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Oral Soft tissues > Exam 2 part 2 > Flashcards

Exam 2 part 2 Flashcards

1
Q

What are the bacteria involved in both NUG and NUP

A

P. intermedia, Spirochetes, Fusiformbacteria

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2
Q

What kind of tissue is involved in NUG

A

Involves both stratified squamous epithelium & underlying CT

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3
Q

Define NUG

A

Acute necrotizing inflammation of the gingival margin

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4
Q

Is NUG contagious?

A

No

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5
Q

What is another name for NUG and why was that made popular?

A

Trench mouth

1914 WWI, WWII

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6
Q

Age groups that NUG occurs in

A

Occurs in all ages but mainly 20-30

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7
Q

Visually what do you see in NUG

A

Forms Pseudomembrane

  • Replaces destroyed epithelium
  • Meshwork of fibrin, necrotic epithelial cells, PMN’s and various microorganisms
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8
Q

Clinical features of NUG

A
  1. Rapid onset
  2. Severe pain
  3. Gingival bleeding; may or may not be spontaneous
  4. Interdental Crater, punched put papilla, PSEUDOMEMBRANE, fetid (sulfur) breath
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9
Q

Etiology - Host Response of NUG

A 
Systemic predisposing factors
Immunosuppression - AIDS
Stress
Smoking
Diet
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10
Q

Etiology - Oral Hygiene of NUG

A

Pre-existing gingivitis

Opportunistic microorganisms

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11
Q

Main Etiology of NUG

A 
Microorganisms
  - P. intermedia, Spirochetes, Fusiformbacteria
Other Factors
  - Host resistance + smoking
  - Oral hygiene
  - Local irritants
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12
Q

In what zone is NUG of the Listgarten’s 4 zones

A

Zone 4: Zone of spirochetal infiltration

- Well-preserved tissue infiltrated with spirochetes

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13
Q

Describe the pseudomembrane feature of NUG

A

Replaces destroyed epithelium

Meshwork of fibrin, necrotic epithelial cells, PMN’s, and various microorganisms

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14
Q

Treatment of NUG

A
  • First visit - debridement, OHI
    • Evaluate systemic factors
  • Recall visit - 1-2 weeks, eval. OH, further tx
  • Final re-eval - 4-6 wks, consider surgery
  • If fever present give antibiotics first: Amoxicillin and Metronidazole
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15
Q

Extraoral and systemic signs and symptoms of NUG

A
  • Slight elevation in temperature
  • Local lymphadenopathy
  • Patients usually ambulatory with no systemic complications
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16
Q

What are the Listgarden’s 4 zones for NUG

A

Zone 1: Bacterial zone
- Superficial, contains bacteria
Zone 2: Neutrophil-rich Zone
- Numerous leukocytes, mostly PMN’s, bacteria, spirochetes
Zone 3: Necrotic Zone
- Dead cells, fibers, spirochetes, and other bacteria
Zone 4: Zone of spirochetal infiltration
- Well-preserved tissue infiltrated with spirochetes

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17
Q

What is NUP

A

Essentially that same as NUG, however there is bone loss involved in NUP

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18
Q

In what people can Primary herpes occur

A

In kids & Immunocompromised adults

- All races equally, both sexes

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19
Q

In what tissue does primary herpes occur?

A

Bound & Unbound tissue

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20
Q

Describe the 4 phases of clinical features of Herpes

A

Prodromal phase
Active phase
Latency
Reactivation

21
Q

Describe the clinical features of the prodromal phase of herpes

A

Fever
Irritability
Headache
Gingival Inflammation

22
Q

Describe the clinical features of the active phase of herpes

A

Vesicles rupture, yellow ulcers, red halo
Viral shedding (Ave. 12 days)
Mobile and Attached tissue
Heal in 7-14 days with no scarring

23
Q

Describe the clinical features of the latency phase of herpes

A

Virus resides in ganglia
Non-replicating state
Latency associated transcripts (LAT)

24
Q

Describe the clinical features of the reactivation of herpes

A 
Recurrent herpetic stomatitis
Spontaneous or stimuli related
Virus migrates
Herpes labialis (extra-oral)
Bound down tissue - Attached gingiva (Intra-oral)
Virus overwhelms local immune response
25
Q

