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oral pathology > 3 periodontal diseases > Flashcards

3 periodontal diseases Flashcards

1
Q

types of gingivitis

A
  • gingivitis
  • localized juvenile spongiotic
  • necrotizing ulcerative gingivitis (NUG)
  • plasma cell
  • granulomatous
  • desquamative
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2
Q

what is gingivitis

A

inflammation of soft tissues surrounding teeth

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3
Q

what causes gingivitis

A

lack of proper oral hygiene, increase in dental plaque and calculus

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4
Q

max or mandibular more common in puberty gingivitis

A

upper teeth aren’t covered so maxillary regions are affected more often

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5
Q

puberty gingivitis is seen in ages

A

9-14

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6
Q

do males or females have a lower frequency of gingivitis

A

females have a lower frequency but are susceptible during pregnancy or taking certain oral contraceptives

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7
Q

gingivitis mouth breathers

A
  • unique pattern

- only affects facial gingiva as smooth, swollen, red

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8
Q

chronic hyperplastic gingivitis

A

chronic inflammation causes edema or fibrosis (gums become swollen or edematous)

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9
Q

where is a pyogenic granuloma seen?

A

chronic hyperplastic gingivitis

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10
Q

pyogenic granuloma

A

inflamed granulation tissue located in gingival sulcus

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11
Q

mouth breathing gingivitis

A

gums in interdental papilla are inflamed

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12
Q

puberty gingivitis

A

red inflamed areas

-mix of hormones + difficulty cleaning with braces

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13
Q

what does healthy gingiva look like?

A

coral pink, stippling, not bleeding

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14
Q

chronic hyperplastic with pyogenic granuloma

A

looks healthy lingually, red edema, pyogenic granulomas are not confined to the gingiva

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15
Q

clinical findings of gingivitis

A

-localized or generalized
-marginal - affects free gingival margins
papillary- affects interdental papilla
- loss of stippling, bleeding on gentle probing, light red in color

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16
Q

generalized gingivitis

A

across entire oral cavity

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17
Q

treatment of gingivitis

A
  • eliminate cause

- receive proper oral hygiene instructions

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18
Q

gingivitis color

A

red instead of coral pink

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19
Q

localized juvenile spongiotic gingival hyperplasia =

A

localized juvenile spongiotic gingivitis

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20
Q

localized juvenile spongiotic gingival hyperplasia

A
  • idiopathic
  • not plaque related
  • fail to respond to improved oral hygiene
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21
Q

localized juvenile spongiotic gingival hyperplasia occurs in patients under

A

20

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22
Q

clinical findings of localized juvenile spongiotic gingival hyperplasia

A
  • small bright red velvety papillary alteration
  • maxillary facial gingiva most affected
  • can involve interproximal areas
  • can be sessile or pedunculated
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23
Q

treatment of localized juvenile spongiotic gingival hyperplasia

A
  • excise conservatively

- can recur but can resolute spontaneously

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24
Q

localized juvenile spongiotic gingival hyperplasia vs. puberty gingivitis

A

maxillary area whereas puberty gingivitis could be in the margin area

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25
Q

necrotizing ulcerative gingivitis =

A

NUG

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26
Q

necrotizing ulcerative gingiviti (NUG) is also called what two names

A

vincent’s infection or trench mouth

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27
Q

necrotizing ulcerative gingiviti (NUG) is caused by

A
  • fusobacterium nucleatum
  • prevotella intermedia
  • porphyromonas gingivalis
  • treponmea and or selenomonas
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28
Q

necrotizing ulcerative gingiviti (NUG) occurs in times of

A

psychologic stress esp military personnel

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29
Q

trench mouth

A
  • during WWI or WWII, men protected themselves in trenches and couldn’t move for periods of time
  • soldiers wouldn’t have time to brush their teeth
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30
Q

factors contributing to necrotizing ulcerative gingivitis (NUG)

A
  • smoking
  • local trauma
  • immunocompromised status
  • poor oral hygiene
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31
Q

**clinical features of necrotizing ulcerative gingivitis (NUG)

A

interdental papilla infected- inflamed, edematous, hemorrhagic, “punched out” appearance with gray pseudomembrane appearance, foul odor, fever, lymphadenopathy, malaise
-if extends through mucosa of skin to face known as noma (cancrum oris)

