chapter 4 perio Flashcards

1
Q

chronic hyperplastic gingivitis underlying path processes

A

enlargement from edema or fibrosis

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2
Q

bacteria in NUG

A

Fusobacterium nucleatum, Prevotella intermedia, Porphyromonas gingivalis, Treponema spp, Selenomonas spp

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3
Q

NUG breakthrough to skin

A

noma

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4
Q

localized aggressive perio affected teeth

A

1 molars and incisors; max 2 other teeth

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5
Q

severe perio dz and palmoplantar keratosis – dzz, genetics

A

Papillon Lefevre – severe perio; cathepsin C on chr 11

Haim Munk less severe peio but also more severe skin infx and skeletal abnormalitis; genetics same

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6
Q

cathepsin C

A

chr 11
haim munk (skin + skel) and papillon lefevre (perio more severe)
both palmoplantar keratosis

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7
Q

related to haim munk/papillon lefevre but only skin changes with no oral findings

A

Unna-Thost syndrome and Meleda disease

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8
Q

Unna Thost

A

related to haim munk/papillon lefevre but only skin changes with no oral findings

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9
Q

Meleda dz

A

related to haim munk/papillon lefevre but only skin changes with no oral findings

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10
Q

Haim Munk vs Papillon Lefevre

A

both – perio dz and palmoplantar keratosis
Cathepsin C, chrom 11

PL – severe perio
HM – also skin infx and skel abnorm, perio milder tho

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11
Q

age of increased susc to gingivitis

A

9-14yo (puberty)

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12
Q

gingivitis of only free ging margins

A

marginal gingivitis

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13
Q

gingivitis only interdental papilla

A

papillary

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14
Q

NUG underlying pathologic processes

A

decreased neutrophilic chemotaxis and phagocytic response

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15
Q

abx for NUG

A

penicillin and metronidazole

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16
Q

NUG –> NUP

A

loss of attachment

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17
Q

NUP –> NUM/NUS

A

(mucositis/stomatitis) – spread to soft tissue

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18
Q

NUM –> noma

A

sptread to skin

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19
Q

NUG NUP NUM NOMA spectrum?

A

necrotizing gingivostomatitis

20
Q

what to rule out for granulomatous gingivitis

A

foreign body, infx, crohns, sarcoid, wegeners

21
Q

foreign body gingivitis vs lichen planus

A

single lesion and no migration

22
Q

histology foreign body gingivitis

A

80% lichenoid or mixed inflammation

20% granulomatous

23
Q

drug related gingival hyperplasia drugs and prevalences

A

phenytoin (~50%), nifedipine (CCB), cyclosporine (~25%)
all affect Ca remodeling (reduce Ca influx)

also erythromycin and verapamil

24
Q

drug related gingival hyperplasia drugs and ages

A

phenytoin (<25yo), nifedipine (older), cyclosporine (broad range)

25
Q

pts w GVHD on cyclosporine gingiva

A

hyperplasia and PG-like soft tissue growth

26
Q

location for juvenile spongiotic gingival hyperplasia

A

almost all on anterior gingiva

81% maxillary

27
Q

familial gingival fibromatosis concurrent findings

A

hypertrichosis, periodontitis, epilepsy, mental retardation, deafness, hypothyroidism, GH deficinecy

28
Q

syndromes with gingival fibromatosis

A

can be isolated

syndromes: Zimmermann-Laband, Murray-Puretic-Drescher, Rutherfurd, Cowden, Cross, Ramon, Jones, and prune belly)

29
Q

GINGF mutations

A

1, 2, 3 mutations chromosome 2 and 5

30
Q

SOS1 locus

A

GINGF

31
Q

Ramon sybdrome components

A

mental and grwoth retardation, fibrous duspalsia, cherubism, and gingival fibromatosis

32
Q

Jones syndrome components

A

gingival fibromatosis + sensorineural hearing loss

33
Q

gingival fibromatosis + sensorineural hearing loss

A

Jones syndrome

34
Q

mental and grwoth retardation, fibrous duspalsia, cherubism, and gingival fibromatosis

A

Ramon sybdrome

35
Q

1, 2, 3 mutations chromosome 2 and 5

A

GINGF

36
Q

risks for chronic periodontitis

A

50% genetics, 20% tobacco, 20% specific bacteria

37
Q

risk factors for periodontal abscess

A

closure of pocket entrance, furcation invovlement, enamel pearls, dens invaginatus, and diabetes

38
Q

risk factors pericoronitis

A

stress, tonsillitis, pharyngitis

can give rise to localized NUG like necrosis

39
Q

aggressive periodontitis what’s up

A

neutrophil dysfx (deficiency in immune response)
not assoc w systemic dz
no systemic manifestations

40
Q

localized vs generalized aggressive perio

A

localized more common
11-13yo; strong serum AB response, 1 molars and incisors + max 2 other teeth; little plaque, predom pathogen – AA

generalized: <30yo, poor serum AB response, 1st molars and incisors + 3 teeth; heavy plaque; more complex pathogens

41
Q

cathepsin C mutation

A

chromosome 11
papillon lefevre
defect in neutrophil chemotactic and impaired B/T activity

42
Q

focal palmopplantar and oral mucosa hyperjeratosis syndrome related to

A

papillon lefevre

no perio dz

43
Q

NUG ddx

A

agranulocytosis and gonorrhea (latter no odor)

44
Q

age for gingival fibroamtosis

A

<20yo

45
Q

additional clinical with gingival fibromatosis

A

Hypertrichosis / Gen.Aggressive periodontitis / Epilepsy / Hypothyroidism / deafness /
intellectually disabled

46
Q

serum aggressive perio

A

generalized – poor

localized – robust

47
Q

papillon lefevre inheritance

A

AR – 1/3 consanguinity