Acute Perio Diseases Flashcards
What are types of Acute Perio Diseases?
1) Acute Pericoronitis
2) Acute Herpetic Gingivostomatitis
3) Acute Necrotizing Ulcerative Gingivitis
4) Acute Periodontal Abscess
5) Acute Gingival Abscess
What are the most common symptoms in order of DECREASING frequency?
Pain–>Swelling & Edema–> Lymphadenopathy–>Fever
What is the Tx for Acute Periocoronitis?
1) Control infection
2) Control inflammation
3) Control Pain
- Irrigation w/ H2O2 or CHX
- Systemic antibiotics
- EXT of MAX 3rd M
- Surgical removal of pericoronal tissue
What is Acute Necrotizing Ulcerative Gingivitis (ANUG) also known as?
1) Vincent’s Stomatitis
2) Vincent’s Infection
3) Ulcerative Gingivitis
4) Gangrenous Stomatitis
5) Trench Mouth
What are the Characteristics of ANUG?
1) Not contagious
2) Strong relationship between onset of disease & level of stress & anxiety
3) Age of onset is generally between 15 & 30 yrs
4) Smoking is commonly associated w/ disease
5) Can occur in clean mouth although disease is generally less severe
6) Disease exhibits an anterior to posterior gradient
Patients with ANUG exhibit a localized defect in __________, ___________, and/or ______________ functions.
- Neutrophil chemotaxis
- Macrophage chemotaxis
- Phagocytic
Patients with ANUG respond to what therapy?
1) Amoxicillin
2) Metronidazole (this is paired with amoxicillin)
3) Debridement
What are the clinical Signs and Symptoms?
1) Pain
2) Sudden onset
3) Necrosis & cratering of gingival papillae
4) Pseudomembrane formation
5) Spontaneous gingival bleeding
6) Foul breath odor
7) Lymphadenopathy
8) Elevated temperature
What are the microscopic zones in ANUG lesion from surface to lamina propria?
1) Bacterial zone
2) Neut rich zone
3) Zone of necrosis
4) Zone of spirochete infiltration
What is the TX & Management of ANUG?
1) Smoking cessation, adequate nutrition & sleep
2) Stress control
3) Systemic ABX
4) Oral rinsing w/ CHX
5) Multiple sessions of debridement w/ ultrasonic or sonic scaler
6) Scaling & root planing or scaling & polishing
7) Surgery may be indicated if residual soft tissue deformities inhibit proper OH
Which patients generally have acute periodontal abscess?
1) 10-15 % of ALL emergency patients
2) 60% of untreated periodontal patients
3) 14% of patient in active perio TX
4) 37% of patients in perio maintenance
Multiple abscess formation is often a manifestation of?
1) Diabetes
2) AIDS
What are the signs and symptoms of Acute Periodontal Abscesses?
1) Pain
2) Localized swelling & fluctuence
3) Purulent exudate
4) Deep periodontal pocket
5) Tooth exhibits vital pulp
6) May present a fistula
7) Tooth mobility
8) Sensitivity to percussion
9) Low grade fever
10) Lymphadenopathy
What are the sequence of events leading to abscess formation?
1) Occlusion of existing perio pocket
2) Bacterial innovation of soft tissue wall
3) Leukocytic infiltration (Neuts)
4) Vascular thrombosis
5) Edema & swelling
6) Tissue necrosis & liquefaction
7) Collagenolysis & bone resorption
8) Production of purulent exudate
65% of the microbial flora that cause Acute Periodontal Abscess are _____________ and ___________
- Gram-negative
- Anaerobic
In Acute Periodontal Abscesses, bacteria that produce proteinases are _________ and ____________.
They are important in pathogeneses of the periodontal abscess since they ____________ the ____________ of nutrients, and ______________ the _________ of bacteria within the abscess environment.
- P. gingivalis and P. intermedia
- increase the availability
- Increase
- number
What are all the microbes involved with Acute Periodontal Abscesses?
1) Treponema (spirochetes)
2) Fusobacterium nucleatum
3) Porphyromonas gingivalis
4) Prevotella intermedia
5) Parvimonas micra
6) Tannerella forsythia
7) Candida albicans
What are the factors required of development of acute periodontal abscesses ?
1) Periodontal pocket
2) Blockage of perio pocket by (calculus, plaque, food debris, restoration, and fibrosis of marginal tissue)
3) Presence of sub gingival plaque
4) Presence of plaque microbes that exhibit multiple virulence factors ( endotoxins, collegians, tissue innovation, and organic acid production)
What is the Histopathology of Acute Periodontal Abscess?
1) Acute inflammatory infiltrate
2) Vascular hyperemia and thrombosis
3) Lysis of the collagen matrix in the lamina propr. ad gingival fibers
4) Ulceration and apical proliferation of JE
5) Osteoclastic mediated bone resorption
What is the Tx for Acute Periodontal Abscesses?
1) Establish drainage (Non surgical or surgical and debridement or surgical therapy w/ flap election with ultrasonic, sutures)
2) Systemic or local delivery antibiotics (if indicated by fever or lymphadenopathy)
3) scale and root planing
4) Surgery if indicated
What are the signs and symptoms of an Acute Gingival Abscess?
1) Localized
2) Painful
3) Rapidly expanding
4) Limited to marginal gingiva or gingival papillae
5) Adjacent teeth may be painful to percussion
6) Etiology is generally impaction of a foreign body (popcorn hull, toothbrush bristle, shrimp husk,) associated bacteria carried into tissue
What is the TX for Acute Gingival Abscess?
1) Establish drainage
2) Systemic or locally delivered ABX
3) Scaling & root planing
4) Surgery if indicated
