Gingival Diseases - 1 10/9/15

Question 1

What are the origins of Gingival lesions?

Answer 1

Bacterial 
Viral
Fungal
Genetic
Systemic 
Traumatic

Question 2

What are 2 types of gingival lesions of specific bacteria origin?

Answer 2

Infective gingivitis and Stomatitis

*Bacteria involved: Streptococci, Mycobaterium chelonae or other organisms.

Question 3

How do bacterial lesions present clinically?

Answer 3

Fiery red painful ulcerations
Asymptomatic chancres
Mucous patches
Atypical non-ulcerated, highly inflamed gingivitis.

Question 4

How do you diagnose bacterial lesions?

Answer 4

Biopsy

Microbiological examination

Question 5

What are common types of viruses that cause gingival lesions?

Answer 5

Herpes Simplex 1 & 2
Varicella-zoster virus
*Herpes 1 usually causes oral manifestations.

Question 6

What is the primary gingival viral lesion?

Answer 6

Primary herpetic gingivostomatitis

Question 7

What are the symptoms of Primary Herpetic gingivostomatitis?

Answer 7

• Painful severe gingivitis with redness
• ulcerations with serofibrinous exudate
• edema accompanied by stomatitis.

Question 8

What are the incubation/healing time of Herpetic gingivostomatitis?

Answer 8

Incubation = 1 week

• Formation of vesicle, which rupture , coalesce and leave fibrin coated ulcers.
• healing = 10-14 days

Question 9

Herpes virus can stay latent in the _____ for years.

Answer 9

Trigeminal ganglion

Question 10

Herpes virus is found in _____, ____ and ______.

Answer 10

gingivitis, NUG/NUP and periodontitis

Question 11

Recurrent herpetic infection occurs in ______% of individuals with primary infection.

Answer 11

20-40%

Question 12

Herpes labialis is a _______.

Answer 12

Recurrent herpetic infection

Question 13

What does Herpes Zoster do?

Answer 13

(chicken pox virus)

• Small ulcers usually on tongue, palatal and gingiva
• latent in the dorsal root ganglion
• unilateral leasions
• 2nd and 3rd branches of the trigeminal ganglion

Question 14

What are some fungal origins of Gingival lesions?

Answer 14

• Candidosis
• Linear gingival erythema
• Histoplasmosis

Question 15

Tell me about Cadidosis…

Answer 15

• Candida species isolated from the mouth. (C. albicans)

Oral carriage of C.albicans in healthy adults 3-48%.

Reduced host defense posture

Question 16

Where is C. albicans frequently isolated?

Answer 16

from the sub gingival flora of patients with severe periodontitis.

Question 17

Describe linear gingival erythema…..

Answer 17

• distinct linear erythematous band limited to the free gingiva.
• lack of bleeding
• positive for C. Albicans by culture: 50% of HIV associated gingivitus sites! 26% of unaffected sites of HIV serotype patients, 3% of health sites of HIV negative patients.

Question 18

Tell me about Histoplasmosis…

Answer 18

• granulomatous disease caused by Histoplasma capsulatum.
• acute and chronic pulmonary histoplasmosis and a disseminated form….immunocomprimised patients.
• Any area of the oral mucosa
• Nodular or papillary and later may become ulcerative types of lesions with pain.

Question 19

What is an example of gingival lesions of genetic origin?

Answer 19

Hereditary gingival fibromatosis

Question 20

What does Hereditary gingival fibrzomatosis cause?

Answer 20

• diffuse gingival enlargement
• Disease entity or part of a syndrome
• May interfere with or prevent tooth eruption.
• You just have to keep cutting the gingiva away every year or two!

*Possible mechanisms: TGF-B1 favor the accumulation of ECM
May be located on chromosome 2 in human.

Question 21

What are type 1 allergic rxns?

Answer 21

The immediate type, mediated by IgE

Question 22

What are type 4 allergic rxns?

Answer 22

The delayed type, mediated by T cells.

Question 23

Allergies to dental restorative material would be type _____.

Answer 23

4

Question 24

What causes traumatic lesions?

Answer 24

Chemicals
Physical
Thermal

Question 25

Where are most thermal lesions seen?

Answer 25

on palatal and labial mucosa

Question 26

What is Hyperkeratosis?

Answer 26

A white leuplakia-like, FRICTIONAL keratosis. (physical traumatic lesion)

Question 27

What are foreign body rxns?

Answer 27

When Epithelial ulceration allows entry of foreign material into gingival connective tissue . *Amalgam tattoo, abrasives, toothpicks….)