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BDS4 Periodontology > Acute Periodontal Conditions > Flashcards

Acute Periodontal Conditions Flashcards

1
Q

What are the 3 categories of endo-periodontal lesions with root damage?

A
  • root fracture or cracking
  • root canal or pulp chamber perforation
  • external root resorption
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2
Q

What are the 3 grades of endo-periodontal lesions without lesions in periodontitis patients?

A
  • grade 1
    • narrow deep pocket in 1 tooth surface
  • grade 2
    • wide deep pocket in 1 tooth surface
  • grade 3
    - deep pockets in more than 1 tooth surface
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3
Q

What are the 3 grades of eddo-periodontal lesions without root damage in non-periodontitis patients?

A
  • grade 1
    • narrow deep pocket in 1 tooth surface
  • grade 2
    • wide deep pocket in 1 tooth surface
  • grade 3
    • deep pockets in more than 1 tooth surface
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4
Q

What symptoms may lead a patient to present with a periodontal emergency?

A
  • swelling of the gum/abscess
  • pain
  • pus
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5
Q

What can be used to differentiate between a periodontal abscess and a periapical abscess?

A
  • location of the abscess
    • gingival margin is likely periodontal
    • apex is likely periapical
  • vitality testing
    • periapical more likely to be non-vital
  • periapical radiograph
    • look for periapical radiolucency
  • pocket depth
    • identify calculus presence
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6
Q

Why is it important to differentiate between a periapical and periodontal abscess?

A
  • treatment is different
    • periapcial
      • RCT
      • XLA
    • periodontal
      • drainage through pocket or incision
      • debridement of pocket
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7
Q

How does necrotising gingivitis/periodontitis present clinically?

A
  • ulcerated necrotic papillae
  • white/yellow slough
  • punched out appearance of papillae
  • marginal erythema
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8
Q

What are the symptoms of necrotising gingivitis/periodontitis?

A
  • bleeding gingiva
    • especially on bleeding and brushing
  • pain
    • extremely sore
    • particularly painful on touching
  • bad taste in mouth
  • halitosis
  • systemic symptoms
    • not common
      • fever
      • malaise
      • lymphadenopathy
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9
Q

What special tests can be carried out for necrotising gingivitis/periodontitis?

A
  • diagnosis based on symptoms
  • radiograph to determine attachment loss
    • aim is initially to relieve symptoms
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10
Q

What are the causative agents of necrotising gingivitis/periodontitis?

A
  • commensal organisms
    • opportunistic infection
  • spirochetes and fusiform bacteria
    • anaerobes
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11
Q

What are the underlying risk factors for necrotising gingivitis/periodontitis?

A
  • immunosuppressed/immunocompromised
    • HIV/AIDS
      • historical
      • excellent diagnosis and treatment
    • chemotherapy/transplant patients
      • anti-rejection medication
  • psychological stress
  • insufficient sleep
  • malnutrition
    • especially developing countries
  • inadequate oral hygiene
    • pre-existing gingivitis
  • smoking, alcohol and poor diet
    • generally poor lifestyle choices
    • push immune system to limits
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12
Q

What treatment can be carried out for necrotising gingivitis/periodontitis?

A
  • superficial debridement
    • remove soft and mineralised deposits
      • ultrasonic scaler
    • remove necrotic tissue and bacteria
    • carried out under local anaesthetic
  • mouthwashes
    • 0.2% chlorhexidine mouthwash
      • twice daily
    • 3% hydrogen peroxide
      • diluted 1:1 with warm water
  • if no improvement or systemic symptoms
    • metronidazole
      • 400mg 3x daily for 3 days
      • good for anaerobes
  • review
    • a couple of days after treatment
  • enforce strict oral hygiene
    • regular oral hygiene
      • PMPR
  • advice on general health
    • smoking
    • diet
    • exercise
  • treatment of gingival recession
    • treated surgically
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13
Q

How does chemical injury to the gingival appear after contact with 37% phosphoric acid?

