ACUTE PERIODONTAL CONDITIONS INCLUDING THE LATERAL PERIODONTAL ABCESS

Question 1

plaque related gingivitus

Answer 1

plaque between teeth
gums sweollen
good OH and scale should resolve in 7days

Question 2

gingival abscess

Answer 2

only involved in gingival tissue full of pus

infected gingival tissues

Question 3

herpes

Answer 3

viral infection 
painful 
red
self limiting 
cold fluid soothing

Question 4

acute herpetic gingivostomatitis

Answer 4

herpes simplex virus 1
highly contagious

sore painful mouth 
vesicles which rupture
ulcers
malaise
lymphadenopathy

Question 5

tx for acute herpetic gingivstomatitis

Answer 5

supportive and symptomatic
fluid intake/cold drinsk
analgesics
anti pyretics
topical antiseptics 5% lignocaine m/w
naturally self limiting
highly infectious

Question 6

complications of acute herpetic gingvostomatitis

Answer 6

herpetic whitlow
herpetic lesion in eye
herpetic satellite lesions
herpetic encephalomeningitus

Question 7

reactivation of herpes virus

Answer 7

primary illness leads to infection trigeminal ganglion

likely to reoccur as herpes labialise

Question 8

HIV associated gingvitus

Answer 8

red bandings around necks of gingivae

Question 9

acute candida gingivitus

Answer 9

superinfection of candela albicans
candida can be rubbed off will leave red patch
under
- can be seen in those tho finished course of broad spectrum antibiotic

Question 10

acute allergic gingivitis types

Answer 10

following systemic adminstrio of drug

direct contact with mouth eg MW

Question 11

acute allergic gingivitis clinically

Answer 11

red shiny gingiva
oedema
loss stippling

Question 12

acute periodontal disorders

Answer 12

traumatic

necrotising

Question 13

clinical nectorising PD signs

Answer 13

lack papilla 
inflamed sore bleeding
bone loss
ulceration (w yellow/grey slough)
necrosis of gingival margin
pain 
halitosis

Question 14

aetiology necrotising PD

Answer 14

opportunistic infection by anaerobes
fuso spirocheta complex
predisposing factors
- compromised immune, defence system 
smoking
stress 
poor OH

Question 15

what is a periodontal abcesss

Answer 15

collection of puss in the connective tissue wall of a periodontal pocket
fluctuant swelling
need to be differentiated from periapical abcess/infections (those are associated with necrotic tooth at apex of root)

Question 16

signs and symptoms of periodontal abcess

Answer 16

pain
swollen tissues, small localised enlargement
red or red/blue
affected tooth tender to bite and TTP
mobile tooth and high in occlusion
perio probing usually reveals presence of deep pocket
can be evidence of a sinus tract draining abcess

Question 17

aetiology of periodontal abcess

Answer 17

deep perio pocket with active inflammation and micro unlceration
- entry of microorganisms through pocket lining into CT produces abcess
blockage trauam
reduction of host repsonce

Question 18

periapical vs periodontal abscess

Answer 18

periodontal
- periodontal disease
deep pocket
vital tooth 
pus in pocket
tooth may be extruded

Periapical
- non vital
acute TTP
pus in tissues
tooth may be extruded
radiograph may show apical change
radiograph may show cavity/resto near pilp

Question 19

,management of periodontal abcess

Answer 19

extraction or retain

Question 20

if retaining tooth following abcess

Answer 20

drain if fluctuant
topical or local anaesthetic
PMPR if not fluctuant, aim for drainage through pocket
hot salt MW

Antibiotics if systemic involedment
amoxicillin 5 days (with or without metronidazole)
azithromycin 3 days