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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
Name the type of gingivitis: allergy causes most cases (toothpaste, mouthwash, candy, gum, food/drink) but some are idiopathic
plasma cell gingivitis
26
Name the type of gingivitis: rapid onset of sore gingiva
plasma cell gingiva
27
Name the type of gingivitis: enlargement and diffuse bright red appearance
plasma cell gingivitis
28
Name the type of gingivitis: histopathology looks like a fried egg
plasma cell gingivitis
29
tx for plasma cell gingivitis
- 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
Name the type of gingivitis: granulomatous inflammation within the gingiva
granulomatous gingivitis
31
Potential causes for granulomatous inflammation:
- embedded foreign material - deep fungal infection - TB - systemic autoimmune granulomatous diseases (Crohn's disease, sarcoidosis)
32
Name the type of gingivitis: affects any age but adults are more common
granulomatous gingivitis
33
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
granulomatous gingivitis
34
Name the type of gingivitis: remains despite improved hygiene measures, tx is surgical excision
granulomatous gingivitis
35
Name the type of gingivitis: clinical term only (NOT a definitive diagnosis), biopsy is necessary to determine etiology
desquamative gingivitis
36
Name the type of gingivitis: gingiva that peels spontaneously or with minor manipulation
desquamative gingivitis
37
Differential diagnoses for desquamative gingivitis:
- mucous membrane pemphigoid - erosive lichen planus - pemphigus vulgaris
38
Name the type of gingivitis: smooth, red, painful gingiva that begins in one area and becomes multifocal
desquamative gingivitis
39
surface of mouth affected more with desquamative gingivitis
facial surfaces more affected than palatal or lingual
40
Name the type of gingivitis: erosions and ulcers
desquamative gingivitis
41
abnormal growth of gingival tissues due to use of a systemic medication
drug-related gingival hyperplasia
42
causes an increase in the amount of collagen in the CT
drug-related gingival hyperplasia
43
Drug-related gingival hyperplasia begins how long after starting drug use?
1-3 months
44
drugs that commonly cause drug-related gingival hyperplasia
Phenytoin (anticonvulsant)- 50% of patients develop hyperplasia Cyclosporine- immunosuppressant Calcium channel blockers (especially Nifedipine)
45
tissues may be pink or red/inflamed, diffuse (starts at interdental papillae then spreads), covers crowns of teeth partially or totally
drug-related gingival hyperplasia
46
drug-related gingival hyperplasia without inflammation vs with
No inflammation: - firm - normal in color With inflammation: - red and edematous/squishy - bleeds easily
47
tx for drug-related gingival hyperplasia
- 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
gingival enlargement due to overgrowth of collagen (not drug related), normal color, firm tissue
gingival fibromatosis
49
causes of gingival fibromatosis (2)
- hereditary | - idiopathic
50
- begins before age 20 - slowly progressive - correlates with tooth eruption (primary or permanent teeth) - localized or diffuse
hereditary gingival fibromatosis
51
location in mouth of hereditary gingival fibromatosis
- palatal and/or buccal | - maxilla > mandible
52
Other findings sometimes seen with gingival fibromatosis:
- hypertrichosis - generalized aggressive periodontitis - epilepsy - intellectual deficit - deafness - hypothyroidism - GH deficiency
53
how to diagnosis gingival fibromatosis
biopsy
54
histology: abundant dense collagen
gingival fibromatosis
55
tx for gingival fibromatosis
gingivectomy, improve oral hygiene, may require multiple treatements
56
- localized accumulation of pus within a pre-existing periodontal pocket - gingival swelling with erythema, hemorrhage - throbbing pain, sensitivity, mobility, foul taste
periodontal abscess
57
causes of a periodontal abscess
- change in oral flora or host resistance - closure of entrance to perio pocket - entrapment of foreign body
58
how to diagnosis a periodontal abscess
clinical and radiographic findings, pus can be expressed from sulcus on palpation and probing
59
ACUTE inflammation of the tissues surrounding the crown of a partially erupted tooth
pericoronitis
60
predisposing factors for pericoronitis (2)
- food debris and bacteria become trapped under the gingival flap overlying the crown - upper respiratory infections (especially tonsillitis or pharyngitis)
61
location of pericoronitis
mandibular third molars
62
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
pericoronitis
63
tx for pericoronitis
antibiotics and gentle flap lavage, extract tooth!
64
inherited autosomal recessive, oral and dermatologic manifestations, characterized by accelerated periodontitis
Papillon-Lefevre syndrome
65
affects both primary and permanent dentitions, develops soon after tooth eruption
Papillon-Lefevre syndrome
66
mutation of this gene causes altered immune response to infection in Papillon-Lefevre syndrome
cathepsin C gene
67
skin condition associated with Papillon-Lefevre syndrome that is evident by age 3, spreads to dorsal surfaces of hands and feet also
palmar-plantar keratosis
68
hemorrhagic hyperplastic gingiva, mobility and migration of teeth, chewing becomes painful, when teeth are absent the gingiva looks normal
Papillon-Lefevre syndrome
69
tx for Papillon-Lefevre syndrome
- aggressive periodontal therapy and high-dose antibiotics (directed at A. actinomycetemacomitans) - systemic retinoids used of skin
70
loss of teeth is inevitable in many cases (by age 4-5 with primary dentition and age 15 with permanent dentition)
Papillon-Lefevre syndrome

Oral Pathology Exam 1 (16 decks)

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