Free Practice Questions for Saudi Board Periodontics

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Sample Saudi Board Periodontics Practice Questions

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1According to the classic histological dimensions established by Gargiulo et al. (1961) and later reaffirmed by Vacek et al. (1994), what are the average dimensions of the epithelial attachment and the connective tissue attachment that constitute the supracrestal tissue attachment (biologic width)?

A.Epithelial attachment ~0.97 mm; connective tissue attachment ~1.07 mm

B.Epithelial attachment ~1.07 mm; connective tissue attachment ~0.97 mm

C.Epithelial attachment ~0.50 mm; connective tissue attachment ~1.50 mm

D.Epithelial attachment ~1.50 mm; connective tissue attachment ~0.50 mm

Explanation: Gargiulo et al. (1961) defined the classic dimensions of the dentogingival junction: an average histologic sulcus depth of 0.69 mm, junctional epithelial attachment of 0.97 mm, and supracrestal connective tissue attachment of 1.07 mm, totaling approximately 2.04 mm for the biologic width (now termed supracrestal tissue attachment). Vacek et al. (1994) confirmed these findings with an average connective tissue attachment of 1.07 mm and epithelial attachment of 1.14 mm.

2Which histological feature uniquely distinguishes the junctional epithelium (JE) from the oral sulcular epithelium (OSE) and oral gingival epithelium (OGE)?

A.Presence of desmosomal junctions with dense keratinization and deep rete pegs

B.Absence of keratinization, wider intercellular spaces, and two basal laminas (internal and external)

C.High density of tonofilaments with stratum corneum formation and absence of hemidesmosomes

D.Presence of a stratum granulosum with pronounced keratohyalin granules and continuous hemidesmosomes

Explanation: The junctional epithelium is non-keratinized, exhibits wide intercellular spaces with low desmosomal density, and possesses two basal laminas: the internal basal lamina adhering to the tooth structure via hemidesmosomes and the external basal lamina adhering to the connective tissue. This semi-permeable morphology facilitates the transmigration of polymorphonuclear leukocytes and flow of gingival crevicular fluid into the sulcus.

3Which principal fiber group of the periodontal ligament (PDL) constitutes the largest group and is primarily oriented to withstand vertical and axial masticatory forces by transforming them into tension on alveolar bone?

A.Alveolar crest fibers

B.Horizontal fibers

C.Oblique fibers

D.Apical fibers

Explanation: The oblique fiber group is the most numerous group in the periodontal ligament, extending obliquely coronally from the cementum to the alveolar bone proper. When vertical masticatory forces are applied axially to the tooth, the oblique fibers are placed under tension, effectively dissipating occlusal forces and converting compressive forces into tensile strain on the alveolar socket wall.

4Which type of cementum covers the coronal two-thirds of the root, contains extrinsic collagen fibers embedded perpendicular to the root surface (Sharpey's fibers), and plays the primary role in functional tooth anchorage?

A.Acellular afibrillar cementum (AAC)

B.Acellular extrinsic fiber cementum (AEFC)

C.Cellular intrinsic fiber cementum (CIFC)

D.Cellular mixed stratified cementum (CMSC)

Explanation: Acellular extrinsic fiber cementum (AEFC, or primary cementum) covers approximately the cervical and middle root thirds. It is composed almost entirely of densely packed extrinsic Sharpey's fibers produced by PDL fibroblasts, mineralized incrementally perpendicular to the root surface, and lacks cementocytes. It is the essential tissue responsible for attaching the periodontal ligament fibers to the root.

5What is the biological reason that the buccal bone crest of anterior teeth undergoes pronounced vertical and horizontal resorption following tooth extraction, as described by Araujo and Lindhe (2005)?

