Chapter 4 -- Periodontal Disease Flashcards
Gingivitis
Inflammation limited to the soft tissue that surround the teeth
Cuases of Gingivitis
Plaque
Necrotizing ulcerative gingivitis
Medication
Allergy
Specific infections (HSV, HIV)
Dematosis – conditions affecting skin, hair, nails and glands
Plaque Related Gingivitis
Lack of proper oral hygiene
Plaque related gingivits SYSTEMIC FACTORS
Hormones
stress
substance abuse
Medications
Diabetes
Down Syndrome
Plaque Related LOCAL FACTORS
Trauma
Tooth crowding
Caries
Iatrogenic factors
Necrotizing Ulcerative Gingivitis
Associated with specific bacteria
Occurs in the presence of psychological stress
“Trench Mouth” –> Fould odor
Immune suppression (AIDS, infectious mononucleosis)
Blunted papillae – punched out
Gray pseudomembrane
Plasma Cell Gingivitis
Related to hypersentivity
Rapid onset of sore mouth
Allergic Reaction - (big red chewing gum)
Cinnamon aldehyde
May appear white – thicker tissue reaction
Plasma cells aggregate (eosinophils)
Necrotizing Gingivitis Bacteria (5)
Fusobacterium nucleatum
Prevotella intermedia
Porphyromonas gingivalis
Treponema spp
Selenomonas spp
Localized juvenile spongiotic gingival hyperplasia – WRIGHT’s Lesion
Idiopathic
Sulcular epithelium proliferation – grows out of th sulcus
Small bright red - due to blood vessels of sulcular epithelium
Velvety or papilary alteration
Bleeds upon manipulation
Predilection –> Maxillary anterior facial gingiva
Vast majority occur under 20 (age 12)
Treatment: Biopsy, excise
Desquamative Gingivits
Gingival epithelium that spontanesouly sloughs or can be removed with minor manipulation
Clinical diagnosis – no a pathological diagnosis
BIOPSY required
Desquamative Gingivitis Differentials (5)
Lichen Planus
Mucous membrane pemphigoid
Pemphigus vulgaris
Systemic lupus erythematosis
Hypersensitivity
Drug related Gingival Hyperplasia
Abnormal growth of gingival tissue - secondary to use of sysemtic medication
3 medications that contibute to Drug-related gingival hyperplasia
Cyclosporin (transplant therapy - antirejection medication)
Phenytoin (anticonvulsant)
Nifedipine (calcium channel blocker)
Cyclosporin
Transplant therapy
occurs in 25%
Phenytoin
Anticonvulsant
Gingival hyperplasia
50%
MOST COMMON
Nifedipine
Calcium channel blocker
Gingival hyperplasia
25% of people
Gingival Fibromatosis
SLOWLY progressive gingival enlargment
Caused by a collagenous overgrowth of gingival fibrous connective tissue
Familial or idopathic
Other common findings:
* Hypertrichosis
* Generalized aggressive periodontitis
* Epilepsy
* Mental retardation
* Growth hormone deficiency
Other findings of gingival fibromatosis: (5)
Hypertrichosis
Generalized aggressive periodontitis
Epilepsy
Mental retardation
Growth hormone deficiency
Clinical Problems of Gingival Fibromatosis
Poor esthetics
Retention of deciduous teeth
Malocclusion
Inadequate lip closure
Difficulty eating and speaking
Periodontitis
Inflammation of the gingival tissues
Loss of PDL and bony support
Chronic periodontitis
Advanced age
Smoking
Diabetes
Osteoporosis
HIV infection
Lower socioeconomic level
Periocornitis
Inflammatory process arises within the tissues
Surrounding a crown of a partially erupted tooth
MANDIBULAR 3rd molars
Papillon- Lefever Syndrome
Autosomal recessive
Loss of Cathepsin C gene (chromosome 11)
Oral and dermatologic manifestations
Accelerated periodontitis – defect in neutrophil function
Teeth floating in air - RADIOGRAPHICALLY
Actionbacillus actinomycetemcoitans
Palmar Plantar keratosis – tylosis
