Acute periodontal conditions Flashcards
List 4 examples of acute periodontal conditions
- Abscesses
- Endo-perio lesions
- Necrotising diseases
- Trauma
What are acute periodontal diseases?
Clinical conditions of rapid onset that involve the periodontium and may be characterized by pain, discomfort or infection. They may or may not be related to gingivitis and periodontitis. May be localised or generalised, with possible systemic manifestations.
Four types of absenses which involve the periodontium
- Gingival
- Periodontal
- Pericoronal
- Endodontic (periapical)
Aetiology, Special tests, and tx of gingival abscess
- Caused by foreign body
- Radiographs and special tests
- Remove aetiological agent, debride and irrigate
What would you include in a differential diagnosis of a periodontal abscess
- Gingival abscess
- Periodontal abscess
- Vertical root fracture
Tx of periodontal abscess:
- Drainage and debridement
- Extraction (if prognosis is hopeless)
- If systemic involvement - antibiotics
- Ongoing periodontal management
- Biopsy if non resolving.
In peri-coronal abscesses what acts are the reservoir for food and plaque
The operculum
Presentation of peri-coronal abscess:
- Pain
- Swelling
- Trismus
- Purulent exudate
- Airway compromise
Tx for peri-coronal abscess
- Drain and debridge
- Occlusal adjustment
- Systemic antibiotics if needed
- Maintain airways
- Operculectomy
- Exo of tooth/opposing tooth
- Will recur if the tooth position unchanged
Presentation of a periapical abscess:
- Pain, TTP
- Non vital tooth
- Swelling, draining sinus
Tx for periapical abscess
- Relief of pain
- Drainage
- RCT or Exo
Which is more common:
A) Primary endo/secondary perio
B) Primary perio/secondary endo
C) True combined lesion
A) Primary endo/Secondary perio
B is rare anc C is very rare.
In endo-perio lesions, what do you do first?
RCT first, then perio tx if required.
Aetiology of necrotizing diseases:
- Psychological stress
- Smoking
- Malnutrition
- Inadequate oral hygiene
- HIV/AIDS/Immunosuppression
Baterira involved in necrotising diseases
Fusoform and spirochetes
Cliniceal features of necrotizing disease
- Confined to gingival tissue
- Punched out papillae
- Yellow-white slough
- Spontaneous bleeding/pain
ANUG tx
First visit - manage predisposing factors, debride under LA, chlorhex, Hydrogen peroxide, metronidazole
Second visit - 2 days later reevaluate and debride
Third visit - 5-7 days debridge, tx for chronic conditions
Reevaluate a month later
What is the difference between ANUG and ANUP
ANUP extends beyond the gingival margin with loss of attachment and crestal bone exposure. Increased pain and salivation and sub-mandibular lymphadenopathy.
How does ANUP tx differ from ANUG tx
May need surgical reconditioning following acute phase debridement
Describe ANUS
Large areas of osteitis/oral-antral fistulae, very painful. Uncommon. Found in people with severe systemic compromise and malnutrition.
List 3 types of acute periodontal conditions of non-bacterial origin
- Viral - HSV, VZV, Coxsackie
- Fungal (candida)
- Hypersensitivity reaction
- Trauma
Name three viruses which may present in the oral mucosa with vesicles
- HSV-1
- VZV
- Coxsackie
IF systemic antibiotics are indicated for aggressive periodontitis, wohat would you precribe
Amoxicillin and Metronidazole combination therapy
What antibiotic is prescribed for ANUG
MEtronidazole
