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Oral Pathology Exam 1 > 4 Periodontal Diseases > Flashcards

4 Periodontal Diseases Flashcards

1
Q

inflammation of the soft tissues surrounding the teeth

A

gingivitis

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2
Q

Name the type of gingivitis: most cases are due to inadequate oral hygiene (many factors affect the gingiva’s susceptibility)

A

plaque-related gingivitis

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3
Q

Name the type of gingivitis: common in all age groups, increasing prevalence with age

A

plaque-related gingivitis

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4
Q

Name the type of gingivitis: loss of stippling, bleeding on probing and flossing

A

plaque-related gingivitis

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5
Q

Name the type of gingivitis: erythema, edema (bulbous interdental papillae)

A

plaque-related gingivitis

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6
Q

Contributing factors to plaque-related gingivitis:

A
  • hormonal changes (puberty, pregnancy, oral contraceptives)
  • diabetes
  • stress
  • poor nutrition, crowding of teeth, dental anomalies
  • overhanging restorations
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7
Q

Name the type of gingivitis: smooth, swollen, red anterior facial gingiva

A

mouth-breathing related gingivitis

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8
Q

Name the type of gingivitis: increased susceptibility to gingivitis during hormonal changes associated with puberty and pregnancy

A

puberty and pregnancy gingivitis

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9
Q

An increase in this hormone causes puberty and pregnancy related gingivitis? How does it cause gingivitis?

A

progesterone (increases the permeability of gingival blood vessels, so greater susceptibility to bacteria)

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10
Q

Name the type of gingivitis: idiopathic, no response to improved oral hygiene, exteriorized junctional epithelium?, usually in patients under 20 yo

A

localized juvenile spongiotic gingival hyperplasia

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11
Q

Name the type of gingivitis: solitary, bright red, velvety or papillary hyperplasia

A

localized juvenile spongiotic gingival hyperplasia

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12
Q

Localized juvenile spongiotic gingival hyperplasia has a predilection for which area of the mouth?

A

maxillary anterior facial gingiva

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13
Q

tx for localized juvenile spongiotic gingival hyperplasia

A

conservative surgical excision (6-16% reported recurrence rate)

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14
Q

Name the type of gingivitis: caused by fusiform and spirochete bacteria of various types

A

necrotizing ulcerative gingivitis (NUG)

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15
Q

Name the fusiform and spirochete bacteria that cause NUG:

A 
Fusobacterium nucleatum 
Prevotella intermedia 
Porphyromonas gingivalis
Treponema spp
Selenomonas spp
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16
Q

Name the type of gingivitis: psychologic stress (“trench mouth”)

A

necrotizing ulcerative gingivitis (NUG)

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17
Q

Risk factors for NUG (4)

A
  • immunosuppression
  • smoking
  • poor nutrition, poor oral hygiene
  • recent illness
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18
Q

Name the type of gingivitis: affects young and middle-aged adults

A

necrotizing ulcerative gingivitis (NUG)

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19
Q

Name the type of gingivitis: clinical findings include inflamed hemorrhagic interdental papillae that become necrotic and develop a gray pseudomembrane (“punched out” appearance)

A

necrotizing ulcerative gingivitis (NUG)

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20
Q

Name the type of gingivitis: painful, malodor

A

necrotizing ulcerative gingivitis (NUG)

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21
Q

Name the type of gingivitis: fever, malaise, lymphadenopathy

A

necrotizing ulcerative gingivitis (NUG)

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22
Q

NUG may progress to _____.

A

NUP –> loss of attachment and bone

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23
Q

tx for NUG

A
  • debridement of necrotic tissues and debris, anesthetic usually necessary
  • antibacterial rinse (chlorhexidine)
  • antibiotic therapy (metronidazole, penicillin)
  • gingiva usually regenerates quickly
  • look for other signs of immunosuppression
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24
Q

Name the type of gingivitis: initially reported as a hypersensitivity to chewing gum

A

plasma cell gingivitis

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25
Q

Name the type of gingivitis: allergy causes most cases (toothpaste, mouthwash, candy, gum, food/drink) but some are idiopathic

A

plasma cell gingivitis

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26
Q

Name the type of gingivitis: rapid onset of sore gingiva

A

plasma cell gingiva

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27
Q

Name the type of gingivitis: enlargement and diffuse bright red appearance

A

plasma cell gingivitis

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28
Q

Name the type of gingivitis: histopathology looks like a fried egg

A

plasma cell gingivitis

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29
Q

tx for plasma cell gingivitis

A
  • Dietary history- record everything that goes into the mouth including foods, drinks, tobacco, toothpaste, mouthwash, gum, candy, medications
  • Allergy testing
  • Elimination diet
  • Topical corticosteroids if idiopathic
30
Q

Name the type of gingivitis: granulomatous inflammation within the gingiva

A

granulomatous gingivitis

31
Q

Potential causes for granulomatous inflammation:

A
  • embedded foreign material
  • deep fungal infection
  • TB
  • systemic autoimmune granulomatous diseases (Crohn’s disease, sarcoidosis)
32
Q

Name the type of gingivitis: affects any age but adults are more common

A

granulomatous gingivitis

33
Q

Name the type of gingivitis: appearance is non-specific (red or red/white tissue change), solitary or multifocal, +/- pain and sensitivity in the affected area

A

granulomatous gingivitis

34
Q

Name the type of gingivitis: remains despite improved hygiene measures, tx is surgical excision