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32
Q

NUG–> noma if infection spreads to

A

face

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33
Q

**8interdental papilla PUNCHED OUT with gray pseudomembrane appearance

A

necrotizing ulcerative gingivitis (NUG) ***

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34
Q

treatment of necrotizing ulcerative gingivitis (NUG) ***

A

currettage, scaling, ultrasonic instrumentation to rid of bacterial component

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35
Q

NOMA starts as **

A

NUG

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36
Q

NOMA

A
  • bacterial infection, intense + extensive, lots of destruction
  • rapidly progressive, polymicrobial, opportunistic infection
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37
Q

What does NOMA result from

A

normal oral flora becoming pathogenic due to compromised immune status

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38
Q

what debilitating illnesses cause infection?

A
  • measles
  • herpes (simplex, varicella)
  • tuberculosis
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39
Q

who does NOMA affect?

A

children (1-10 yrs old)

adults w/ debilitating disease

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40
Q

clinical findings of NOMA

A
  • well-defined, unilateral w/ odor
  • begins on gingiva and extend to soft tissues (necrotizing ulcerative mucositis)
  • necrosis extends as blue-black discoloration with cone growth pattern
  • spreads through anatomic barriers and not follow tissue planes (past gingiva to face, scalp, neck)
  • affects bone creating oteomyelitis (ill defined radiolucency)
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41
Q

necrosis extends as blue-black discoloration with CONE SHAPED growth pattern***

A

NOMA

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42
Q

cone shaped noma

A

starts at the tip and then spreads

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43
Q

treatment of NOMA

A
  • antibiotics
  • local wound care
  • correcting imbalances with nutrition, hydration, electrolytes
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44
Q

another name for plasma cell gingivitis

A

atypical gingivostomatitis

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45
Q

**allergic response with a distinc pattern of gingival involvement

A

plasma cell gingivitis= atypical gingivostomatitis

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46
Q

plasma cell gingivitis= atypical gingivostomatitis occurs quickly because it’s an

A

allergic reaction

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47
Q

plasma cell gingivitis= atypical gingivostomatitis rapid onset made worse by

A

hot/spicy foods (cinnamon) or dentrifices

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48
Q

plasma cell gingivitis= atypical gingivostomatitis attached and free gingiva affected

A
  • diffuse enlargement (bright red + inflamed)
  • loss of stippling
  • bright erythema
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49
Q

histopathology of plasma cell gingivitis= atypical gingivostomatitis

A

plasma cells in fibrous CT

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50
Q

plasma cell gingivitis= atypical gingivostomatitis treatment

A

try to rule out causative agent

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51
Q

plasma cell gingivitis= atypical gingivostomatitis

A

allergic reaction so once you remove the allergen, the gingiva should go back to coral pink

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52
Q

plasma cell gingivitis= atypical gingivostomatitis

A

firey red appearance= bright erythema

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53
Q

granulomatous gingivitis

A
  • unexplained granulomatous inflammation, diagnosis of exclusion
  • may result from dental materials into CT
54
Q

foreign body gingivitis **

A

granulomatous gingivitis

55
Q

granulomatous gingivitis= FBG

A

damage to epithelium during dental procedures and foreign material into gingiva

56
Q

what is the most common form of granulomatous inflammation?

A

foreign bodies

57
Q

what age does granulomatous gingivitis occur?

A

any age

58
Q

granulomatous gingivitis lesions

A

solitary or multifocal lesions on interdental papillae or marginal gingiva

  • red or red/white machules
  • FBG resembles gingival lichen planus
59
Q

histopathology of granulomatous gingivitis

A
  • collections of histiocytes with lymphocytic infiltrate

- may see well-formed granulomas with multi-nucleated giant cells

60
Q

treatment of granulomatous gingivitis

A
  • if foreign body -surgical excision of affected tissue

- rule out any granulomatous inflammatory diseases

61
Q

granulomatous inflammatory diseases

A
  • sarcoidosis
  • crohn’s
  • deep fungal
  • bacterial
  • orofacial granulomatosis
  • cat-scratch disease
62
Q

granulomatous gingivitis

A

red inflamed, localized, multinucleated giant cells

63
Q

desquamative gingivitis clinical term

A

not giving a definitive diagnosis; biopsy will be necessary

64
Q

desquamative gingivitis

A

superficial peeling of epithelium with formation of vesicles or bulla

65
Q

nikolsky sign

A

desquamative gingivitis

66
Q

nikolsky sign

A

-manipulate affected epithelium with object or compressed air that results in sloughing or vesicle formation