A

red erythematous border with white areas of necrotic tissue

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14
Q

What are the symptoms of a chemical burn?

A
  • pain
    • restricted to affected area
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15
Q

How can a chemical burn to the gingival be diagnosed?

A
  • thorough history
  • no special tests
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16
Q

What are the possible causative agents of chemical burns?

A
  • medications
  • dental matrerials
17
Q

What does the treatment of a chemical burn to the gingival involve?

A
  • analgesics
  • removal of cause
  • monitor wound healing
  • treatment of gingival recession likely
18
Q

How does primary herpetic gingival stomatitis present clinically?

A
  • diffuse erythema of the gingival
    • extends beyond gingival margin
  • shiny, glazed appearance
  • thinning of epithelium
19
Q

What are the symptoms of primary herpetic gingival stomatitis?

A
  • bleeding
  • pain
    • extreme
    • vesicles burst throughout mouth
      • mucosa, tongue, palate, etc.
    • affects eating, talking, drinking
  • halitosis
  • systemic symptoms
    • lymphadenopathy
    • fever
20
Q

What special tests could be used to diagnose primary herpetic gingival stomatitis?

A
  • mouth rinse
  • swab
21
Q

What are the causative agents involved in primary herpetic gingival stomatitis?

A
  • herpes virus
22
Q

What are the treatment options for primary herpetic gingival stomatitis?

A
  • not many treatment options
    • bed rest
    • soft diet
    • hydration
    • wait for healing
  • systemic symptoms
    • acyclovir
  • no dental treatment carried out
    • highly infectious
    • avoid AGP procedures
23
Q

How does recurrent herpetic gingival stomatitis present clinically?

A
  • multiple round red lesions
    • 1mm diameter each
    • broken vesicles
24
Q

What are the symptoms of recurrent herpetic gingival stomatitis?

A
  • pain, tingling, burning
    • reduced from primary episode
    • affects one branch
  • headache
  • systemic symptoms
    • fever
    • lymphadenopathy
25
Q

What special tests can be used to aid the diagnosis of recurrent herpetic gingival stomatitis?

A

swabs

26
Q

What causative agents are involved in recurrent herpetic gingival stomatitis?

A
  • herpes virus
  • reduced immune system
27
Q

What are the underlying risk factors for recurrent herpetic gingival stomatitis?

A
  • immunosuppressed/immunocompromised
  • primary herpetic gingival stomatitis
28
Q

What treatment should be carried out for recurrent herpetic gingival stomatitis?

A
  • bed rest
  • hydration and soft diet
  • chlorhexidine 0.2% mouthrinse
  • acyclovir for immunocompromised children
29
Q

How can leukaemia present clinically intra-orally?

A
  • rolled erythematous gingival margin
    • gingiva infiltrated with immune cells
30
Q

What are the oral symptoms a patient with leukaemia might present with?

A
  • tenderness
    • not severe
  • bleeding
  • gingival oedema
  • systemic symptoms
    • fever
    • lymphadenopathy
31
Q

What special tests may be used to aid in a diagnosis of a patient presenting with oral symptoms of leukaemia?

A
  • thorough history
    • rule out other cause
    • determine time scales
  • blood tests
  • tactile sensation of tissue
    • very puffy and soft
    • can be squashed with probe
32
Q

What are the underlying risk factors for leukaemia?

A
  • no local risk factors
    • systemic disease
  • genetic
33
Q

What treatment should be carried out for patients presenting with oral symptoms of leukaemia?

A

urgent GP referral

34
Q

How does desquamative gingivitis/periodontitis present?

A

peeling of the mucosa

35
Q

How does drug induced hyperplasia occur and how does it feel clinically?

A
  • associated with plaque accumulation
    • drugs induce fibrocytes
  • feels hard to probe

BDS4 Periodontology (3 decks)

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