3 periodontal diseases Flashcards
1
Q
types of gingivitis
A
- gingivitis
- localized juvenile spongiotic
- necrotizing ulcerative gingivitis (NUG)
- plasma cell
- granulomatous
- desquamative
2
Q
what is gingivitis
A
inflammation of soft tissues surrounding teeth
3
Q
what causes gingivitis
A
lack of proper oral hygiene, increase in dental plaque and calculus
4
Q
max or mandibular more common in puberty gingivitis
A
upper teeth aren’t covered so maxillary regions are affected more often
5
Q
puberty gingivitis is seen in ages
A
9-14
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
7
Q
gingivitis mouth breathers
A
- unique pattern
- only affects facial gingiva as smooth, swollen, red
8
Q
chronic hyperplastic gingivitis
A
chronic inflammation causes edema or fibrosis (gums become swollen or edematous)
9
Q
where is a pyogenic granuloma seen?
A
chronic hyperplastic gingivitis
10
Q
pyogenic granuloma
A
inflamed granulation tissue located in gingival sulcus
11
Q
mouth breathing gingivitis
A
gums in interdental papilla are inflamed
12
Q
puberty gingivitis
A
red inflamed areas
-mix of hormones + difficulty cleaning with braces
13
Q
what does healthy gingiva look like?
A
coral pink, stippling, not bleeding
14
Q
chronic hyperplastic with pyogenic granuloma
A
looks healthy lingually, red edema, pyogenic granulomas are not confined to the gingiva
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
16
Q
generalized gingivitis
A
across entire oral cavity
17
Q
treatment of gingivitis
A
- eliminate cause
- receive proper oral hygiene instructions
18
Q
gingivitis color
A
red instead of coral pink
19
Q
localized juvenile spongiotic gingival hyperplasia =
A
localized juvenile spongiotic gingivitis
20
Q
localized juvenile spongiotic gingival hyperplasia
A
- idiopathic
- not plaque related
- fail to respond to improved oral hygiene
21
Q
localized juvenile spongiotic gingival hyperplasia occurs in patients under
A
20
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
23
Q
treatment of localized juvenile spongiotic gingival hyperplasia
A
- excise conservatively
- can recur but can resolute spontaneously
24
Q
localized juvenile spongiotic gingival hyperplasia vs. puberty gingivitis
A
maxillary area whereas puberty gingivitis could be in the margin area
25
necrotizing ulcerative gingivitis =
NUG
26
necrotizing ulcerative gingiviti (NUG) is also called what two names
vincent's infection or trench mouth
27
necrotizing ulcerative gingiviti (NUG) is caused by
- fusobacterium nucleatum
- prevotella intermedia
- porphyromonas gingivalis
- treponmea and or selenomonas
28
necrotizing ulcerative gingiviti (NUG) occurs in times of
psychologic stress esp military personnel
29
trench mouth
- 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
30
factors contributing to necrotizing ulcerative gingivitis (NUG)
- smoking
- local trauma
- immunocompromised status
- poor oral hygiene
31
**clinical features of necrotizing ulcerative gingivitis (NUG)
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)
32
NUG--> noma if infection spreads to
face
33
**8interdental papilla PUNCHED OUT with gray pseudomembrane appearance
necrotizing ulcerative gingivitis (NUG) ***
34
treatment of necrotizing ulcerative gingivitis (NUG) ***
currettage, scaling, ultrasonic instrumentation to rid of bacterial component
35
NOMA starts as **
NUG
36
NOMA
- bacterial infection, intense + extensive, lots of destruction
- rapidly progressive, polymicrobial, opportunistic infection
37
What does NOMA result from
normal oral flora becoming pathogenic due to compromised immune status
38
what debilitating illnesses cause infection?
- measles
- herpes (simplex, varicella)
- tuberculosis
39
who does NOMA affect?
