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

Diagnosis and Treatment of Necrotising Periodontal Diseases Flashcards

1
Q

what are characteristics of necrotising periodontal diseases

A

rapidly destructive
painful, bleeding gyms and ulceration and necrosis of interdental papilla

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2
Q

what type of disease is NPD

A

opportunistic infection - bacteria inhabiting a healthy oral cavity

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3
Q

what are the classifications of NPD

A

necrotising gingivitis
necrotising periodontitis
necrotising stomatitis

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4
Q

what is necrotising gingivitis

A

constricted to soft tissue and gingiva
clinical attachment loss is not present
bone is not involved

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5
Q

what is necrotising periodontitis

A

infection leads to loss of attachment and bone loss

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6
Q

what is necrotising stomatitis

A

the infection spreads to alveolar bone - leading to destruction of alveolar bone and can create OAFs

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7
Q

what is cancrum oris

A

necrotising and destructive infection of mouth and face
seen in malnourished children
disfiguring and can develop from NG

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8
Q

what are the old terms for NG and NP

A

ANUG - acute necrotising ulcerative gingivitis
ANUP - acute necrotising ulcerative periodontitis

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9
Q

how is necrotising diseases diagnosed

A

by symptoms

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10
Q

why are the diagnoses for necrotising diseases not based on tests

A

histopathology is not pathognomic
the bacteria taken from a biopsy or swab would just be normal bacteria

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11
Q

what symptoms would give a diagnosis of necrotising gingivitis

A

ulcerated and necrotic papilla
punched out appearance of papilla
ulcers are covered with yellow/ white/ grey slaim
lesions develop quickly and are very painful

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12
Q

what is the pseudomembrane in NG

A

yellow/ white/ grey slaim
there is no coherence, just accumulation of fibrin, necrotic tissue and bacteria

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13
Q

what are ulcerations in NP associated with

A

deep pocket formation

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14
Q

what do ulcers with central necrosis develop into in NP

A

craters

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15
Q

what does lack of a fever mean for diagnosis

A

it is not herpetic gingivostomatitis

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16
Q

what occurs in necrotising stomatitis

A

the bone destruction extends through the alveolar mucosa

17
Q

what is the difference between NP and herpetic gingivostomatitis

A

NP caused by bacteria, HG caused by herpes simplex virus
HG is mostly in children
NP is usually just in the interdental papilla and HG affects the entire oral mucosa

18
Q

since NPDs are opportunistic infections what are risk factors

A

developed countries - psychological stress, sleep deprivation, poor OH, smoking, immunosuppression

developing countries - malnourished children

19
Q

what is the two main objectives in treatment in the acute phase of NPDs

A

arrest the process and tissue destruction
control the patients general feeling of discomfort and pain

20
Q

what is the first phase of treatment for NPDs

A

superficial debridement - should be carried out daily for the whole of the acute phase (2-4 days)

21
Q

what is the second phase of treatment for NPDs

A

mechanical oral hygiene measures should be limited - because brushing directly in the wounds may impair healing and induce pain

22
Q

what should the patient be encouraged to use in the acute phase

A

chemical plaque control - chlorhexidine- based mouthwashes (0.2%) daily

23
Q

what treatment should be provided if no improvement is seen after the acute phase or if there is systemic involvement

A

prescribe antibiotics
metronidazole 400mg TID for 3 days

24
Q

why is diluted hydrogen peroxide solution and drugs like metronidazole more effective in treating NPDs

A

because of the anaerobic bacteria

25
Q

what should the patients be informed as their symptoms and signs improve

A

strict mechanical hygiene measures should be enforced
complete debridement of the lesions

26
Q

how should you treat the pre-existing conditions of NPDs

A

professional prophylaxis
root planing
scaling
OHI
improve local predisposing factors

27
Q

what are the major problems of NPDs

A

creation of craters which then plaque can accumulate in - consider flap surgery

28
Q

what should you check if a patient has NPD but has no local or systemic factors they are aware of that would be causing it

A

HIV

BDS3 Periodontology (5 decks)

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