67
Q

how to check for nikolsky sign

A

create a vesicle; gently blow air or use another instrument to see where the epithelium is blowing away

68
Q

represents a vesiculobullous condition

A

desquamative gingivitis

69
Q

what is not a true vesiculobullous condition (desquamative gingivitis)

A

lichen planus

70
Q

what are true vesiculobollus conditions during desquamative gingivitis?

A
  • linear IgA
  • pemphigus vulgaris
  • mucous membrane pemphigoid
  • epidermolysis bullosa acquisita
  • systemic lupus erythematosus
71
Q

types of gingival hyperplasia

A
  • drug-related gingival hyperplasia

- gingival fibromatosis

72
Q

drug related gingival hyperplasia is also called

A

drug-related gingival overgrowth

73
Q

What is drug related gingival hyperplasiaa

A

abnormal gingival growth due to systemic medications

74
Q

what does drug related gingival hyperplasia result from

A

increased amount of extracellular matrix (collagen)

75
Q

when can drug related gingival hyperplasia occur?

A

after taking medication for 1-3 months

76
Q

medications that affect the gingiva in drug related gingival hyperplasia

A

cyclosporine, erythromycin, oral contraceptives

and calcium channel blockers like Nifedipine

77
Q

**anticonvulsants like phenytoin (dilantin) for patients with convulsions or epilepsy can cause

A

drug related gingival hyperplasia

78
Q

example of anticonvulsant

A

phenytoin (dilantin)

79
Q

clinical findings for drug related gingival hyperplasia

A

-begins in interdental papillae and spreads across teeth surfaces

80
Q

what surfaces of teeth are most affected in patients with drug related gingival hyperplasia

A

anterior and facial surfaces

81
Q

if no inflammation in drug related gingival hyperplasia

A

gingiva is normal in color and firm

82
Q

if inflammation in drug related gingival hyperplasia

A

gingiva is dark-red, edematous, friable surface

-edentulous people can have this effect as well

83
Q

treatment for drug related gingival hyperplasia

A

discontinue medication (advice of physician) and switch to another

DISCUSS WITH PHYSICIANS

84
Q

if phenytoin is stopped but gingiva is still overgrowing, consider

A

gingivectomy

85
Q

cyclosporines can cause

A

extra overgrowth of inflamed tissue

86
Q

what kind of patient takes nifedipine and what can it lead to?

A

patient with hypertension or heart problems, drug related gingival hyperplasia

87
Q

gingival fibromatosis is also called

A

fibromatosis gingivae/elephantiasis ginigvae

88
Q

gingival fibromatosis

A

slow progressive gingival enlargement

89
Q

gingival fibromatosis is caused by

A

collagen overgrowth

90
Q

gingival fibromatosis is genetically related to

A

autosomal dominant or recessive

91
Q

gingival fibromatosis is seen with

A
  • hypertrichosis
  • generalized aggressive periodontitis
  • epilepsy
  • intellectual disability
  • hypothryoidism
  • growth hormone deficiency
  • sensorineural deafness
92
Q

hypertrichosis

A

abnormal amount of hair growth over the body

93
Q

gingival fibromatosis clinical findings

A
  • generalized orlocalized
  • affect deciduous/ permanenet dentition
  • covers crowns of teeth after erupting
  • firm and normal in color
  • maxilla affected more
  • palatal surfaces increased in thickness
94
Q

treatment of gingival fibromatosis

A

gingivectomy + oral hygiene instructions

95
Q

types of periodontitis

A
  • chronic
  • necrotizing ulcerative periodontitis (NUP)
  • periodontal abscess
  • pericoronitis
  • localized aggressive
  • generalized aggressive
  • papillon-lefevre syndrome
96
Q

gingivitis

A

inflammation of soft tissue

97
Q

what is periodontitis

A

inflammation of gingival tissues with loss of attachment of periodontal ligament and bone support

