Periodontal therapy practice questions for the periodontics Qualifying Exam
Non-surgical and surgical periodontal therapy is the core of the specialty and one of the largest domains. Expect technique selection, expected outcomes and the evidence for adjuncts and materials.
2027 ABP blueprint domain: Periodontal Therapy: Non-Surgical and Surgical
14%of our mock exams
~28of 200 full-length mock questions
133questions on this domain in the bank
What the blueprint covers
The 2027 Qualifying Exam blueprint lists these objectives for this domain:
Oral hygiene, scaling and root planing, occlusal therapy and re-evaluation
Adjunctive antimicrobials, host modulation, probiotics and lasers
Correcting restorative and anatomic factors, and orthodontics in support of periodontal care
Root coverage and gingival augmentation, autogenous and non-autogenous
Vestibular procedures, extraction, ridge preservation, pre-prosthetic surgery and surgery with orthodontics
Laser surgery, pain control and postoperative complications
High-yield areas
Expected probing depth and attachment changes after SRP by starting depth
The EFP S3 steps, and when systemic amoxicillin and metronidazole are justified
Defect morphology and furcation class in choosing regeneration
Coronally advanced flap with connective tissue graft versus substitutes by recession type
Supracrestal tissue attachment and crown lengthening
How to study it
For each procedure, know the indication, the defect it suits, the expected result in millimeters and the main complication. Then compare procedures head to head, because questions ask which is best for this patient.
Free practice questions: Periodontal therapy
4 questions from the bank, with the full rationale and source. Pick your answer, then open the rationale.
Question 1 of 4 · hardPeriodontal Therapy: Non-Surgical and Surgical
A 23-year-old woman has a localized 8 mm pocket with bleeding on the palatal surface of the maxillary right lateral incisor. The tooth is vital and caries-free, and all other sites probe 3 mm or less. A developmental groove is visible crossing the cingulum and disappearing under the palatal gingiva. Which finding will most influence whether the tooth can be maintained?
How far the groove extends apically along the root
The width of keratinized gingiva on the facial surface
The patient's age at diagnosis
The presence of an incisal edge wear facet
The color of the palatal gingiva
Show answer and rationale
Answer: A. How far the groove extends apically along the root
A (correct): The prognosis of a tooth with a palatogingival groove depends on the groove's location and type (shallow or deep, short or long), the severity of the associated periodontal disease and access to the defect. Apical extension of the groove has been significantly associated with poor periodontal health. A short, shallow groove can be managed by odontoplasty with periodontal treatment, whereas a groove running far down the root carries a much poorer outlook.
B (incorrect): Facial gingival width has no bearing on a plaque-retentive groove on the palatal root. The prognostic factors for a groove-related lesion concern the groove itself and the disease around it. This finding does not decide maintainability.
C (incorrect): Age is not among the factors that determine the prognosis of a groove-related lesion. Prognosis depends on the groove's location and type, the severity of the periodontal destruction and access to the defect. Age alone does not decide whether this tooth can be kept.
D (incorrect): A wear facet reflects function or parafunction and does not explain a localized palatal pocket on a vital tooth. It is not among the prognostic factors for a groove-related lesion. This is not the key finding.
E (incorrect): Gingival color reflects inflammation, which the bleeding pocket already shows. It does not distinguish a short, shallow groove from one extending far along the root. The groove's extent is the critical variable.
Source: Kim HJ, Choi Y, Yu MK, Lee KW, Min KS. Recognition and management of palatogingival groove for tooth survival: a literature review. Restor Dent Endod. 2017;42(2):77-86. Relationship between PGG and periodontal/pulpal health; Treatment of PGG; Prognosis. https://pmc.ncbi.nlm.nih.gov/articles/PMC5426222/
Question 2 of 4 · easyPeriodontal Therapy: Non-Surgical and Surgical
A 49-year-old nonsmoker with stage III periodontitis has completed steps 1 and 2. Plaque score is 12%. The distal of the mandibular left first molar has a 7 mm pocket with bleeding, and the radiograph shows a 4 mm deep intrabony defect with mostly 2 and 3 bony walls. The tooth has no furcation involvement and no mobility. What is the most appropriate treatment for this site?
Repeat subgingival instrumentation and reassess in 3 months
Access flap debridement with no added biomaterial
Osseous resective surgery to eliminate the defect
Extraction and replacement with a dental implant
Periodontal regenerative surgery for the intrabony defect
Show answer and rationale
Answer: E. Periodontal regenerative surgery for the intrabony defect
A (incorrect): Repeated instrumentation is suggested for residual pockets of 4 to 5 mm. A 7 mm pocket with a 4 mm intrabony component has already failed to resolve after step 2 and needs surgical treatment.
B (incorrect): Regenerative surgery achieves greater attachment gain and probing reduction than access flap alone in intrabony defects. With a favorable defect, choosing access flap alone gives up a predictable benefit.
C (incorrect): Eliminating a 4 mm intrabony defect by resection would remove a lot of supporting bone from the molar and its neighbors. This is why intrabony defects of 3 mm or more are regenerated rather than resected.
D (incorrect): A tooth with a treatable intrabony defect and no mobility should be retained. Regenerative therapy can improve the prognosis of such teeth, so extraction is premature.
