DIAGNOSIS & TREATMENT OF NECROTISING PERIO DISEASES

Question 1

What are the main features of necrotising periodontal disease?

Answer 1

• pain
• extreme bleeding gums
• ulceration of gingivae
• necrosis of interdental papilla

Question 2

what is necrotising stomatitis?

Answer 2

necrosis progresses to deeper tissues beyond the mucogingival line
- lip
- check mucosa
- tongue
etc

Question 3

What can cause necrotising stomatitis?

Answer 3

Malnutrition and HIV infection

Question 4

What can necrotising stomatitis lead to?

Answer 4

Denudation of the bone leading to:
- osteitis
- oro antral fistulas

Question 5

What are the symptoms of necrotising gingivitis?

Answer 5

• ulcerated & necrotic papillae and gingival margin (punched out appearance)
• sloughthing over the top of gingivae
• extreme pain
• bleeding readily provoked

Question 6

What are the symptoms of necrotising periodontitis?

Answer 6

Same as necrotising gingivitis BUT
- deep pocket formation
- loss of alveolar bone
- adenopathy
- MAYBE fever

Question 7

What are risk factors for development of necrotising periodontal disease?

Answer 7

• psychological stress
• sleep deprivation
• poor OH
• smoking!!!!
• immunosuppression (HIV/leukaemia etc)
• malnutrition

Question 8

How should acute necrotising periodontal disease be treated?

Answer 8

• superficial debridement of deposits
• mechanical oral hygiene should be limited to prevent impaired healing of wounds
• chlorohexidine mouthwash twice daily
• prescribe antibiotics

Question 9

What antibiotic is typically prescribed for patients with acute necrotising periodontal disease?

Answer 9

Metronidazole
- 400mg 3 times daily for 3 days

Question 10

How should pre-existing necrotising periodontal disease be treated/managed once acute phase has been stabilised?

Answer 10

• professional prophylaxis
• scaling/root planing
• OHI
• assess systemic risk factors = smoking cessation, stress reduction, dietary advice

Question 11

What aesthetic consequence can occur as a result of necrotising periodontal disease? how can this be managed?

Answer 11

Gingival craters
- gingivectomy
- gingivoplasty
- periodontal flap surgery

Question 12

The occurrence of necrotising periodontal disease in systemically healthy individuals without any predisposing factors may be suggestive of what…

Answer 12

HIV infection