytophaga. The enzyme is detected by degradation of a synthetic substrate, BANA, in a colorimetric assay. A blue black color on the reagent card indicates a positive test.

Perioguard:       

It is aspartate amino transferase based (released from destroyed tissue) test. Aspartate amino transferase (AST) and Lactate dehydrogenase (LDH), have been widely used in medicine for several decades as diagnostic aids to assess cell death and tissue destruction.

Periocheck.
Perioscan.
Perioguard.
ParoCheck.
Correct Answer - option 2

10. Which of the following acts as a marker for maturation of osteoblasts, odontoblasts and cementoblasts

Bone sialoprotein and osteopontin are fundamental constituents of cementum matrix, during both its development and repair. Present data suggest that osteopontin is involved in regulating mineral growth, whereas bone sialoprotein promotes mineral formation on the root surface. Bone Gla protein (osteocalcin) is a marker for maturation of osteoblasts, odontoblasts and cementoblasts that may regulate the extent of mineralization.

Reference: Antonio Nanci & Dieter D. Bosshardt. Structure of periodontal tissues in health and disease. Periodontology 2000, Vol. 40, 2006, 11–28.

Osteopontin.
Bone sialoprotein.
Bone Gla protein (osteocalcin).
All of above.
Correct Answer - option 3

11. Sensitivity & Specificity of indirect immunofluorescence assay for AAC bacteria is

Sensitivity is a measure of positive cases that test positive (i.e., the ratio of true positives to the sum of true positives and false negatives). Specificity is a measure of negative cases that test negative (i.e., the ratio of true negatives to the sum of true negatives and false positives).

Reference:

Carranza 10th Edition Page 591, Chapter 37

82 to 100%; 88 to 92%
88 to 92%; 82 to 100%
68 to 88%; 88 to 98%
82 to 92%; 60 to 80%
Correct Answer - option 1

12. Bisphosphonates used as HMT have all the features except

Bisphosphonates are a class of drugs that prevent the loss of bone mass. They have in common the P–C–P structure, which is similar to the P–O–P structure of native pyrophosphate. Bisphosphonates inhibit osteoclastic bone resorption by attaching to hydroxyapatite binding sites on bony surfaces, especially surfaces undergoing active resorption. When osteoclasts begin to resorb bone that is impregnated with bisphosphonate, the bisphosphonate released during resorption impairs the ability of the osteoclasts to form the ruffled border, to adhere to the bony surface, and to produce the protons necessary for continued bone resorption. Bisphosphonates also reduce osteoclast activity by decreasing osteoclast progenitor development and recruitment and by promoting osteoclast apoptosis.

Reference:

Hughes DE, Wright KR, Uy HL, Sasaki A, Yoneda T, Roodman GD, Mundy GR, Boyce BF. Bisphosphonates promote apoptosis in murine osteoclasts in vitro and in vivo. J Bone Miner Res. 1995;10(10):1478.

Interferes with osteoblast metabolism
Posses anti collagenase properties
Increases bones density
Promotes bone calcification
Correct Answer - option 4

13. All are locally administered HMT except

Periostat® (doxycycline hyclate) is available as a 20 mg tablet formulation of doxycycline for oral administration. The dosage of doxycycline achieved with this product during administration is well below the concentration required to inhibit microorganisms commonly associated with chronic and aggressive periodontitis. Studies have shown host modulatory activity of doxycycline. This does achieves this activity but still not having any anti-microbial activity.

Reference:

Golub L.M., Sorsa T., Lee H-M, Ciancio S., Sorbi D., Ramamurthy N.S., Gruber B., Salo T., Konttinen Y.T.: Doxycycline Inhibits Neutrophil (PMN)-type Matrix Metalloproteinases in Human Adult Periodontitis

Gingiva. J. Clin. Periodontol 1995; 22: 100-109.

Golub L.M., Ciancio S., Ramamurthy N.S., Leung M., McNamara T.F.: Low-dose Doxycycline

Therapy: Effect on Gingival and Crevicular Fluid Collagenase Activity in Humans. J. Periodont Res

1990; 25: 321-330.

Golub L.M., Lee H.M., Greenwald R.A., Ryan M.E., Salo T., Giannobile W.V.: A Matrix Metalloproteinase Inhibitor Reduces Bone-type Collagen Degradation Fragments and Specific Collegenases in Gingival Crevicular Fluid During Adult Periodontitis. Inflammation Research 1997; 46: 310-319.

Emdogain
BMP
Growth factors
Periostat
Correct Answer - option 4

14. An antimicrobial agent that is generally applied to inanimate surface to destroy microbes is

Sterilization is defined as the process where all the living microorganisms, including bacterial spores are killed. Sterilization can be achieved by physical, chemical and physiochemical means. Chemicals used as sterilizing agents are called chemisterilants.

Disinfection is the process of elimination of most pathogenic microorganisms (excluding bacterial spores) on inanimate objects. Disinfection can be achieved by physical or chemical methods. Chemicals used in disinfection are called disinfectants. Different disinfectants have different target ranges, not all disinfectants can kill all microorganisms. Some methods of disinfection such as filtration do not kill bacteria, they separate them out. Sterilization is an absolute condition while disinfection is not. The two are not synonymous.

Decontamination is the process of removal of contaminating pathogenic microorganisms from the articles by a process of sterilization or disinfection. It is the use of physical or chemical means to remove, inactivate, or destroy living organisms on a surface so that the organisms are no longer infectious.

Asepsis is the employment of techniques (such as usage of gloves, air filters, uv rays etc) to achieve microbe-free environment.

Antisepsis is the use of chemicals (antiseptics) to make skin or mucus membranes devoid of pathogenic

microorganisms.

Reference:

Sridhar Rao PN. Sterilization and Disinfection.

Antibiotic
Disinfectant
Antiseptic
None of above
Correct Answer - option 2

15. T-lymphocytes play a primary role in

The primary function of T- Lymphocytes is the production of lymphokines for further amplification of immune response and delayed hypersensitivity.

Production of Antibodies
Production of lymphokines and delayed hypersensitivity
Activation of complement system
Immediate hypersensitivity
Correct Answer - option 2



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