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Periodontology BDS3 > Diagnosis and Treatment of Necrotising Periodontal Diseases > Flashcards

Diagnosis and Treatment of Necrotising Periodontal Diseases Flashcards

1
Q

what causes necrotising periodontal diseases

A

plaque bacteria

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2
Q

what are the characteristics of NPD

A

rapidly destructive and debilitating
shared predisposing factors - under stress
opportunistic infection

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3
Q

what are the main features of NPD

A

painful, bleeding gums and ulceration and necrosis of interdental papilla - punched out appearance

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4
Q

what is necrotising gingivitis

A

when only gingival tissues infected

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5
Q

what is necrotising periodontitis

A

when necrosis progresses into PDL and alveolar bone leading to attachment loss

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6
Q

what is necrotising stomatitis

A

necrosis progresses into deeper tissues beyond mucogingival line including lip or cheek mucosa and tongue

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7
Q

who does necrotising stomatitis usually occur in

A

malnutrition or HIV infected peopled

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8
Q

what does necrotising stomatitis result in

A

denudation of bone leading to osteitis and oral antral fistula

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9
Q

what is cancrum oris

A

necrotising and destructive infection of mouth and face occurring in malnourished children

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10
Q

what is vincents angina

A

disease of throat

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11
Q

how do you diagnose between different necrotising diseases

A

based on symptoms

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12
Q

what does the gingiva look like in necrotising gingivitis

A

ulcerated and necrotic papillae and gingival margin resulting in a characteristic punched out appearance

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13
Q

what are the ulcers covered with

A

slime made of fibrin, necrotic tissue, leucocytes, erythrocytes and mass of bacteria

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14
Q

what are the symptoms of necrotising gingivitis

A

ulcerated papilla covered in slime
quick developing lesions which are painful
bleed if provoked
first lesions interproximally in mandibular anterior region

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15
Q

what are the symptoms of necrotising periodontitis

A

ulcers with deep pockets
ulcers which develop into craters due to central necrosis
adenopathies in severe cases
fever and feeling of discomfort

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16
Q

why is diagnosis not based on bacterial tests

A

as spirochetas and fusobacterias are not always found in the primary lesion

17
Q

what do you need to differentiate between when deciding if a patient has NPD

A

oral mucositis
HIV associate periodontitis
HSV
scurvy
gingivostomatitis
desquamative gingivitis
invasive fungal disease
illicit drug related gingival disease
agranulocytosis
leukaemia
chronic periodontitis

18
Q

what is herpetic gingivostomatitis caused by

A

HSV

19
Q

who does herpetic gingivostomatitis affect

A

children

20
Q

what area in the mouth does herpetic gingivostomatitis affect

A

gingiva and entire oral mucosa

21
Q

what is the symptoms of herpetic gingivostomatitis

A

multiple vesicles which disrupt, leaving small round fibrin covered ulcerations

22
Q

what are the risk factors for NPD

A

stress, sleep deprivation, poor OH, smoking, immunosuppression
malnourished children - developing countries

23
Q

what are the 2 objectives of treatment

A

arrest disease process and tissue destruction
control patients general feeling of discomfort and pain interfering with nutrition and OH

24
Q

what is treatment of NPD

A

superficial debridement to remove deposits daily for as long as acute phase lasts (2-4 days)

25
Q

what should the patient not do during NPD treatment and what should they do instead

A

no mechanical oral hygiene
use chlorhexidine mouthwash instead

26
Q

why should the patient not use mechanical oral hygiene during NPD treatment

A

it can disrupt healing process after debridement

27
Q

what should you prescribe if patient shows unsatisfactory response to debridement or shows systemic effects

A

metronidazole
400mg
three times daily
3 days

28
Q

why are locally delivered antimicrobials not recommended in NPD

A

large numbers of bacteria present within tissues where local drug will not be able to achieve adequate concentrations

29
Q

how often should you be seeing NPD patients

A

every day

30
Q

what do you do once you have treated the acute phase of the disease

A

treat the pre-existing condition (gingivitis/periodontitis)
control systemic predisposing factors

31
Q

why should correction of gingival anatomy be considered

A

plaque accumulation can occur in the craters

32
Q

what are the options for corrective treatment of the disease

A

gingivectomy/gingivoplasty procedures
periodontal flap surgery
regenerative surgery

33
Q

what is the goal during supportive or maintenance phases

A

compliance with oral hygiene practices and control of predisposing factors

34
Q

what should the patient be screened for if they have NPD and why

A

HIV as they might not be aware of their condition

Periodontology BDS3 (7 decks)

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