Periodontics
What the exam expects
Periodontics questions cover the etiology, pathogenesis, diagnosis, and treatment of periodontal disease. You must understand the role of plaque biofilm, the host response, the classification of periodontal disease, and the principles of nonsurgical and surgical therapy.
Concepts to master
- Etiology: dental plaque biofilm is the primary cause; calculus is a secondary factor; systemic conditions (diabetes, smoking) modify the host response.
- Pathogenesis: the host inflammatory response causes tissue destruction; cytokines and matrix metalloproteinases mediate collagen breakdown.
- Diagnosis: probing depth, clinical attachment level, bleeding on probing, and radiographs. Attachment loss distinguishes periodontitis from gingivitis.
- Treatment: scaling and root planing is the foundation; surgical therapy is considered when nonsurgical therapy fails; maintenance is essential.
Traps
A frequent trap is confusing gingivitis (reversible, no attachment loss) with periodontitis (irreversible attachment loss). Another is assuming that probing depth alone defines disease; attachment level is the key measure. Questions may also test whether antibiotics are indicated; they are adjunctive, not primary therapy.
Worked rule of thumb
When a question asks whether a patient has gingivitis or periodontitis, look for attachment loss or radiographic bone loss. If present, it is periodontitis; if absent, it is gingivitis.
Study strategy
Review the classification of periodontal diseases and the evidence for smoking and diabetes as risk factors. Practice interpreting probing depth and attachment level together.