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gingival diseases 2 Flashcards

1
Q

inflammatory condition of the skin and mucous membranes; oral involvement alone is common and can affect any area of the oral mucosa

A

lichen planus

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2
Q

lichen planus has characteristic skin lesions called ____ and has various clinical appearances

A

wickham striae

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3
Q

forms of lichen planus that are generally asymptomatic

A

papular, reticular, and plaque-like forms

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4
Q

forms of lichen planus that are generally symptomatic

A

atrophic, ulcerative, bullous forms

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5
Q

lichen planus characterized by subepithelial, band-like accumulation of ____ and ____, characteristic of a ____ hypersensitivity reaction

A

lymphocytes and macrophages

type IV

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6
Q

lichen planus characterized by ____ in the basement membrane and deposits of _____

A

fibrin; IgM, C3, C4, and C5

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7
Q

group of disorders in which autoantibodies towards components of the basement membrane result in detachment of the epithelium from the connective tissue

A

pemphigoid

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8
Q

histology of pemphigoid shows autoantibody reactions against _____ and _____ components

A

hemidesmosome; lamina lucida

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9
Q

deposits of _____ in pemphigoid

A

C3, IgG and other Igs

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10
Q

three types of pemphigoid

A
  • bullous
  • benign mucous membrane
  • cicatrical (scar formation)
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11
Q

in pemphigoid, rubbing of the gingiva creates bulla formation

A

Nicholsky sign

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12
Q

pemphigus vulgaris characterized by the formation of _____ in skin and mucous membranes

A

intraepithelial bullae

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13
Q

histology of pemphigus vulgaris shows _____ due to destruction of desmosomes and pericellular epithelial deposits of _____

A

acantholysis ; IgG and C3

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14
Q

histology of pemphigus vulgaris also shows circulating autoantibodies against _____

A

interepithelial adhesion molecules

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15
Q

acute, sometimes recurrent, vesiculobullous disease affecting both mucous membranes and skin; oral involvement in as much as 25-60% of cases

A

erythema multiforme

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16
Q

erythema multiforme characterized by ____, often with extensive crust formation of the _____

A

swollen lips; vermilion border

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17
Q

the extensive necrosis of erythema multiforme is called _____

A

stevens-johnson syndrome (oral, ocular, genital, skin)

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18
Q

erythema multiforme appears to be a cytotoxic immune reaction towards keratinocytes caused by a wide range of factors including _____ and _____

A

herpes simplex virus; various drugs

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19
Q

autoimmune connective tissue disorder in which autoantibodies form to various cellular constituents

A

lupus erythematosus

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20
Q

LE lesions characterized by central atrophic area with small white dots surrounded by irradiating fine ____ with a periphery of _____

A

white striae; telangiectasia

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21
Q

characteristic skin lesions of LE called _____

A

butterfly lesions

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22
Q

histology of LE shows degeneration of ____ and increased ____ of the BM

A

basal cells; width

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23
Q

mild chronic form of LE which affects skin and mucous membranes

A

discoid forms

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24
Q

drug-induced mucocutaneous disorders

A 
gingival hyperplasia (enlargement)
erythema multiforme
oral ulceration
epithelial atrophy, superficial sloughing
intense erythema
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25
Q

drugs that can induce these mucocutaneous disorders

A

immunosuppressants, calcium channel blockers, anti-epilepsy drugs, anti-malarial drugs, anti-neoplastic drugs, methotrexate (for leukemia)

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26
Q

_____ diseases and _____ disorders can systemic problems that can cause gingival manifestations

A

GI diseases; hematological disorders (such as leukemia)

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27
Q

reactive processes of periodontal soft tissues

A
  • fibroma/focal fibrous hyperplasia
  • calcified fibroblastic granuloma
  • pyogenic granuloma
  • peripheral giant cell granuloma
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28
Q

reactive process of periodontal hard tissues

A

periapical cemental dysplasia

29
Q

benign neoplasms of periodontal soft tissues

A
  • hemangioma
  • nevus
  • papilloma
  • verruca vulgaris (type of papilloma)
  • peripheral odontogenic tumors
30
Q

benign neoplasm derived from odontogenic epithelium; well-circumscribed radiolucency

A

ameloblastoma

31
Q

benign neoplasm derived from PDL, presumably from epithelial rests of Malassez; often asssoc with lateral root surface; rarely seen

A

squamous odontogenic tumor

32
Q

benign, slow-growing neoplasm forming hard tissue around the apex of a tooth; radiopacity typically surrounded by a radiolucent margin

A

benign cementoblastoma

33
Q

malignancy often seen in the mandible; posterior to the premolars; nodular lesions, often with ulceration and surrounding leukoplakia

A

squamous cell carcinoma

34
Q

skin lesion followed by oral lesions; gingiva second most detected site after palate; re-occurrence with AIDS

A

Kaposi’s sarcoma

35
Q

rare in the oral cavity but occurs within HIV-infected patients frequently

A

malignant lymphoma

36
Q

widening of the PDL is common in this malignancy

A

osteosarcoma

37
Q

swelling, tenderness, pain, and loosening of the teeth are frequent symptoms of this malignancy