A.The coronal buccal plate is almost entirely bundle bone, which loses its blood supply

B.Excessive periosteal stripping during flapless extraction triggers irreversible osteoclastic activation in the medullary space

C.The lingual bone plate has higher cortical bone density which actively resorbs the opposing buccal plate via the RANKL-osteoprotegerin cascade

D.The presence of cellular intrinsic cementum stimulates macrophage recruitment that digests the adjacent cortical crest

Explanation: Araujo and Lindhe (2005) demonstrated that the coronal portion of the facial bone plate in anterior and premolar sites is thin (<1 mm) and composed entirely of bundle bone (the bone lining the socket where Sharpey's fibers insert). Because bundle bone is a tooth-dependent structure vascularized primarily through the periodontal ligament, tooth extraction leads to ischemia and unavoidable osteoclastic resorption of this bundle bone, resulting in substantial coronal ridge reduction.

6In the 2017/2018 World Workshop classification of periodontal phenotype, which clinical method is universally standardized to categorize gingival thickness as thin (<=1.0 mm) or thick (>1.0 mm)?

A.Visual assessment of gingival scalloping and crown width-to-length ratio alone

B.Transparency of a periodontal probe through the gingival margin during sulcular probing

C.Ultrasonic biometer scanning at the mucogingival junction only

D.Orthopantomographic evaluation of the interdental alveolar bone peak

Explanation: The 2017/2018 World Workshop consensus on mucogingival conditions (Jepsen et al., 2018) standardized gingival phenotype assessment using the periodontal probe visibility test. When a standard periodontal probe inserted into the facial sulcus is visible through the gingival margin, the phenotype is categorized as thin (<=1.0 mm); if the probe cannot be seen shining through, it is categorized as thick (>1.0 mm).

7Which collagen fiber bundle of the gingival apparatus spans interdentally above the alveolar crest between adjacent teeth, embeds into the cementum of both teeth, and is remarkably resistant to rapid periodontal destruction, often reforming even in severe bone loss?

A.Dentogingival fibers

B.Alveologingival fibers

C.Transseptal fibers

D.Circular fibers

Explanation: Transseptal fibers extend interproximally over the alveolar bone crest and embed into the cementum of adjacent teeth. They maintain interdental tooth relationships and arch integrity. Histologically, transseptal fibers are remarkably resilient: during active periodontitis, as bone resorbs apically, transseptal fibers continuously reform and reconstitute just coronal to the advancing osseous defect.

8A 46-year-old with generalised stage IV grade B periodontitis has pathological migration and flaring of the maxillary incisors. Steps 1 to 3 of periodontal therapy are complete, probing depths are 4 mm or less with no bleeding on probing, and intra-bony defects were treated with a regenerative procedure 2 months ago. According to the EFP S3-level clinical practice guideline for stage IV periodontitis, what is the appropriate approach to the orthodontic correction the patient requests?

A.Avoid orthodontic therapy permanently, because tooth movement in a reduced periodontium always causes further attachment loss

B.Use removable appliances only, since fixed appliances are contraindicated after any regenerative periodontal procedure

C.Defer orthodontic therapy for at least 24 months after the regenerative surgery before any force is applied to the teeth

D.Start fixed-appliance therapy now and check the periodontium at each orthodontic visit, with lifelong retention afterwards

Explanation: The EFP stage IV guideline suggests undertaking orthodontic therapy once the endpoints of periodontal therapy have been reached, on the evidence that in a stable patient tooth movement does not worsen clinical attachment level, probing depth or radiographic bone level, tends to reduce bleeding on probing and may improve interdental papilla height. Where intra-bony defects have been regenerated the guideline recommends combining the two therapies and suggests NOT waiting for a prolonged healing period, because a short interval of about 1 month and a prolonged interval of 6 months give comparable outcomes. Fixed rather than removable appliances are suggested, the periodontal status should ideally be reviewed at every orthodontic appointment, active movement is interrupted if periodontitis recurs, and permanent passive retention plus lifelong supportive periodontal care follow completion.

9A patient with no periodontitis elsewhere in the mouth presents with a necrotic maxillary lateral incisor and a single narrow probing depth of 9 mm at one point on the palatal surface. Cone-beam imaging shows no root fracture, no perforation and no external resorption. How is this lesion classified under the 2018 World Workshop scheme for endo-periodontal lesions?

