3 (m) Flashcards
T/f
there is little evidence that NUG (necrotizing ulcerative
gingivitis) progresses to NUP although they have many
similarities
T
T/F
NUG may be an extension of NUP although these two are
different diseases, still there is little evidence to support that
there is a relationship between these two; it has been suggested
that these two are classified under necrotizing periodontal
diseases
F
NUP may be an extension of NUG although these two are
different diseases, still there is little evidence to support that
there is a relationship between these two; it has been suggested
that these two are classified under necrotizing periodontal
diseases
necrosis and ulceration of:
o interdental papilla
o gingival margin
NECROTIZING ULCERATIVE PERIODONTITIS
T/f
NECROTIZING ULCERATIVE PERIODONTITIS is painful, bright red gingival margin which bleeds easily
T
interdental osseous craters
NECROTIZING ULCERATIVE PERIODONTITIS
CLINICAL FEATURES:
→no pockets, gingival recession
→ tooth mobility, tooth loss, oral malodor, fever, malaise,
lymphadenopathy
NECROTIZING ULCERATIVE PERIODONTITIS
pockets are formed when _____ cells migrate apically to cover areas of lost connective tissue attachment
junctional epithelium
WHY NO POCKET IS FORMED IN NUP
this cannot happen in NUP because necrosis of JE creates _____ that prevent epithelial migration and a pocket cannot form
ulcers
T/f
there is striking histologic similarities between NUP in HIV
positive patients and NUG in HIV negative patients
T
MICROSCOPIC FINDINGS in NECROTIZING ULCERATIVE PERIODONTITIS
there is a surface biofilm composed of mixed _______ with subsurface of Spirochetes (bacterial zone)
microbial flora
MICROSCOPIC FINDINGS in NECROTIZING ULCERATIVE PERIODONTITIS
Arrange:
- necrotic cells (necrotic zone)
- below bacterial zone is a layer of PMNs (neutrophil-rich
zone) - others:
o yeasts and herpes-like viruses - mixed microbial
flora with subsurface of Spirochetes (bacterial zone)
4, 2, 1, 3
It is severe, progressive lesion with extension into vestibular area and palate
necrotizing ulcerative stomatitis
ETIOLOGY OF Necrotizing Ulcerative Periodontitis
mixed fusiform-spirochete bacteria flora plus predisposing
“host” factors like:
o poor oral hygiene
o pre-existing periodontal disease
o smoking
o viral infections
o immunocompromised status
o psychosocial stress
o malnutrition
o heavy tobacco use (most significant factor)
NUP in HIV positive patients (8)
o Aggregatibacter Actinomycetemcomitans
o Candida Albicans
o Prevotella Intermedia
o Porphyromonas Gingivalis
o Fusobacterium Nucleatum
o Campylobacter Species
o Spirochetes
o Herpes Viruses
they modulate the host’s immune response they stimulate host inflammatory reactions, these in turn will reduce local immune competence leading to
necrotizing disease
SPIROCHETES
deregulate the host immune system, this leads to an increase in the colonization and activity of other pathogens
HERPESVIRUSES
produce eicosanoids leading to release of pro-inflammatory
mediators which facilitate spirochete colonization and invasion and promote development of necrotizing periodontal diseases
CANDIDA ALBICANS
CANDIDA ALBICANS
produce _____ leading to release of pro-inflammatory
mediators which facilitate spirochete colonization and invasion and promote development of necrotizing periodontal diseases
eicosanoids
compromised immune system in HIV-infected patients is due to:
o impaired ______ function (decreased PMN phagocytosis and killing function)
o altered ____ ratios
T-cell
stress increases the systemic ____ levels which in turn
suppresses the immune system, thus impairing the host response
cortisol
MaLNUTRITION
in children, may lead to lesions, which resemble necrotizing
periodontal diseases “ _______”
gangrenous stomatitis or noma
this is caused by the impairment of host defenses, antibody, and
cytokine production
MALNUTRITION
the depletion of nutrients to cells and tissues results in
immunosuppression and increases susceptibility to disease
MALNUTRITION
MICROSCOPIC FINDINGS
Necrotic cells (necrotic zone)
● Others: yeasts and herpes-like viruses ( ______ odor)
fetid
