Diagnosis and Treatment of Necrotising Periodontal Diseases Flashcards
what causes necrotising periodontal diseases
plaque bacteria
what are the characteristics of NPD
rapidly destructive and debilitating
shared predisposing factors - under stress
opportunistic infection
what are the main features of NPD
painful, bleeding gums and ulceration and necrosis of interdental papilla - punched out appearance
what is necrotising gingivitis
when only gingival tissues infected
what is necrotising periodontitis
when necrosis progresses into PDL and alveolar bone leading to attachment loss
what is necrotising stomatitis
necrosis progresses into deeper tissues beyond mucogingival line including lip or cheek mucosa and tongue
who does necrotising stomatitis usually occur in
malnutrition or HIV infected peopled
what does necrotising stomatitis result in
denudation of bone leading to osteitis and oral antral fistula
what is cancrum oris
necrotising and destructive infection of mouth and face occurring in malnourished children
what is vincents angina
disease of throat
how do you diagnose between different necrotising diseases
based on symptoms
what does the gingiva look like in necrotising gingivitis
ulcerated and necrotic papillae and gingival margin resulting in a characteristic punched out appearance
what are the ulcers covered with
slime made of fibrin, necrotic tissue, leucocytes, erythrocytes and mass of bacteria
what are the symptoms of necrotising gingivitis
ulcerated papilla covered in slime
quick developing lesions which are painful
bleed if provoked
first lesions interproximally in mandibular anterior region
what are the symptoms of necrotising periodontitis
ulcers with deep pockets
ulcers which develop into craters due to central necrosis
adenopathies in severe cases
fever and feeling of discomfort
why is diagnosis not based on bacterial tests
as spirochetas and fusobacterias are not always found in the primary lesion
what do you need to differentiate between when deciding if a patient has NPD
oral mucositis
HIV associate periodontitis
HSV
scurvy
gingivostomatitis
desquamative gingivitis
invasive fungal disease
illicit drug related gingival disease
agranulocytosis
leukaemia
chronic periodontitis
what is herpetic gingivostomatitis caused by
HSV
who does herpetic gingivostomatitis affect
children
what area in the mouth does herpetic gingivostomatitis affect
gingiva and entire oral mucosa
what is the symptoms of herpetic gingivostomatitis
multiple vesicles which disrupt, leaving small round fibrin covered ulcerations
what are the risk factors for NPD
stress, sleep deprivation, poor OH, smoking, immunosuppression
malnourished children - developing countries
what are the 2 objectives of treatment
arrest disease process and tissue destruction
control patients general feeling of discomfort and pain interfering with nutrition and OH
what is treatment of NPD
superficial debridement to remove deposits daily for as long as acute phase lasts (2-4 days)