A.Endo-periodontal lesion without root damage, in a non-periodontitis patient, grade 1

B.Endo-periodontal lesion without root damage, in a periodontitis patient, grade 3

C.Endo-periodontal lesion with root damage, grade 2, because the pocket exceeds 6 mm

D.Necrotising periodontitis, grade 3, because the pulp of the affected tooth is necrotic

Explanation: The 2018 classification (Herrera et al.) first asks whether root damage is present: root fracture or cracking, root canal or pulp chamber perforation, or external root resorption. When root damage is excluded, the lesion is categorised by whether the patient has periodontitis, and then graded by the periodontal defect of the affected tooth: grade 1 is a narrow deep pocket on one tooth surface, grade 2 a wide deep pocket on one surface, and grade 3 deep pockets on more than one surface. A single narrow 9 mm defect in a patient without periodontitis is therefore a grade 1 lesion without root damage, and the prognosis is comparatively favourable: root canal treatment is carried out first and the periodontal component is re-evaluated before any periodontal surgery is planned.

10While preparing a maxillary first premolar for a full-coverage crown, the margin is taken 1 mm coronal to the alveolar crest, encroaching on the supracrestal tissue attachment. What should be expected periodontally, and what corrective principle applies?

A.Loss of pulp vitality alone; the periodontal attachment is unaffected wherever oral hygiene is excellent

B.Immediate ankylosis of the root, managed by sectioning the crown and letting the tooth erupt passively

C.Chronic inflammation and unpredictable crestal bone loss; correct by crown lengthening or extrusion

D.No biological consequence, because cementum regenerates coronally and re-forms the lost attachment apparatus

Explanation: Gargiulo's histological dimensions (epithelial attachment about 0.97 mm plus connective tissue attachment about 1.07 mm, roughly 2 mm of supracrestal tissue attachment) plus about 1 mm of healthy sulcus mean that about 3 mm of sound tooth structure is needed between the alveolar crest and the restorative margin. The 2017/2018 World Workshop recognised restorations that encroach on the supracrestal tissue attachment as being associated with gingival inflammation and loss of attachment, and the response is unpredictable: some sites inflame persistently while others lose crestal bone until the dimension re-establishes itself. Correction is by surgical crown lengthening with osseous recontouring, by orthodontic extrusion of the tooth, or by relocating the margin coronally.

About the Saudi Board Periodontics Exam

Independent English-language MCQ study adaptation by OpenExamPrep. Independent practice question bank by OpenExamPrep for candidates preparing for the Saudi Board Final Written Examination in Periodontics administered by the Saudi Commission for Health Specialties (SCFHS). This practice resource covers periodontal structures, pathogenesis, microbiology, diagnosis, surgical and nonsurgical therapy, and implant dentistry. It is an independent MCQ study aid for the written final exam and does not simulate the clinical, OSCE, or structured oral examination.

Exam sponsor: Saudi Commission for Health Specialties (SCFHS). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

Two papers, each with 100–125 single-best-answer MCQs. Up to 10% additional unscored items may be added. Duration is not stated in the written blueprint.

Time Limit

Not published by SCFHS

Passing Score

70% (lowered to minimum 65% if pass rate under 70%)

Exam / Certification Fees

Not published by SCFHS

Exam sponsor website

Reported exam pass rate: Not published by SCFHS. SCFHS publishes no candidate pass rate. The blueprint instead sets the passing score at 70% and, if fewer than 70% of candidates pass before final approval, lowers that score one mark at a time until a 70% pass rate is reached or the score reaches 65%, whichever comes first; it is never lowered below 65%. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

Periodontal Structures

Gingiva, periodontal ligament, cementum and alveolar bone: histology, dimensions of the supracrestal tissue attachment and the fibre groups of the gingival apparatus.

