Periodontology
What the exam tests
Periodontology questions test classification, risk assessment, nonsurgical and surgical therapy, maintenance and peri-implant disease. The exam expects the 2017 World Workshop classification and a staged, risk-based approach to treatment.
Core rules and concepts
- Classification: periodontitis is staged I–IV by severity and complexity, and graded A–C by rate of progression and risk. Do not diagnose from probing depth alone; use clinical attachment loss, bone loss, tooth loss and risk factors.
- Gingivitis: plaque-induced gingivitis is reversible; systemic modifying factors and medications can exaggerate the response.
- Nonsurgical therapy: oral hygiene instruction plus scaling and root surface debridement; re-evaluate after six to eight weeks before deciding on surgery.
- Surgical therapy: flap surgery, regenerative procedures and bone grafting are selected according to defect morphology and patient factors; GTR is not indicated for every intrabony defect.
- Maintenance: set supportive periodontal therapy intervals according to risk; smoking and poorly controlled diabetes increase recurrence.
- Peri-implant disease: peri-implant mucositis is reversible; peri-implantitis involves bone loss and needs debridement, risk-factor control and possibly surgical correction.
Worked example
A 45-year-old smoker has generalized probing depths of 6 mm, 40% bone loss and two teeth lost to periodontitis. Reasoning: this is stage III, grade C because of severity and smoking-related progression. Start with hygiene instruction and full-mouth debridement, re-evaluate at six to eight weeks, then consider surgery for residual deep pockets; reinforce smoking cessation at every visit.
Traps
Using the old chronic/aggressive labels; staging by probing depth alone; prescribing antibiotics without mechanical debridement; ignoring smoking; failing to re-evaluate before surgery; treating peri-implantitis as mucositis.