A

granulomatous gingivitis

35
Q

Name the type of gingivitis: clinical term only (NOT a definitive diagnosis), biopsy is necessary to determine etiology

A

desquamative gingivitis

36
Q

Name the type of gingivitis: gingiva that peels spontaneously or with minor manipulation

A

desquamative gingivitis

37
Q

Differential diagnoses for desquamative gingivitis:

A
  • mucous membrane pemphigoid
  • erosive lichen planus
  • pemphigus vulgaris
38
Q

Name the type of gingivitis: smooth, red, painful gingiva that begins in one area and becomes multifocal

A

desquamative gingivitis

39
Q

surface of mouth affected more with desquamative gingivitis

A

facial surfaces more affected than palatal or lingual

40
Q

Name the type of gingivitis: erosions and ulcers

A

desquamative gingivitis

41
Q

abnormal growth of gingival tissues due to use of a systemic medication

A

drug-related gingival hyperplasia

42
Q

causes an increase in the amount of collagen in the CT

A

drug-related gingival hyperplasia

43
Q

Drug-related gingival hyperplasia begins how long after starting drug use?

A

1-3 months

44
Q

drugs that commonly cause drug-related gingival hyperplasia

A

Phenytoin (anticonvulsant)- 50% of patients develop hyperplasia

Cyclosporine- immunosuppressant

Calcium channel blockers (especially Nifedipine)

45
Q

tissues may be pink or red/inflamed, diffuse (starts at interdental papillae then spreads), covers crowns of teeth partially or totally

A

drug-related gingival hyperplasia

46
Q

drug-related gingival hyperplasia without inflammation vs with

A

No inflammation:

  • firm
  • normal in color

With inflammation:

  • red and edematous/squishy
  • bleeds easily
47
Q

tx for drug-related gingival hyperplasia

A
  • if possible, discontinue drug and substitute with another
  • oral hygiene is very important (worse hygiene = worse hyperplasia, minimize plaque with frequent recall appts)
  • conservative management (doesn’t seem to lead to early tooth loss despite increasing probing depths)
  • may require gingival recontouring (gingivectomy)
48
Q

gingival enlargement due to overgrowth of collagen (not drug related), normal color, firm tissue

A

gingival fibromatosis

49
Q

causes of gingival fibromatosis (2)

A
  • hereditary

- idiopathic

50
Q
  • begins before age 20
  • slowly progressive
  • correlates with tooth eruption (primary or permanent teeth)
  • localized or diffuse
A

hereditary gingival fibromatosis

51
Q

location in mouth of hereditary gingival fibromatosis

A
  • palatal and/or buccal

- maxilla > mandible

52
Q

Other findings sometimes seen with gingival fibromatosis:

A
  • hypertrichosis
  • generalized aggressive periodontitis
  • epilepsy
  • intellectual deficit
  • deafness
  • hypothyroidism
  • GH deficiency
53
Q

how to diagnosis gingival fibromatosis

A

biopsy

54
Q

histology: abundant dense collagen

A

gingival fibromatosis

55
Q

tx for gingival fibromatosis

A

gingivectomy, improve oral hygiene, may require multiple treatements

56
Q
  • localized accumulation of pus within a pre-existing periodontal pocket
  • gingival swelling with erythema, hemorrhage
  • throbbing pain, sensitivity, mobility, foul taste
A

periodontal abscess

57
Q

causes of a periodontal abscess

A
  • change in oral flora or host resistance
  • closure of entrance to perio pocket
  • entrapment of foreign body
58
Q

how to diagnosis a periodontal abscess

A

clinical and radiographic findings, pus can be expressed from sulcus on palpation and probing

59
Q

ACUTE inflammation of the tissues surrounding the crown of a partially erupted tooth

A

pericoronitis

60
Q

predisposing factors for pericoronitis (2)

A
  • food debris and bacteria become trapped under the gingival flap overlying the crown
  • upper respiratory infections (especially tonsillitis or pharyngitis)
61
Q

location of pericoronitis

A

mandibular third molars

62
Q

Symptoms:

  • extreme pain, foul taste
  • inability to close the jaws
  • pain may radiate to the throat, ear, or floor of the mouth
  • tissue is erythematous and edematous
  • lymphadenopathy, fever, malaise
A

pericoronitis

63
Q

tx for pericoronitis

A

antibiotics and gentle flap lavage, extract tooth!

64
Q

inherited autosomal recessive, oral and dermatologic manifestations, characterized by accelerated periodontitis

A

Papillon-Lefevre syndrome

65
Q

affects both primary and permanent dentitions, develops soon after tooth eruption

A

Papillon-Lefevre syndrome

66
Q

mutation of this gene causes altered immune response to infection in Papillon-Lefevre syndrome

A

cathepsin C gene

67
Q

skin condition associated with Papillon-Lefevre syndrome that is evident by age 3, spreads to dorsal surfaces of hands and feet also

A

palmar-plantar keratosis

68
Q

hemorrhagic hyperplastic gingiva, mobility and migration of teeth, chewing becomes painful, when teeth are absent the gingiva looks normal

A

Papillon-Lefevre syndrome

69
Q

tx for Papillon-Lefevre syndrome

A
  • aggressive periodontal therapy and high-dose antibiotics (directed at A. actinomycetemacomitans)
  • systemic retinoids used of skin
70
Q

loss of teeth is inevitable in many cases (by age 4-5 with primary dentition and age 15 with permanent dentition)

A

Papillon-Lefevre syndrome

Oral Pathology Exam 1 (16 decks)

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