Test Bank for Comprehensive Periodontics for the Dental Hygienist 4th by Weinberg

Test Bank for Comprehensive Periodontics for the

Dental Hygienist 4th by Weinberg

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 Weinberg: Comprehensive Periodontics for the Dental Hygienist, 4e (0133097714)

Comprehensive Periodontics for the Dental Hygienist, 4e (Weinberg)

Chapter 7 Gingival Diseases

Multiple-Choice Questions

1) Which of the following bacteria has been implicated in pregnancy gingivitis?

A) Prevotella intermedia
B) Porphyromonas gingivalis
C) Aggregator actinomycetemcomitans
D) Streptococcus mutans
Answer: A

2) All of the following conditions are classified (AAP Classification 1999) as gingival diseases
except one. Which one is the exception?
A) Malnutrition
B) Allergic reactions
C) Lupus erythematosus
D) Physical injury
E) Pericoronal abscess
Answer: E

3) Gingivitis is a disease affecting the soft tissues because the inflammatory infiltrate is confined
to the gingival.
A) Both statement and reason are correct.
B) Both statement and reason are incorrect.
C) The statement is correct, but the reason is incorrect.
D) The statement is incorrect, but the reason is correct.
Answer: A

4) All of the following are local factors associated with gingival diseases except one. Which one
is the exception?
A) Medications
B) Dental restorative materials
C) Systemic diseases
D) Occlusal trauma
E) Fungal infections
Answer: D

5) Which of the following terms describes the gingival condition of a patient taking nifedipine?
A) Loss of attachment
B) Gingival enlargement
C) Bone loss
D) A periodontal pocket
Answer: B

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 Weinberg: Comprehensive Periodontics for the Dental Hygienist, 4e (0133097714)

6) Which of the following viral diseases is listed as gingival disease of viral origin?
A) Primary herpetic gingivostomatitis
B) Hereditary gingival fibromatosis
C) Pemphigoid
D) Pemphigus vulgaris
E) Linear gingival erythema
Answer: A

7) All of the following classifications are listed as gingival diseases modified by medications
except one. Which one is the exception?
A) Gingival enlargements
B) Oral contraceptive-associated gingivitis
C) Drug-influenced gingivitis
D) Recurrent oral herpes
Answer: D

8) Which of the following statements describes a gingival pocket?

A) Sometimes referred to as a periodontal pocket
B) Bone loss is present.
C) Gingival enlargement
D) Attachment loss is present.
Answer: C

9) Which of the following is true about the host response to gingival inflammation?
A) First response is an acute vasodilation.
B) Migration of lymphocytes
C) Increased number of fibroblasts
D) Decreased movement of immune cells
Answer: A

10) Vascular changes during gingivitis occur in the

A) oral epithelium.
B) sulcular epithelium.
C) lamina propria.
D) lamina dura.
E) periodontal ligament.
Answer: C

11) Which of the following risk factors is primarily associated with gingivitis?
A) Dental biofilms
B) Dental calculus
C) Systemic medication
D) Viral diseases
E) Fungal diseases
Answer: A

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 Weinberg: Comprehensive Periodontics for the Dental Hygienist, 4e (0133097714)

12) All of the following statements are true concerning diabetes mellitus except one. Which one
is the exception?
A) It presents an important risk factor for gingivitis.
B) It presents an important risk factor for periodontitis.
C) It results in viral infections.
D) It results in hypoglycemia.
E) It alters wound healing.
Answer: D

13) Which of the following microorganisms is associated with puberty gingivitis?

A) Prevotella intermedia
B) Porphyromonas gingivalis
C) Streptococcus mutans
D) Treponema denticola
E) Staphylococcus aureus
Answer: A

14) Which of the following terms is used to describe a gingival condition that is of long duration
to only a few anterior teeth?
A) Acute, localized
B) Acute, generalized
C) Chronic, localized
D) Chronic, generalized
Answer: C

15) In which stage of gingival inflammation is bleeding on probing seen?

A) Initial stage
B) Early stage
C) Established stage
D) Advanced stage
Answer: B

16) In which of the following lesions does clinical gingivitis first appear?
A) Initial
B) Early
C) Established
D) Advanced
Answer: C

17) The inflammatory cells involved in the host's response come from
A) blood vessels in the connective tissue.
B) lymph nodes in the tissue.
C) alveolar bone.
D) periodontal ligament.
E) cementum.
Answer: A

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 Weinberg: Comprehensive Periodontics for the Dental Hygienist, 4e (0133097714)

18) In which of the following stages is the B-cell found?