Aetiology, Microbiology and Immunology

Biofilm formation and microbial complexes, keystone pathogens and dysbiosis, host innate and adaptive responses, and the RANKL/OPG control of bone resorption.

12%

Examination, Diagnosis, Risk Factors and Classification

Clinical and radiographic examination, the 2017/2018 staging and grading system, phenotype, recession and furcation classifications, mobility, occlusal trauma, prognosis and risk factors.

10%

Non-Surgical Periodontal Therapy, Periodontal Medicine and Pharma-Therapeutics

Subgingival instrumentation and its healing outcome, ultrasonic and air-polishing technology, local and systemic antimicrobials, host modulation, re-evaluation, and the systemic links of periodontitis.

14%

Periodontal Surgical Techniques and Complications

Access and resective flaps, osseous surgery, regenerative therapy and biologics, mucogingival and root-coverage surgery, graft harvesting, and management of surgical complications.

Inter-relation between Periodontal Therapy and other Dental Specialties

Periodontal-restorative and prosthodontic interfaces, crown lengthening and forced eruption, orthodontic treatment of the periodontitis patient, and endo-periodontal lesions.

Periodontal Maintenance and long-term health

Supportive periodontal care intervals and content, risk assessment tools, compliance, re-instrumentation decisions, and long-term tooth survival data.

Indications, Contraindications and Biomechanical Principles for Dental Implants

Patient selection and medical and periodontal prerequisites, the growing patient, loading protocols, and the biomechanical consequences of the absent periodontal ligament.

Pre-Surgical Assessment and Treatment Planning for Dental Implants

Post-extraction ridge changes, socket and bone classification, radiographic and anatomical assessment, safety margins, inter-implant distances and papilla dimensions.

Surgical Site Preparation in Dental Implant Therapy

Osteotomy technique and thermal limits, primary stability, immediate placement, guided bone regeneration, block grafting, ridge expansion and sinus floor elevation.

Peri-implant Soft and Hard Tissue Management

Keratinised mucosa and soft-tissue thickness, connective tissue grafting and roll flaps, platform switching, peri-implant tissue histology and emergence profile.

Surgical Complications and Management of Peri-Implant Diseases and Failures

Case definitions for peri-implant mucositis and peri-implantitis, non-surgical and surgical treatment, implantoplasty, titanium particle release and explantation.

Maintenance of Dental Implants

Baseline records and peri-implant probing, professional biofilm removal, supportive peri-implant care intervals, adjunctive agents and iatrogenic risk factors such as retained cement.

Preparing for the Saudi Board Periodontics Exam

What You Need to Know

Passing score: 70% (lowered to minimum 65% if pass rate under 70%)
Assessment: Two papers, each with 100–125 single-best-answer MCQs. Up to 10% additional unscored items may be added. Duration is not stated in the written blueprint.
Time limit: Not published by SCFHS
Exam / certification fees: Not published by SCFHS Official sources

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Frequently Asked Questions

What is the structure of the Saudi Board Final Written Examination in Periodontics?

Two papers, each with 100–125 single-best-answer MCQs. Up to 10% additional unscored items may be added. Duration is not stated in the written blueprint.

What is the passing score for the Saudi Board Periodontics written examination?

The standard pass mark is 70%. If the overall candidate pass rate falls below 70%, the passing score is adjusted downward one percentage mark at a time to target a 70% pass rate, but it is never lowered below 65%.

Does this practice bank include clinical or oral exam preparation?

This bank is an independent English-language MCQ study adaptation for the written examination. It does not simulate or replace the separate mandatory final clinical/practical assessment. Consult the specialty clinical blueprint for its station formats and any structured oral or OSCE components.

Is OpenExamPrep affiliated with the Saudi Commission for Health Specialties (SCFHS)?

No. OpenExamPrep is an independent educational prep platform. This resource is not endorsed by, sponsored by, or affiliated with the Saudi Commission for Health Specialties.

Free Practice Questions for Saudi Board Periodontics

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