A

Langerhans cell disease (Histiocytosis X)

38
Q

cysts of the periodontium

A
  1. gingival cyst
  2. lateral periodontal cyst
  3. inflammatory paradental cyst
  4. odontogenic keratocyst
  5. radicular cyst
39
Q

has a strong genetic background (jewish and mediterranean); painful desquamative lesions, erosions, or ulcerations; chronic course with recurrent bulla formation; typically in the middle aged or elderly

A

pemphigus vulgaris

40
Q

bullae that rupture and leave extensive ulcers; characteristic skin lesions (iris appearance + bullae); may occur at any age but mostly young individuals

A

erythema multiforme

41
Q

lesions can be ulcerated and cannot be differentiated from leukoplakia or atrophic oral lichen planus

A

lupus erythematosus

42
Q

sessile, well-circumscribed smooth surfaced nodules; cell poor, hyperplastic collagenous tissue ; may show hyperkeratinization

A

fibroma/focal fibrous hyperplasia

43
Q

often reddish and ulcerated reactive lesion; fibrous proliferation in which bone or cementum-like hard tissue is formed; highly cell-rich areas below ulcerated sites

A

calcified fibroblastic granuloma

44
Q

ulcerated (may resemble purulence); gingival margin; reddish or bluish, sometimes lobulated; sessile or pedunculated ; bleeding is common; highly vascular with chronic inflammatory cells

A

pyogenic granuloma

45
Q

symptoms are painful severe gingivitis with redness; ulcerations with serofibrinous exudate; edema accompanied by stomatitis

A

primary HSV

46
Q

incubation period for primary HSV is ____; formation of ____, which rupture, coalesce, and leave _____

A

one week; vesicles; fibrin-coated ulcers

47
Q

there is healing of primary HSV within _____

A

10-14 days

48
Q

common presentation of recurrent HSV is _____

A

herpes labialis

49
Q

recurrent HSV usually occurs at the same location on the _____ and/or _____

A

vermilion border; skin adjacent to it

50
Q

recurrent HSV characterized by intra-oral ulcers in ____ and _____; lesions mistaken for _____

A

attached gingiva; hard palate; aphthous ulcers

51
Q

aphthous ulcers do not affect ____

A

keratinized mucosa

52
Q

treatment for recurrent HSV

A
  • limit bacterial superinfection (careful plaque control)

- anti virals (such as acyclovir) in immunocompromised patients

53
Q

small ulcers usually on the tongue, palatal, and gingiva ; initial symptoms are pain and paresthesia; diagnosis usually obvious due to unilateral occurrence of lesions associated with severe pain

A

herpes zoster

54
Q

most common type of oral candidiasis; acquired during birth; psuedomembranous/erosive lesions; caused by c. albicans

A

thrush

55
Q

acute candidiasis (thrush) seen in 3 types of individuals:

A
  • immunosuppressed individuals
  • the infant
  • adult who has been on antibiotic therapy for some time
56
Q

predisposing conditions for thrush (acute pseudomembranous candidiasis)

A

antibiotics, immunosuppression, malnutrition, HIV, diabetes

57
Q

most clinical characteristic of gingival candidal infections is _____, often associated with ____

A

redness of the attached gingiva; granular surface

58
Q

____ candidosis shows whitish patches that can be whiped off

A

pseudomembranous

59
Q

____ candidosis is intensely red, usually associated with pain

A

erythematous

60
Q

treatment for oral candidiasis (thrush)

A
  • correction of predisposing factors

- fluconazole, nystatin, amphotericin B (IV)

61
Q

pain, ulceration, and necrosis of the interdental papillae; bleeding

A

necrotizing ulcerative gingivitis (NUG)

62
Q

people commonly affected by NUG

A

adolescents or young adults, smokers, and individuals under stress

63
Q

differential diagnosis of NUG

A

primary herpetic gingivostomatitis

64
Q

predisposing factors to NUG

A
  • systemic diseases like ulcerative colitis, blood dyscrasias, and nutritional deficiency states
  • abnormalities of WBC function
  • patients suffering from AIDS
65
Q

treatment for NUG

A
  • OHI
  • mechanical debridement
  • systemic antibiotic therapy
  • surgical correction of gingival destruction
66
Q

fibrous-osseous cemental lesions; tooth is usually vital; usually no symptoms; periapical bone is replaced by cellular fibroblastic tissue through a cementoblastic phase

A

periapical cemental dysplasis

67
Q

diffuse gingival enlargement (may be confined to marginal gingiva, interdental papilla or include the attached gingiva); disease entity or a part of a syndrome; may interfere with or prevent tooth eruption

A

hereditary gingival fibromatosis

68
Q

possible mechanism of hereditary gingival fibromatosis includes ____ favoring accumulation of ____; may be located on ____ in humans

A

TGF-b1; ECM

chromosome 2

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