Acute perio diseases- NUG/NUP Flashcards
How is NUG diagnosed?
Clinically
Describe the pain in NUG?
Sudden onset (acute), can be severe, may affect eating.
What are the clinical features of NUG? (8)
Necrotic ulcers
Initial red swollen interdental papilla
Ulceration starts on tip of ID papillae- spreads laterally along ging margin
SLOUGH- yellow fibrinous tissue consisting of fibrin and pus.
Halitosis (foetor oris)
Spontaneous bleeding (metallic taste)
How long do the acute symptoms last?
2-3 days - 2-3 weeks
What does acute symptoms turn into?
Chronic gingivitis
NUG creates stagnation areas and likely to come back due to loss of ID papilla
YES
What is cancrum oris?
Sequelae of NUG in developing countries resulting in facial tissue loss.
What is the microbiology if NUG? (principle bacteria)
Anaerobic fuso-spirochaetal complex (destructive) TREPONEMA VINCENTII & DENTICOLA FUSOBACTERIUM NUCLEATUM PREVOTELLA INTERMEDIA PORPHYROMONAS GINGIVALIS
What are the predisposing factors of NUG? (4)
Poor OH
Smoking (causes vasoconstriction creating anearobic state, it suppresses serum igG levels against subgingival bacteria, reduces motility of PMNs so healing is impaired)
Stress (changes behaviour (poor oh, increased smoking, poor diet)
Immunodeficiency
Histopathology of NUG (4)
Bacterial zone (surface slough creates lots of bacteria) PMNs rich zone (epithelium and CT full of lots of PMNs Necrotic zone (many spirochetes) Deeper tissues (still variable with plasma and macrophages)
What is the treatment of NUG/
OHI & explanation of disease
Gentle USS- cleans out anaerobic bacteria and water is soothing
Metronidazole- 200mg given if systemic symptoms
Review every 48 hours
What treatment can you do subsequently?
OHI, Smoking advice, RSD, review and maintenance
NUP is associated with what?
AIDS and immuno-suppression.