6.7.1 Acute Problems (Therapy 19 Questions)

18. Which of the following is also called "Vincent's " or "trenchmouth"?

1. Desquamative 2. Acute necrotizing ulcerative gingivitis* 3. Juvenile gingivitis 4. Atrophic gingivitis

30. Which of the following is the best way to distinguish between a periodontal and a periapical (pulpal) abscess?

1. Radiograph 2. testing* 3. Hot and cold tests 4. Patient perception of

43. A in which periodontal and endodontic problems occur simultaneously is called a perio/endo lesion; in treatment of these , the periodontal therapy should be performed prior to the endodontic therapy.

3. The first statement is TRUE, the second is FALSE*

104. A

1. Is also referred to as a tumor* 2. Tends to occur frequently in cases of 3. Is usually associated with 4. Is frequently associated with juvenile periodontitis 5. Is usually treated with antibiotics

128. Which of the following clinical is characteristic of necrotizing ulcerative gingivitis?

1. Painless 2. Periodontal pocket formation 3. Ulcerated, crater-like gingival lesions* 4. Gingival bleeding 5. Severe erythema

164. The diagnosis of necrotizing ulcerative gingivitis is best made by

1. biopsy. 2. exfoliative cytology. . 3. bacteriologic examination. 4. clinical signs and symptoms.* 5. psychological profile. 6. nutritional analysis.

195. Primary herpetic gingivostomatitis usually occurs

1. prior to age 10.* 2. between ages 13 and 30. 3. at the onset of the menstrual period. 4. during menopause. 5. as an occupational hazard.

197. An emotional factor is often part of the etiology in

1. periodontitis. 2. chronic gingivitis. 3. acute . 4. acute herpetic gingivostomatitis. 5. necrotizing ulcerative gingivitis.*

216. Antibiotics may be useful in treating

(a) herpetic gingivostomatitis. . (b) necrotizing ulcerative gingivitis. (c) (gingivosis). (d) periodontal .

5. (b) and (d)*

217. Periodontal conditions that may require immediate treatment are

(a) . (b) desquamative gingivitis (gingivosis) (c) lateral periodontal abscess. (d) necrotizing ulcerative gingivitis.

3. (a), (c) and (d)*

222. Treatment of necrotizing ulcerative gingivitis includes

(a) . (b) instruction. (c) penicillin therapy. (d) dietary counseling. (e) surgical correction of residual soft tissue and osseous deformities after the acute phase has been brought under control.

2. (a) and (b) only*

234. Which of the following is most useful in differentiating an acute periodontal abscess from an acute periapical abscess?

1. Type of exudate 2. Intensity of pain 3. Nature of the swelling 4. Degree of 5. Response to periodontal probing*

259. Electron microscopic examination of the bacterial flora of necrotizing ulcerative gingivitis indicates the presence of microorganisms within non-necrotic tissues in advance of other . The organisms involved are

1. cocci. 2. spirochetes.* 3. bacteriophages. 4. filamentous rods.

273. Treatment of primary herpetic gingivostomatitis should include

(a) steroid therapy. (b) palliative treatment. (c) control of secondary infection. (d) application of dilute .

4. (b) and (c)*

294. Which of the following treatments is contraindicated for a 15-year-old patient with necrotizing ulcerative gingivitis who has no history of previous gingival problems?

1. Antibiotic therapy 2. Local debridement 3. Topical steroid therapy* 4. Warm saline solution rinses

324. A 6-year-old boy complains that his mouth has hurt for four days. Three days before the onset of local symptoms, he had palpable, tender, submandibular lymph nodes and an oral temperature of 101.2 o F. Oral examination reveals generalized of the attached gingiva and alveolar mucosa. Loose, white debris covers free gingival margins and fills interproximal embrasures. Discrete areas of ulceration within rings of intense inflammation are noted on the facial mucosa and the . Interdental papillae are intact. There are no lesions on the extremities. The most probable diagnosis is

1. candidiasis. 2. . 3. acute herpetic gingivostomatitis.* 4. necrotizing ulcerative gingivitis.

326. A patient has a periodontal abscess on the distal aspect of a maxillary second molar. Pain and mobility are moderate. The remaining dentition is generally healthy. Immediate treatment of choice is to

1. provide drainage.* 2. extract the tooth. 3. relieve the occlusion. 4. prescribe an antibiotic. . 5. prescribe an antibiotic and relieve the occlusion.

392. Which of the following lesions may create gingival deformities that require to eliminate the defects?

1. Erosive 2. Desquamative gingivitis 3. Acute herpetic gingivostomatitis 4. Necrotizing ulcerative gingivitis*

394. Interproximal , ulceration, pain and bleeding are significant criteria used in the clinical diagnosis of

1. lichen planus. 2. necrotizing ulcerative gingivitis.* 3. (Dilatin® hyperplasia). 4. chronic inflammatory periodontal . 5. all of the above.

403. The treatment of necrotizing ulcerative gingivitis should begin with

1. vitamin therapy. 2. occlusal equilibration. 3. dietary restriction of sucrose. 4. debridement and instrumentation.* 5. cauterization with escharotic drugs. 6. rinsing with a 3% solution of hydrogen peroxide.

414. Which of the following are most useful in differentiating necrotizing ulcerative gingivitis from acute primary herpetic gingivostomatitis?

(a) presenting symptoms (b) history of heavy cigarette smoking. (c) observed gingival form (d) gram-stained plaque smears

2. (a) and (c) *

468. Primary treatment of necrotizing ulcerative gingivitis in patients free of systemic involvement includes

(a) debridement. (b) oral hygiene instruction. (c) penicillin therapy. (d) occlusal adjustment. (e) gingivoplasty.

2. (a) and (b) only*

473. Treatment of primary herpetic gingivostomatitis includes

(a) steroid therapy. (b) palliative treatment. (c) control of secondary infection. (d) application of dilute hydrogen peroxide.

4. (b) and (c)*

498. It is rare for a 16-year-old patient to have necrotizing ulcerative gingivitis because this disease most commonly occurs before the onset of .

5. NEITHER statement nor reason is correct.*

511. Which of the following will most likely result in the absence of adequate drainage in a periodontal pocket?

1. 2. Cyst formation 3. Abscess formation* 4. Epithelial hyperplasia 5. Increased formation

525. A non-carious tooth with deep periodontal pockets that do not involve the apical third of the root has developed an acute pulpitis. There is no history of trauma other than a mild prematurity in lateral excursion. What is the most likely explanation for the pulpitis?

1. Normal mastication plus toothbrushing has driven microorganisms deep into tissues with subsequent pulp involvement at the apex. 2. During a general bacteremia, bacteria settled in this aggravated pulp and produced an acute pulpitis. 3. Repeated thermal shock from air and fluids getting into the deep pockets caused the pulpitis. 4. An accessory pulp canal in the gingival or the middle third of the root was in contact with the pockets.*

559. Which of the following periodontal causes the most rapid destruction of alveolar bone?

A. Periodontal abscess* B. C. Phenytoin-induced gingival enlargement D. Necrotizing ulcerative gingivitis

568. Which of the following is the most appropriate initial treatment for a patient with HIV-associated necrotizing ulcerative gingivo-periodontitis?

A. Debridement and antimicrobial rinses * B. Definitive root planing and curettage C. Administration of antibiotics D. and gingivoplasty