19. Plaque induced gingival diseases, modified by systemic medication

Question 1

Diabetes effect on Gingivitis

Answer 1

• Level of diabetic control important in determining extend of periodontal disease
• Decreased salivary flow
• Predisposition to candidiasis, burning mouth, abcess formation
• Impaired healing=>poor leukocyte function
• Reduction in growth and proliferation of CT=>hyperglycemic environment

Question 2

Leukemia effect on gingivitis

Answer 2

• Abnormal proliferation of leukocytes in blood and marrow
• Increased bleeding
• Paleness of mucosa
• Swollen, glazed, spongy tissues=>deep red to purple
• Gingival enlargement=>interdental papilla folllowed by marginal and attached

Question 3

Linear gingival erythema effect on gingivitis

Answer 3

*Can occur from Immunosuppression=>HIV
* 2-3 mm marginal band of intense erythema in free gingiva
* May extend to attached gingiva or alveolar mucosa
* May be localised but more commonly is generalised

Question 4

Drugs that can cause gingival enlargement

Answer 4

• Anticonvulsants(pheyntoin, sodium valproate)
• Immunosuppressants(cyclosporin A)
• Calcium channel blockers(Nifidepine, verapamil)

-Phenytoin causes gingival enlargment in 50% of users

Question 5

The gingival enlargement mechanism is linked to

Answer 5

• Excessive fibroblast production
• Increased production of CT extracellular matrix

Question 5

Characteristics of gingival enlargement due to systemic medications

Answer 5

• Common in anterior gingiva
• Higher prevelance in children
• Onset within 3 months
• Found in gingiva with or without bone loss
• Pronounced repsonse in relation to amount of plaque present