E (correct): The EFP S3 guideline recommends regenerative surgery for teeth with residual deep pockets associated with intrabony defects 3 mm or deeper. This defect is 4 mm deep, mostly contained, and the patient has excellent plaque control and does not smoke, so conditions favor a good outcome.
Source: Sanz M, Herrera D, Kebschull M, Chapple I, Jepsen S, Berglundh T, Sculean A, Tonetti MS, et al. Treatment of stage I-III periodontitis: the EFP S3 level clinical practice guideline. J Clin Periodontol. 2020;47(Suppl 22):4-60. Recommendation R3.7. https://pmc.ncbi.nlm.nih.gov/articles/PMC7891343/
Question 3 of 4 · moderatePeriodontal Therapy: Non-Surgical and Surgical
A 58-year-old man with treated stage IV periodontitis has 19 remaining teeth with advanced bone loss and needs intrusion and retraction of extruded, flared maxillary incisors. The posterior teeth have 40% to 60% bone loss and limited anchorage value. Which anchorage strategy is most appropriate?
Skeletal anchorage with cortical screws or a palatal implant
Reciprocal anchorage between the incisors and the compromised molars
Headgear worn at night to reinforce posterior anchorage
Splinting all posterior teeth together to act as one anchorage unit
Postponing orthodontics until implants replace the missing teeth
Show answer and rationale
Answer: A. Skeletal anchorage with cortical screws or a palatal implant
A (correct): Bone loss reduces the anchorage quality of natural teeth, so the reciprocal forces of each movement are poorly absorbed by neighboring teeth and cause unwanted side effects. Skeletal anchorage such as palatal implants and cortical screws is especially indicated where anchorage is reduced, as with extruded teeth, advanced bone loss and tooth loss. Evidence in periodontitis patients is still limited to case reports.
B (incorrect): With 40% to 60% bone loss, the posterior teeth have reduced anchorage quality. Reciprocal forces from moving the incisors would be poorly absorbed and could move them unintentionally. Skeletal anchorage avoids relying on them.
C (incorrect): Headgear still relies on the compromised posterior teeth to resist the forces. It does not provide the stable anchorage these teeth lack. Skeletal anchorage is the better-supported option.
D (incorrect): Splinting still relies on teeth with reduced support and does not create stable anchorage. Their combined anchorage value remains limited. Skeletal devices are the better option.
E (incorrect): Waiting for implants is unnecessary when temporary skeletal devices such as cortical screws can provide anchorage now. Delay postpones correction of the extruded, flared incisors. Waiting is not the most appropriate strategy.
Source: Erbe C, Heger S, Kasaj A, Berres M, Wehrbein H. Orthodontic treatment in periodontally compromised patients: a systematic review. Clin Oral Investig. 2023;27(1):79-89. Discussion (anchorage in periodontally compromised patients). https://pmc.ncbi.nlm.nih.gov/articles/PMC9877066/
Question 4 of 4 · easyPeriodontal Therapy: Non-Surgical and Surgical
A healthy 38-year-old woman has a mandibular first molar removed surgically with a flap and osteotomy. She takes no medications and has no contraindication to any analgesic. Which postoperative analgesic plan is most appropriate to start?
Hydrocodone 5 mg with acetaminophen 325 mg every 6 hours
Ibuprofen 400 mg alone or with acetaminophen 500 mg
Acetaminophen 1,000 mg alone as the first-line agent
Oxycodone 5 mg with ibuprofen 400 mg for 5 days
Dexamethasone 4 mg orally added to acetaminophen
Show answer and rationale
Answer: B. Ibuprofen 400 mg alone or with acetaminophen 500 mg
A (incorrect): Opioids are reserved for when first-line therapy is insufficient or NSAIDs are contraindicated. Starting with an opioid combination is not recommended.
B (correct): Nonopioid analgesics are first-line therapy after surgical extraction. The ADA guideline suggests starting with an NSAID alone (for example ibuprofen 400 mg or naproxen sodium 440 mg) or combined with acetaminophen (for example 500 mg).
C (incorrect): Acetaminophen alone at 1,000 mg is suggested when NSAIDs are contraindicated. This patient can take an NSAID, which is the preferred first-line option.
D (incorrect): Adding an opioid from the start is not recommended, and a 5-day opioid supply exceeds the usual duration, which rarely needs to go beyond 3 days.
E (incorrect): The guideline suggests against adding corticosteroids to standard analgesics for pain after surgical extraction. Acetaminophen alone is also not the preferred start when an NSAID can be used.
Source: Carrasco-Labra A, Polk DE, Urquhart O, Aghaloo T, Claytor JW, Dhar V, Dionne RA, et al. Evidence-based clinical practice guideline for the pharmacologic management of acute dental pain in adolescents, adults, and older adults: a report from the American Dental Association Science and Research Institute, the University of Pittsburgh, and the University of Pennsylvania. J Am Dent Assoc. 2024;155(2):102-117.e9. Box 1, recommendations 1 and 1.1. https://pmc.ncbi.nlm.nih.gov/articles/PMC10919895/
For exam preparation only, not clinical advice.
Practice all 133 questions in this domain
The full bank has 937 questions across all 11 domains, timed full-length, half-length and quick mock exams, and your accuracy by domain. $249 USD, one time, with a pass-or-refund guarantee.