Gingival Diseases - 1 10/9/15 Flashcards
What are the origins of Gingival lesions?
Bacterial Viral Fungal Genetic Systemic Traumatic
What are 2 types of gingival lesions of specific bacteria origin?
Infective gingivitis and Stomatitis
*Bacteria involved: Streptococci, Mycobaterium chelonae or other organisms.
How do bacterial lesions present clinically?
Fiery red painful ulcerations
Asymptomatic chancres
Mucous patches
Atypical non-ulcerated, highly inflamed gingivitis.
How do you diagnose bacterial lesions?
Biopsy
Microbiological examination
What are common types of viruses that cause gingival lesions?
Herpes Simplex 1 & 2
Varicella-zoster virus
*Herpes 1 usually causes oral manifestations.
What is the primary gingival viral lesion?
Primary herpetic gingivostomatitis
What are the symptoms of Primary Herpetic gingivostomatitis?
- Painful severe gingivitis with redness
- ulcerations with serofibrinous exudate
- edema accompanied by stomatitis.
What are the incubation/healing time of Herpetic gingivostomatitis?
Incubation = 1 week
- Formation of vesicle, which rupture , coalesce and leave fibrin coated ulcers.
- healing = 10-14 days
Herpes virus can stay latent in the _____ for years.
Trigeminal ganglion
Herpes virus is found in _____, ____ and ______.
gingivitis, NUG/NUP and periodontitis
Recurrent herpetic infection occurs in ______% of individuals with primary infection.
20-40%
Herpes labialis is a _______.
Recurrent herpetic infection
What does Herpes Zoster do?
(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
What are some fungal origins of Gingival lesions?
- Candidosis
- Linear gingival erythema
- Histoplasmosis
Tell me about Cadidosis…
- Candida species isolated from the mouth. (C. albicans)
Oral carriage of C.albicans in healthy adults 3-48%.
Reduced host defense posture
Where is C. albicans frequently isolated?
from the sub gingival flora of patients with severe periodontitis.
Describe linear gingival erythema…..
- 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.
Tell me about Histoplasmosis…
- 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.
What is an example of gingival lesions of genetic origin?
Hereditary gingival fibromatosis
What does Hereditary gingival fibrzomatosis cause?
- 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.
What are type 1 allergic rxns?
The immediate type, mediated by IgE
What are type 4 allergic rxns?
The delayed type, mediated by T cells.
Allergies to dental restorative material would be type _____.
4
What causes traumatic lesions?
Chemicals
Physical
Thermal
Where are most thermal lesions seen?
on palatal and labial mucosa
What is Hyperkeratosis?
A white leuplakia-like, FRICTIONAL keratosis. (physical traumatic lesion)
What are foreign body rxns?
When Epithelial ulceration allows entry of foreign material into gingival connective tissue . *Amalgam tattoo, abrasives, toothpicks….)