What 4 things may be involved in virus activation

A

Sunlight
Trauma
Fever
Stress

26
Q

Describe herpetic whitlow

A

Recurrent infection
Fingers and hands
Latent site - dorsal root ganglion
Debilitating

27
Q

T or F, Primary Herpetic Gingivostomatitis is contagious

A

True

28
Q

Diagnosis of herpes includes

A

History and clinical findings
Tzanck smear
Serum antibody titer
ELISA or PCR

29
Q

T or F, If young adults contract primary herpes it is less severe than if they were children

A

False, More severe

30
Q

Treatment of primary herpes

A 
Supportive treatment
  - Bed rest, bland mouthwashes (alcohol free)
  - Force fluids, Antipyretics 
  - Lidocaine gel, CHX
Systemic medication
  - Valcyclovir, Vibaradine, Acyclovir
31
Q

Describe the periodontium in children or deciduous dentition

A

Pale pink
Firm
Either smooth or stippled (stippled in 35% of children between ages of 5-13)
Interdental gingiva is broad facio-lingually, and narrow mesiodistally

32
Q

Mean gingival sulcus depth in deciduous dentition

A

1mm

33
Q

Is PDL of deciduous teeth more narrow or wider than permanent teeth

A

Wider than that of permanent teeth

34
Q

Describe the trabeculae in alveolar bone of deciduous dentition

A

Trabeculae in alveolar bone are fewer but thicker than in the adult

35
Q

Crests of interdental bony septa of deciduous dentition compared to permanent dentition

A

Deciduous dentition are flat

36
Q

Chronic Marginal Gingivitis (deciduous dentition)

A 
Most prevalent disease of childhood
Looks like chronic gingivitis
BOP and pocketing is less common
Plaque etiology (less than in adults)
- Calculus (4-6, 9%; 7-9, 18%; 10-15, 33-43%)
37
Q

Malpositioned teeth in deciduous dentition:

A 
Accumulate more plaque
Increased gingivitis
  - excessive overbite
  - excessive overjet
  - nasal obstruction
  - mouthbreathing
38
Q

Diseases altering oral mucosa including the gingiva in deciduous dentition

A

Varicella
Rubeola (measles)
Scarlatina (scarlet fever)
Diphtheria

39
Q

Describe the pre-eruption bulge

A

Before crown appears in oral cavity, the gingiva presents a bulge that is firm, slightly blanched and conforms to the shape of the underlying crown

40
Q

T or F, during mixed dentition, it is normal for the marginal gingiva around the permanent teeth to be very prominent, especially in the maxillary anterior region

A

True

41
Q

Suprabony pocket vs Intra/Infrabony pocket

A

Suprabony

  • Base of pocket is coronal to level of underlying bone
  • Horizontal bone loss
  • Transseptal CT fibers are horizontal

Infra/Intrabony

  • Base of pocket is apical to the level of the adjacent bone
  • Vertical bone loss
  • Transseptal CT fibers run length of defect vertically (obliquely)
42
Q

Why do we do pocket reduction therapy?

A
  • Rationale for pocket reduction is based on the need to eliminate areas of plaque accumulation
  • Pockets create area where daily plaque removal becomes impossible
43
Q

Define Periodontal abscess

A

Acute localized accumulation of viable and nonviable PMNs within the pocket wall

44
Q

Define Gingival Abscess

A

Acute localized purulent infection that involves the marginal gingiva and interdental papilla due to bacteria carried into gingival tissue

45
Q

Etiology or causes of Periodontal abscess

A

Extension from infected pocket: G- MO
Incomplete removal of calculus
Root fracture
Multiple abscesses

46
Q

Clinical features of periodontal abscess

A

Localized purulent inflammation in periodontal tissues
Dull, constant pain, recent origin
Edematous, erythematous, smooth, shiny surface
Mobility
Rapid pocket formation
Discharge of pus with probe or pressure

47
Q

Fenestrations vs Dehiscence

A

Fenestrations: Window in bone on facial or lingual
Dehiscence: Loss of alveolar bone on the facial (rarely lingual) aspect of a toothat that leaves a characteristic oval, root-exposed defect from the cementoenamel junction apically

48
Q

Normal bone morphology

A
  1. Crest follows the CEJ and is 1-2 mm apical
  2. Interproximal higher (more coronal) than facial and lingual
  3. Scalloped
  4. Usually thicker facial alveolar bone than lingual alveolar bone

Oral Soft tissues (5 decks)

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