Chapter 6: Periodontal Disease and Conditions

Question 1

What are two common local contributory factors that can cause plaque-inducated gingival enlargement?

Answer 1

Mouth Breathing

Orthodontic appliances

Question 2

What are three common types of drugs that can cause drug influenced gingival enlargment?

Answer 2

Phenytoin (Dilantin, anti-epileptic)
Cyclosporin (Innunosuppressant)
Calcium channel blockers (diltiazem, nifedipine, amlodipine)

Question 3

This is a painless localized gingival enlargment that can be a blue-red color and occurs in pregnancy.

Answer 3

Pyogenic granuloma (Granuloma Gravidarum specifically)

Question 4

• This type of gingivitis has a rapid onset that is very painful and can lead to inter-proximal and marginal necrosis and ulceration of ginigiva. It can progress to necrotizing ulcerative periodontitis in immunocompromised individuals.
• Peak incidence in late teens and 20s in developed countries.
• Common in young children in less developed countries

Answer 4

Acute Necrotizing Ulcerative Gingivitis (ANUG)

Dental Managment

• Local debridement
• NSAIDs for pain
• Penicillin or metronidazole for systemic involvement.

Question 5

This vitamin deficiency can cause edematous, spongy gingiva that can spontaneously bleed and have impaired wound healing.

Answer 5

Vitamine C-Deficiency

Question 6

About what percentage of adults are significantly affected by chronic periodontitis?

Answer 6

About 50%!!

Question 7

What percentage of 14-17 year-olds have attachment loss of at least 2 mm in one or more sites?

Answer 7

About 20%

Question 8

Chronic periodontitis is a polymicrobial infection. What bacteria is strongly associated with chronic perio?

Answer 8

Porpharomonas Gingivalis.

Question 9

What is the primary host defense mechanism to chronic periodontitis?

Answer 9

Neutrophils

-Host inflammatory response contributes to disease process.

Question 10

Previously known as prepubertal periodontitis, this type of perio can cause attachment loss and bone loss around some primary teeth (most commonly primary molars) and has a prevalence of less than 1%

Answer 10

Localized Aggressive Periodontitis (LAgP)

Question 11

What are three suggested etiologic factors for localized aggressive periodontitis?

Answer 11

1. Leukocyte chemotactic defect
2. Cementum defect
3. Actinobacillus actinomycetemcomitans (usually)

Question 12

Scaling and root planing followed by systemic antibiotics after completion of mechanical therapy is suggested treatment of LAgP. What are the recommended antibiotics and their duration of use?

Answer 12

-Amoxicillin and metronidazole for 7-10 days
or
-Azithromycin for 3-5 days.

Question 13

What are common dental features of hypophosphatasia?

Answer 13

• Early loss of primary teeth (May be the first clinical sign in mild forms)
• Abnormal cementum formation (which leads to the early loss of primary teeth)
• Teeth are can be lost in order of eruption
• Most likely to affect primary incisors
• Pulp chambers may be abnormally large

Question 14

What is the etiology for hypophosphatasia?

Answer 14

Deficient or defective tissue non-specific alkaline phosphatase (TNSALP)

Question 15

How can hypophosphatasia diagnosed?

Answer 15

Checking serum alkaline phosphatase levels. (Which will be low)
Checking serum pyridoxal phosphate levels (Which will be elevated)
Checking phosphoethanolamine levels in the urine. (Which will be high)