children (1-10 yrs old)
| adults w/ debilitating disease
40
clinical findings of NOMA
- 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)
41
necrosis extends as blue-black discoloration with CONE SHAPED growth pattern***
NOMA
42
cone shaped noma
starts at the tip and then spreads
43
treatment of NOMA
- antibiotics
- local wound care
- correcting imbalances with nutrition, hydration, electrolytes
44
another name for plasma cell gingivitis
atypical gingivostomatitis
45
**allergic response with a distinc pattern of gingival involvement
plasma cell gingivitis= atypical gingivostomatitis
46
plasma cell gingivitis= atypical gingivostomatitis occurs quickly because it's an
allergic reaction
47
plasma cell gingivitis= atypical gingivostomatitis rapid onset made worse by
hot/spicy foods (cinnamon) or dentrifices
48
plasma cell gingivitis= atypical gingivostomatitis attached and free gingiva affected
- diffuse enlargement (bright red + inflamed)
- loss of stippling
- bright erythema
49
histopathology of plasma cell gingivitis= atypical gingivostomatitis
plasma cells in fibrous CT
50
plasma cell gingivitis= atypical gingivostomatitis treatment
try to rule out causative agent
51
plasma cell gingivitis= atypical gingivostomatitis
allergic reaction so once you remove the allergen, the gingiva should go back to coral pink
52
plasma cell gingivitis= atypical gingivostomatitis
firey red appearance= bright erythema
53
granulomatous gingivitis
- unexplained granulomatous inflammation, diagnosis of exclusion
- may result from dental materials into CT
54
foreign body gingivitis **
granulomatous gingivitis
55
granulomatous gingivitis= FBG
damage to epithelium during dental procedures and foreign material into gingiva
56
what is the most common form of granulomatous inflammation?
foreign bodies
57
what age does granulomatous gingivitis occur?
any age
58
granulomatous gingivitis lesions
solitary or multifocal lesions on interdental papillae or marginal gingiva
- red or red/white machules
- FBG resembles gingival lichen planus
59
histopathology of granulomatous gingivitis
- collections of histiocytes with lymphocytic infiltrate
| - may see well-formed granulomas with multi-nucleated giant cells
60
treatment of granulomatous gingivitis
- if foreign body -surgical excision of affected tissue
| - rule out any granulomatous inflammatory diseases
61
granulomatous inflammatory diseases
- sarcoidosis
- crohn's
- deep fungal
- bacterial
- orofacial granulomatosis
- cat-scratch disease
62
granulomatous gingivitis
red inflamed, localized, multinucleated giant cells
63
desquamative gingivitis clinical term
not giving a definitive diagnosis; biopsy will be necessary
64
desquamative gingivitis
superficial peeling of epithelium with formation of vesicles or bulla
65
nikolsky sign
desquamative gingivitis
66
nikolsky sign
-manipulate affected epithelium with object or compressed air that results in sloughing or vesicle formation
67
how to check for nikolsky sign
create a vesicle; gently blow air or use another instrument to see where the epithelium is blowing away
68
represents a vesiculobullous condition
desquamative gingivitis
69
what is not a true vesiculobullous condition (desquamative gingivitis)
lichen planus
70
what are true vesiculobollus conditions during desquamative gingivitis?
- linear IgA
- pemphigus vulgaris
- mucous membrane pemphigoid
- epidermolysis bullosa acquisita
- systemic lupus erythematosus
71
types of gingival hyperplasia
- drug-related gingival hyperplasia
| - gingival fibromatosis
72
drug related gingival hyperplasia is also called
drug-related gingival overgrowth
73
What is drug related gingival hyperplasiaa
abnormal gingival growth due to systemic medications
74
what does drug related gingival hyperplasia result from
increased amount of extracellular matrix (collagen)
75
when can drug related gingival hyperplasia occur?
after taking medication for 1-3 months
76
medications that affect the gingiva in drug related gingival hyperplasia
cyclosporine, erythromycin, oral contraceptives
| and calcium channel blockers like Nifedipine
77
**anticonvulsants like phenytoin (dilantin) for patients with convulsions or epilepsy can cause
drug related gingival hyperplasia
78
example of anticonvulsant
phenytoin (dilantin)
79
clinical findings for drug related gingival hyperplasia
-begins in interdental papillae and spreads across teeth surfaces
80
what surfaces of teeth are most affected in patients with drug related gingival hyperplasia
anterior and facial surfaces
81
if no inflammation in drug related gingival hyperplasia
gingiva is normal in color and firm
82
if inflammation in drug related gingival hyperplasia
gingiva is dark-red, edematous, friable surface
| -edentulous people can have this effect as well
83
treatment for drug related gingival hyperplasia
discontinue medication (advice of physician) and switch to another
DISCUSS WITH PHYSICIANS
84
if phenytoin is stopped but gingiva is still overgrowing, consider
gingivectomy
85
cyclosporines can cause
extra overgrowth of inflamed tissue
86
what kind of patient takes nifedipine and what can it lead to?