98
Q

what creates periodontal pockets in periodontitis

A

apical migration of crevicular epithelium creating periodontal pockets

99
Q

factors that lead to periodonttitis

A
  • dental plaque

- shift in bacterial plaque due to changes in dentogingival environment

100
Q

what changes in dentogingival environment leads to shift in bacterial plaque

A

facultative gram-positive organisms (actinomycetes, streptococci) to anaerobic and microaerophilic gram-negative organisms

101
Q

periodontitis is associated with what diseases

A

CV disease, rsepiratory disease, and low birth weigh babies

102
Q

systemic disorders with premature attachment loss need to be ruled out of periodontitis

A
  • acrodynia
  • leukemia
  • cyclic neutropenia
  • crohn disease
  • diabetes mellitus
  • sarcoidosis
  • langehans cell disease
  • papillonlefevre
  • trisomy 21
103
Q

bacteria associated with chronic periodontitis (organized in a biofilm)

A
  • treponema denticola
  • tannerella forsynthesis
  • porphyromonas gingivalis
104
Q

what is the primary cause of tooth loss in people greater than 25 yrs old

A

chronic periodontitis

105
Q

chronic periodontitis can be seen in

A
  • advancing age
  • smoking
  • diabetes mellitus
  • osteoporosis
  • HIV infection
  • low socioeconomic level**
106
Q

can chronic periodontitis be seen in people with no abnormal immune system?

A

yes

107
Q

HIV infection can lead to chronic periodontitis

A

low term birth weight can lead to periodontitis so pregnant womenshould take care of their oral hygiene

108
Q

chronic periodontitis clinical and radiographic findings

A
  • loss of gingival attachment
  • pocket depths more than 3–4mm with periodontal probe
  • tooth mobility with singificant bone loss
109
Q

chronic periodontitis clinical and radiographic findings- loss of gingival attachment

A

blunting and apical positioning of margins

110
Q

what kind of bone loss is seen in radiographic findings of chronic periodontitis?

A

vertical bone loss

111
Q

treatment of periodontitis

A
  • eliminate causing factors
  • disrupt biofilm
  • develop good oral hygiene practices (scaling, root planing, , curretage, plaque control)
  • surgical flaps, antibiotic delivery if needed
112
Q

necrotizing ulcerative periodontitis is similar to

A

necrotizing ulcerative gingivitis (NUG)

113
Q

necrotizing ulcerative periodontitis has loss of

A

clinical attachment and alveolar bone

114
Q

in order to have periodontitis, you have to have

A

bone loss

115
Q

necrotizing ulcerative periodontitis is

A

destructive

116
Q

necrotizing ulcerative periodontitis patients are usually

A

immunosupressed or malnoursheed

117
Q

necrotizing ulcerative periodontitis are younger than those with

A

chronic periodontitis

118
Q

necrotizing ulcerative periodontitis

A

gingival ulceration and necrosis with rapidly progressing loss of periondontal attachment but deep pockets not seen

119
Q

necrotizing ulcerative periodontitis

A

edema or severe pain

120
Q

what is periodontal abscess

A

localized purulent infection involving periodontal attachment and alveolar bone-

121
Q

periodontal abscess seen in adults but rare in

A

children

122
Q

periodontal abscess occurs in preexisting periodontal lesion and changes in

A

subgingival flora

123
Q

clinical presentation of periodontal abscess

A
  • gingival enlargement along lateral aspect of tooth

- erythematous + edematous

124
Q

symptoms of periodontal abscess

A
  • throbbing pain
  • sensitivity to palpation of involved gingiva
  • foul taste
  • fever, lymphadenopathy
125
Q

treatment of periodontal abscess

A
  • drain and or incise affected area

- antibiotics and analgesics if needed

126
Q

pericoronitis

A

inflammatory process

127
Q

pericoronitis

A

tissue surrounds a partially erupted tooth

128
Q

predisposing factors of pericoronitis

A
  • food debris and bacteria
  • stress
  • upper respiratory infection
129
Q

abccess form of pericoronitis esecially in

A

mandibular 3rd molars

  • extreme pain
  • foul taste
  • inability to close jaws
  • area is erythematous + edematous
130
Q

treatment of pericoronitis

A
  • antiseptic lavage under flap/removal of excess tissue

- extraction of tooth if needed

oral pathology (6 decks)

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