A) Initial and early
B) Early and established
C) Established and advanced
D) Initial and advanced
E) Early and advanced
Answer: C

19) What percentage of collagen is lost in the connective tissue during the early lesion?
A) 10–20
B) 30–40
C) 50–60
D) 60–70
E) 70–80
Answer: D

20) Which of the following cells make up the protective wall between the plaque mass and the
junctional epithelium?
A) Neutrophils
B) Plasma cells
C) B-lymphocytes
D) T-lymphocytes
Answer: A

Fill-in-the-Blank Questions

1) Page and Schroeder's Stages of Histopathogenesis of periodontal diseases were based on

________ models.
Answer: animal

2) The initial lesion is ________ dominated.

Answer: neutrophil

3) The ________ lesion is considered to be chronic gingivitis.

Answer: established

4) The ________ lesion is T-cell dominated.

Answer: early

5) B-lymphocytes predominate in the body's response to ________.

Answer: periodontitis

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 Weinberg: Comprehensive Periodontics for the Dental Hygienist, 4e (0133097714)

Critical Thinking Questions

1) Discuss the importance of including a classification of gingival diseases in the newest 1999
Academy of Periodontology Classification of Periodontal Diseases.
Answer: In the development of a detailed classification of gingival diseases and lesions, dental
plaque was not included until the latest 1999 classification from the American Academy of
Periodontology. This inclusion was an acknowledgment that the clinical expression of gingivitis
can be substantially modified by (a) systemic factors (e.g., endocrine), (b) medications (e.g.,
phenytoin), and (c) malnutrition. Many plaque and non-plaque-related gingival diseases are
frequently encountered in clinical practice.

2) A 22-year-old male patient has not brushed his teeth for the past 2 weeks because he is too
busy with school. What are the histopathologic/inflammatory and immune changes that are
occurring in the tissues?
Answer: This patient has not brushed for 2 weeks. This is considered the established stage of
chronic gingivitis with all of the signs and symptoms of gingivitis. There is gingival redness and
bleeding. At this stage the B-lymphocytes predominate and antibodies are being produced that
will form a complex with the foreign antigen (bacteria) and will stimulate the complement
system.

3) Discuss the clinical features of plaque-induced gingivitis.

Answer: Clinical features of plaque-induced gingivitis include plaque at the gingival margin,
change in gingival color, contour, consistency and surface texture, gingival bleeding, and no
attachment loss or bone loss. It is reversible with adequate plaque control.

Case Study Questions

Case Study 7.1

A 42-year-old pregnant female patient has not brushed her teeth for the past 3 days because of a
stressful situation in her life. Examination of the gingival tissues did not reveal any bleeding or
redness, and she has no chief complaint. She states she is here because she chipped a tooth.

1) What are the histopathologic/inflammatory and immune changes that are occurring in the
tissues?
Answer: This patient's periodontal disease is in the initial phase or lesion. The clinical symptoms
of plaque accumulation such as redness and gingival bleeding are not evident because this stage
is considered to be subclinical, no signs or symptoms of gingivitis showing yet. Inflammatory
changes include dilation of blood vessels found within the gingival connective tissue. As blood
vessels dilate because of the inflammation, there is an increased flow of crevicular fluid into the
crevice and an increased migration of PMNs out of the blood vessels into the gingival connective
tissue (especially directly under the junctional epithelium).

2) What microorganism is implicated in this patient's gingival disease?

Answer: Prevotella intermedia.

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 Weinberg: Comprehensive Periodontics for the Dental Hygienist, 4e (0133097714)

3) Explain why this patient is complaining of bleeding and edematous gingival.

Answer: Because of inflammation due to the accumulation of dental plaque. Inflammatory
response begins in the gingival connective tissue. There is vasodilation of the blood vessels in
the lamina propria, which allows the leakage of fluid, resulting in edema. The increased
vascularity, including engorgement and vasodilation of the blood vessels, "peek through" the
microulcerations of the epithelium that lines the soft tissue wall of a pocket.

Matching Questions

Match the term in Column A with the correct statement/definition in Column B.

A) Fluid filled
B) No attachment loss
C) Mucocutaneous disease
D) Exaggerated response to plaque
E) Inflammation of the gingival unit

1) Gingivitis

2) Edema

3) Pregnancy gingivitis

4) Lichen planus

5) Gingival pocket

Answers: 1) E; 2) A; 3) D; 4) C; 5) B

Essay Questions

List the type of histopathologic lesion (initial, early, established, advanced) associated with the
following statements.

1) Not clinically visible yet

Answer: initial lesion

2) Migration of polymorphonuclear leukocytes

Answer: initial lesion

3) Predominated by plasma cells and B-lymphocytes

Answer: established lesion

4) Destruction of connective tissue attachment

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Test Bank for Comprehensive Periodontics for the Dental Hygienist 4th by Weinberg

Weinberg: Comprehensive Periodontics for the Dental Hygienist, 4e (0133097714)

Answer: advanced lesion

5) Occurs about 7 days after plaque accumulation

Answer: early lesion

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