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periodontics 2 > 2 - NPD, PA and EPL > Flashcards

2 - NPD, PA and EPL Flashcards

1
Q

What does NPD stand for?

A

Necrotizing Periodontal Diseases

NPD includes necrotizing gingivitis, necrotizing periodontitis, and necrotizing stomatitis.

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2
Q

What are the three typical clinical features of NPD?

A
  • Papilla necrosis
  • Bleeding
  • Pain
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3
Q

Define Necrotizing Gingivitis (NG).

A

Acute inflammatory process of the gingival tissues characterized by necrosis/ulcer of the interdental papillae, gingival bleeding, and pain.

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4
Q

List other signs and symptoms of Necrotizing Gingivitis (NG).

A
  • Halitosis
  • Pseudomembranes
  • Regional lymphadenopathy
  • Fever
  • Sialorrhea (in children)
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5
Q

Define Necrotizing Periodontitis (NP).

A

Inflammatory process of the periodontium characterized by necrosis/ulcer of the interdental papillae, gingival bleeding, halitosis, pain, and rapid bone loss.

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6
Q

List additional signs and symptoms associated with Necrotizing Periodontitis (NP).

A
  • Pseudomembranes
  • Regional lymphadenopathy
  • Fever
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7
Q

Define Necrotizing Stomatitis (NS).

A

Severe inflammatory condition where soft tissue necrosis extends beyond the gingiva, potentially involving bone denudation and larger areas of osteitis.

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8
Q

What is the prevalence range of Necrotizing Gingivitis (NG) in general populations attending dental clinics?

A

0.51 to 3.3%

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9
Q

What was the reported prevalence of Necrotizing Gingivitis (NG) in military personnel during the end of the 2nd World War?

A

3.96–20.6%

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10
Q

List some predisposing factors for Necrotizing Periodontal Diseases (NPD).

A
  • HIV/AIDS
  • Malnutrition
  • Psychological stress
  • Insufficient sleep
  • Inadequate oral hygiene
  • Tobacco
  • Alcohol
  • Young age (15-34 years)
  • Ethnicity (Caucasians)
  • Seasonal variations
  • Local factors (orthodontic therapy, crowns)
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11
Q

What microbiological agents are associated with Necrotizing Periodontitis (NP)?

A
  • Prevotella intermedia
  • Treponema
  • Selenomonas
  • Fusobacterium
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12
Q

True or False: The importance of host immune response in the etiopathogenesis of NPD is disputed.

A

False

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13
Q

What does the histological examination of Necrotizing Gingivitis (NG) show?

A

Presence of an ulcer within the stratified squamous epithelium surrounded by a nonspecific acute inflammatory reaction.

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14
Q

What are the four regions described in NG lesions?

A
  • Superficial bacterial area
  • Neutrophil-rich zone
  • Necrotic zone
  • Spirochetal infiltration zone
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15
Q

What are the most relevant findings in the diagnosis of Necrotizing Gingivitis (NG)?

A
  • Necrosis and ulcer in interdental papilla (94%-100%)
  • Gingival bleeding (95-100%)
  • Pain (86-100%)
  • Pseudomembrane formation (73-88%)
  • Halitosis (84-97%)
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16
Q

What is the treatment objective for Necrotizing Periodontal Diseases (NPD)?

A

Eliminate disease activity and avoid pain and general discomfort.

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17
Q

What is the preferred method for debridement during the acute stage of NPD treatment?

A

Ultrasonic scaling

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18
Q

tooth brushing is not possible

A

0.2% chlorhexidine rinse 2x day

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19
Q

general health in affected what treatment

A

amoxicillin 500 mg (1 tablet / 8h / 7 days), metronidazole 250 mg (2 tablet/8h/7days)

20
Q

What is a periodontal abscess?

A

Localized accumulation of pus located within the gingival wall of the periodontal pocket. easily detectable clinical symptoms

21
Q

how often should a patient be seen with acute symptoms of NPD

A

every day until symptoms get better than every 5 days

22
Q

What percentage of dental emergencies do periodontal abscesses represent?