patient with hypertension or heart problems, drug related gingival hyperplasia
87
gingival fibromatosis is also called
fibromatosis gingivae/elephantiasis ginigvae
88
gingival fibromatosis
slow progressive gingival enlargement
89
gingival fibromatosis is caused by
collagen overgrowth
90
gingival fibromatosis is genetically related to
autosomal dominant or recessive
91
gingival fibromatosis is seen with
- hypertrichosis
- generalized aggressive periodontitis
- epilepsy
- intellectual disability
- hypothryoidism
- growth hormone deficiency
- sensorineural deafness
92
hypertrichosis
abnormal amount of hair growth over the body
93
gingival fibromatosis clinical findings
- 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
treatment of gingival fibromatosis
gingivectomy + oral hygiene instructions
95
types of periodontitis
- chronic
- necrotizing ulcerative periodontitis (NUP)
- periodontal abscess
- pericoronitis
- localized aggressive
- generalized aggressive
- papillon-lefevre syndrome
96
gingivitis
inflammation of soft tissue
97
what is periodontitis
inflammation of gingival tissues with loss of attachment of periodontal ligament and bone support
98
what creates periodontal pockets in periodontitis
apical migration of crevicular epithelium creating periodontal pockets
99
factors that lead to periodonttitis
- dental plaque
| - shift in bacterial plaque due to changes in dentogingival environment
100
what changes in dentogingival environment leads to shift in bacterial plaque
facultative gram-positive organisms (actinomycetes, streptococci) to anaerobic and microaerophilic gram-negative organisms
101
periodontitis is associated with what diseases
CV disease, rsepiratory disease, and low birth weigh babies
102
systemic disorders with premature attachment loss need to be ruled out of periodontitis
- acrodynia
- leukemia
- cyclic neutropenia
- crohn disease
- diabetes mellitus
- sarcoidosis
- langehans cell disease
- papillonlefevre
- trisomy 21
103
bacteria associated with chronic periodontitis (organized in a biofilm)
- treponema denticola
- tannerella forsynthesis
- porphyromonas gingivalis
104
what is the primary cause of tooth loss in people greater than 25 yrs old
chronic periodontitis
105
chronic periodontitis can be seen in
- advancing age
- smoking
- diabetes mellitus
- osteoporosis
- HIV infection
- low socioeconomic level****
106
can chronic periodontitis be seen in people with no abnormal immune system?
yes
107
HIV infection can lead to chronic periodontitis
low term birth weight can lead to periodontitis so pregnant womenshould take care of their oral hygiene
108
chronic periodontitis clinical and radiographic findings
- loss of gingival attachment
- pocket depths more than 3--4mm with periodontal probe
- tooth mobility with singificant bone loss
109
chronic periodontitis clinical and radiographic findings- loss of gingival attachment
blunting and apical positioning of margins
110
what kind of bone loss is seen in radiographic findings of chronic periodontitis?
vertical bone loss
111
treatment of periodontitis
- eliminate causing factors
- disrupt biofilm
- develop good oral hygiene practices (scaling, root planing, , curretage, plaque control)
- surgical flaps, antibiotic delivery if needed
112
necrotizing ulcerative periodontitis is similar to
necrotizing ulcerative gingivitis (NUG)
113
necrotizing ulcerative periodontitis has loss of
clinical attachment and alveolar bone
114
in order to have periodontitis, you have to have
bone loss
115
necrotizing ulcerative periodontitis is
destructive
116
necrotizing ulcerative periodontitis patients are usually
immunosupressed or malnoursheed
117
necrotizing ulcerative periodontitis are younger than those with
chronic periodontitis
118
necrotizing ulcerative periodontitis
gingival ulceration and necrosis with rapidly progressing loss of periondontal attachment but deep pockets not seen
119
necrotizing ulcerative periodontitis
edema or severe pain
120
what is periodontal abscess
localized purulent infection involving periodontal attachment and alveolar bone-
121
periodontal abscess seen in adults but rare in
children
122
periodontal abscess occurs in preexisting periodontal lesion and changes in
subgingival flora
123
clinical presentation of periodontal abscess
- gingival enlargement along lateral aspect of tooth
| - erythematous + edematous
124
symptoms of periodontal abscess
- throbbing pain
- sensitivity to palpation of involved gingiva
- foul taste
- fever, lymphadenopathy
125
treatment of periodontal abscess
- drain and or incise affected area
| - antibiotics and analgesics if needed
126
pericoronitis
inflammatory process
127
pericoronitis
tissue surrounds a partially erupted tooth
128
predisposing factors of pericoronitis
- food debris and bacteria
- stress
- upper respiratory infection
129
abccess form of pericoronitis esecially in
mandibular 3rd molars
- extreme pain
- foul taste
- inability to close jaws
- area is erythematous + edematous
130
treatment of pericoronitis
- antiseptic lavage under flap/removal of excess tissue
| - extraction of tooth if needed
