Gingival Diseases - 2 10/14/15

Question 1

What are the 6 Mucocutaneous disorders?

Answer 1

1. Lichen planus
2. Pemphigoid
3. Pemphigus vulgaris
4. Erythema Multiforme
5. Lupus Erythematous
6. Drug induced mucocutaneous disorders

Question 2

Tell me about Lichen planus….

Answer 2

• Oral involvement alone is common
• Prevalence = 0.1-4% any age, but rare in children
• A premalignant potential 0.5-2%
• Characteristic skin lesions
• ** various clinical appearances: Papular, reticular, plaque-like, atrophic, ulcerative, bullous.
• Any area of the mucosa.

Question 3

_____ is characteristic of a type IV hypersensitivity reaction.]

Answer 3

Sub epithelial, band-like accumulation of lymphocytes and macrophages

Question 4

What are examples of Oral Lichenoid lesions?

Answer 4

Lesion in contact with dental restorations, lesions associated with various types of medications (NSAIDS, DIURETICS, BETABLOCKERS )

Question 5

_______ is a group of disorders in which the autoantibodies moment towards components of the basement membrane results in detachment of epithelium from connective tissue.

Answer 5

Pemphigoid

Question 6

What is the mechanism of Pemphigoid?

Answer 6

Autoantibody rxns against hemidemsome and lamina lucida components.

Question 7

In pemphigoid, there is deposits of ____, _____ and _____.

Answer 7

C3, IgG and other Ig’s

Question 8

In whom is Pemphigoid, most common?

Answer 8

Females over 50

Question 9

What is Pemphigus Vulgaris?

Answer 9

The formation of mucous membranes.

• Strong genetic background (jewish and Mediterranean)
• Painful desquamative lesions, erosions, ulcerations
• chronic course with recurrent bull formation
• Typically in middle age or elderly

Question 10

What is the Histology/mechanism of Pemphigus Vulgaris?

Answer 10

Acantholysis (due to destruction of desmosomes)

• Pericellular epithelial deposits of IgG and C3
• Circulating autoantibodies against interepithelial adhesion molecules.

Question 11

What are drug induced mucocutaneous disorders?

Answer 11

Stuff like:
Gingival enlargment
Erythema Multiform
Oral ulceration
Epithelial atrophy
Intense erythema

Question 12

What are 2 other gingival manifestations of systemic conditions?

Answer 12

Caron’s disease (gastrointestinal disease)

Leukemia (hematological disorder)

Question 13

What are the gingival manifestations of Leukemia?

Answer 13

Swelling, ulceration, petechia, and erythema of gingiva.

- 69% of patients with acute leukemia had oral signs of leukemia.

Question 14

What is the reactive process of Periodontal soft tissue (Fibroma/Focal fib?

Answer 14

• A focal fibrous hyperplasia caused by irritation
• Sessile, well-circumscribed smooth surfaced nodules
• Cell poor, hyperpalstic collagenous tissue
• May show hyperkeratinization
• Differential diagnosis = Giant Cell Fibroma