23
Q

List some factors that can lead to the formation of a periodontal abscess.

A
  • Bacterial invasion
  • Inflammatory response
  • Changes in subgingival microbiota
  • Foreign body impaction
24
Q

What are some common behaviors that can negatively impact oral health?

A

Biting wire, nail biting, clenching

25
What orthodontic factors can contribute to periodontal issues?
Inadequate orthodontic forces, cross-bite
26
What condition is characterized by an increase in gum tissue?
Gingival enlargement
27
What types of alterations can occur on the root surface?
* Invaginated tooth * Cement tears * Enamel pearls * Perforations * Vertical root fracture * Cracked tooth syndrome * External root resorption
28
What are common signs of periodontal abscess (PA)?
* Ovoid elevation in the gingiva * Suppuration on probing * Associated with deep periodontal pocket * Bleeding on probing * Increased tooth mobility * Bone loss * Uncommon: facial swelling, elevated body temperature, malaise, regional lymphadenopathy
29
List some symptoms associated with periodontal abscess (PA).
* Pain * Tenderness of the gingiva * Tooth ‘elevation’ * Swelling
30
What are some differential diagnoses for periodontal abscess (PA)?
* Other odontogenic abscesses * Tumor lesions * Oral lesions * Self-inflicted gingival injuries * Sickle cell anemia * Abscesses after surgical procedures
31
What initial treatment should be used for abscesses with marked swelling, tension, and pain?
Systemically administered antibiotics
32
What are some treatment options for periodontal abscess (PA) once the acute condition has receded?
* Incision and drainage * Scaling and root planning * Periodontal surgery * Tooth extraction
33
What are Endo-Periodontal Lesions (EPL)?
Clinical conditions involving both the pulp and periodontal tissues, which may occur in acute or chronic forms
34
What is the most common manifestation of EPL associated with a recent traumatic or iatrogenic event?
Abscess + pain
35
What are common signs and symptoms associated with a tooth affected by an Endo-Periodontal Lesion (EPL)?
* Deep periodontal pockets reaching or close to the apex * Negative or altered response to pulp vitality tests * Bone resorption * Sinus tract * Spontaneous pain or pain on palpation and percussion * Crown and gingival color alterations * Purulent exudate * Tooth mobility
36
What factors can lead to the development of Endo-Periodontal Lesions (EPL)?
* Microbial contamination of dental pulp and periodontal tissues * Trauma * Iatrogenic events
37
What are recognized periodontal pathogens associated with EPL?
* P. gingivalis * T. forsythia * Prevotella species * Treponema species * Fusobacterium species
38
True or False: There are major differences between the microorganisms found in endodontic and periodontal lesions.
False
39
What are some risk factors for Endo-Periodontal Lesions (EPL)?
* Advanced periodontitis * Trauma * Iatrogenic events
40
What is the pathophysiology of Endo-Periodontal Lesions (EPL)?
Communication between dental pulp and periodontium through apical radicular foramina, accessory canals, and dentinal tubules, leading to migration of microorganisms and inflammatory mediators.
41
What are the two phases of diagnosing Endo-Periodontal Lesions (EPL)?
* 1st phase: Assess patient’s history and clinical/radiographic examination * 2nd phase: Full-mouth periodontal assessment if no perforations/fractures are identified
42
What were the limitations of the 1999 EPL classification system?
* Grouping all EPL under a single section was not ideal * Single category ‘Combined Periodontal-Endodontic Lesions’ was too generic
43
What factors contribute to the prognosis of Endo-Periodontal Lesions (EPL)?
* Good prognosis * Bad prognosis * Impossible prognosis
44
Fill in the blank: An established EPL is always associated with varying degrees of _______.
microbial contamination
45
What is the common clinical approach in the first phase of treating Endo-Periodontal Lesions (EPL)?
* Root-canal treatment * Scaling and root planning * Reevaluation
46
What treatment may be considered in the second phase of managing Endo-Periodontal Lesions (EPL)?
Periodontal regeneration if possible

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