Acute Perio Lesions and Mucogingival conditions

Question 1

A. 7‐14% of all emergency patients, 3rd most common
B. 60% of untreated periodontal patients
C. 13.5% of patients in active periodontal treatment
D. 37% of patients in periodontal maintenance

Answer 1

Perio abcess

Question 2

Localized accumulation 
of pus located within the 
gingival wall of the 
periodontal pocket, with 
an expressed periodontal 
breakdown occurring 
during a limited period of 
time,  and with easily 
detectable clinical 
symptoms. 

Etiology
Pulp necrosis,
Periodontal infections
Pericoronitis
Trauma
Surgery
Foreign body impaction

Answer 2

Perio abcess

Question 3

Sequence of events of \_\_\_\_\_\_\_:
1.Occlusion on existing perio pocket
2. Bacterial invasion of soft tissue wall
3. Leukocytic infiltration
4. Vascular thrombosis
•5.  Edema and swelling.
•6. Tissue necrosis & liquefaction.
•7.  Collagenolysis & bone resorption.
•8.  Production of purulent exudate.

Answer 3

Abscess formation

Question 4

•Most common symptoms in order of

decreasing frequency of perio abscess (4)

Answer 4

•
1.  Pain
•
2.  Swelling and Edema
•
3.  Lymphadenopathy
•
4.  Fever

Question 5

•Multiple abscess formation is often a manifestation of what 3 things?

Answer 5

•Diabetes (Uncontrolled or undiagnosed): the vast
majority of the cases have this as cause.
•AIDS (compromised immune system)
•Depressed Immune System (steroid therapy,
chemotherapy)

Question 6

The majority of the microorgs in perio abscesses are gram ____ and aerobic or anaerobic

Answer 6

Gram neg; anaerobi

Question 7

What are the 2 most important microrgs in acute abscesses?

Answer 7

P gingivalis

P intermedia

Question 8

Microbiology of \_\_\_\_\_\_\_
•Treponema (spirochetes)
•Fusobacterium nucleatum
•Prevotella intermedia
•Porphyromonas gingivalis
•Peptostreptococcus micros
•Tannerella forysthia
•Candida albicans

Answer 8

Perio abscesses

Question 9

Histopathology of ______:
Acute inflammatory infiltrate
Vascular hyperemia and thrombosis
Lysis of the collagen matrix in the lamina propria and the gingival
fibers
Ulceration and apical proliferation of JE
Osteoclastic mediated bone resorption

Answer 9

Perio Abscess

Question 10

What are the abscess complications? 3

Answer 10

Tooth loss (up to 45% of teeth with 
periodontal abscesses  in maintenance 
are extracted)
Bacteremia following abscess 
treatment
Chronic or episodic bacteremia from 
untreated periodontal disease

Question 11

SHould every abscess be given abx?

Answer 11

NO; only with fever and lymphadenopathy

Question 12

What are the 4 conditions that present with pain in perio disease?

Answer 12

Acute pericoronitis
Acute perio abscess
Acute Herpetic Gingivostomatisis
Acute NUG

Question 13

What is the minimum mm of keratinized gingiva needed? Attached gingiva?

Answer 13

2mm; 1 mm

Question 14

Is keratinized tissue the same thing as attached gingiva?

Answer 14

Nope; all attached gingiva is keratinized by not all keratinized tissue is attached (free gingiva)

Question 15

_______ by definition is apical migration of
the gingival margin with concomitant exposure of the
root surface.
•This condition affects a large population irrespective of
Oral Hygiene.
•Estimated prevalence:
•54.5% of young adults
•100% Middle aged‐Elderly adults suffer from Gingival
recessions with an average prevalence of 78.6%

Answer 15

•Gingival recession

Question 16

NCCL

CEJ detectable without step

Answer 16

Class A -

Question 17

NCCL

CEJ detectable with step

Answer 17

Class A +

Question 18

NCCL

CEJ undetectable without step

Answer 18

Class B -

Question 19

NCCL

CEJ undetectable with step

Answer 19

Class B +

Question 20

Predisposing factors of \_\_\_\_\_\_\_:
•1. Periodontal Biotype and 
attached Gingiva
•2. The impact of tooth brushing
•3. The impact of cervical 
restorative margins
•4. The impact of orthodontics
•5. Other conditions

Answer 20

Mucogingival defects

• Ging recession
• Inadequate zone of keratinized gingiva

Question 21

Recession Type (RT)  \_\_\_\_\_
Gingival Recession with No 
loss of interproximal 
attachment. Interproximal 
CEJ was not detected either 
on the mesial or distal aspect 
of the tooth. 
Cairo F, Pagliaro U, Nieri M. Treatment of gingival recession with

Answer 21

RT 1

Question 22

Recession Type (RT) ____‐Gingival recession associated with loss
of interproximal attachment. The amount of interproximal
attachment loss was less or equal to the buccal attachment
loss.

Answer 22

RT 2

Question 23

Recession Type (RT) ____‐Gingival recession with the loss of interproximal
attachment. Interproximal attachment loss is greater than the buccal
attachment loss.

Answer 23

RT 3

Question 24

If recession is left untreated, what usually occurs?

Answer 24

Increased recession along with new sites of recession