gingival diseases 2 Flashcards by Jamie Jones

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

lichen planus

How well did you know this?

Not at all

Perfectly

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

wickham striae

How well did you know this?

Not at all

Perfectly

forms of lichen planus that are generally asymptomatic

papular, reticular, and plaque-like forms

How well did you know this?

Not at all

Perfectly

forms of lichen planus that are generally symptomatic

atrophic, ulcerative, bullous forms

How well did you know this?

Not at all

Perfectly

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

lymphocytes and macrophages

type IV

How well did you know this?

Not at all

Perfectly

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

fibrin; IgM, C3, C4, and C5

How well did you know this?

Not at all

Perfectly

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

pemphigoid

How well did you know this?

Not at all

Perfectly

histology of pemphigoid shows autoantibody reactions against _____ and _____ components

hemidesmosome; lamina lucida

How well did you know this?

Not at all

Perfectly

deposits of _____ in pemphigoid

C3, IgG and other Igs

How well did you know this?

Not at all

Perfectly

three types of pemphigoid

bullous
benign mucous membrane
cicatrical (scar formation)

How well did you know this?

Not at all

Perfectly

in pemphigoid, rubbing of the gingiva creates bulla formation

Nicholsky sign

How well did you know this?

Not at all

Perfectly

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

intraepithelial bullae

How well did you know this?

Not at all

Perfectly

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

acantholysis ; IgG and C3

How well did you know this?

Not at all

Perfectly

histology of pemphigus vulgaris also shows circulating autoantibodies against _____

interepithelial adhesion molecules

How well did you know this?

Not at all

Perfectly

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

erythema multiforme

How well did you know this?

Not at all

Perfectly

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

swollen lips; vermilion border

How well did you know this?

Not at all

Perfectly

the extensive necrosis of erythema multiforme is called _____

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

How well did you know this?

Not at all

Perfectly

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

herpes simplex virus; various drugs

How well did you know this?

Not at all

Perfectly

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

lupus erythematosus

How well did you know this?

Not at all

Perfectly

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

white striae; telangiectasia

How well did you know this?

Not at all

Perfectly

characteristic skin lesions of LE called _____

butterfly lesions

How well did you know this?

Not at all

Perfectly

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

basal cells; width

How well did you know this?

Not at all

Perfectly

mild chronic form of LE which affects skin and mucous membranes

discoid forms

How well did you know this?

Not at all

Perfectly

drug-induced mucocutaneous disorders

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

How well did you know this?

Not at all

Perfectly

drugs that can induce these mucocutaneous disorders

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

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

GI diseases; hematological disorders (such as leukemia)

reactive processes of periodontal soft tissues

- fibroma/focal fibrous hyperplasia - calcified fibroblastic granuloma - pyogenic granuloma - peripheral giant cell granuloma

reactive process of periodontal hard tissues

periapical cemental dysplasia

benign neoplasms of periodontal soft tissues

- hemangioma - nevus - papilloma - verruca vulgaris (type of papilloma) - peripheral odontogenic tumors

benign neoplasm derived from odontogenic epithelium; well-circumscribed radiolucency

ameloblastoma

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

squamous odontogenic tumor

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

benign cementoblastoma

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

squamous cell carcinoma

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

Kaposi's sarcoma

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

malignant lymphoma

widening of the PDL is common in this malignancy

osteosarcoma

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

Langerhans cell disease (Histiocytosis X)

cysts of the periodontium

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

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

pemphigus vulgaris

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

erythema multiforme

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

lupus erythematosus

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

fibroma/focal fibrous hyperplasia

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

calcified fibroblastic granuloma

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

pyogenic granuloma

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

primary HSV

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

one week; vesicles; fibrin-coated ulcers

there is healing of primary HSV within _____

10-14 days

common presentation of recurrent HSV is _____

herpes labialis

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

vermilion border; skin adjacent to it

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

attached gingiva; hard palate; aphthous ulcers

aphthous ulcers do not affect ____

keratinized mucosa

treatment for recurrent HSV

- limit bacterial superinfection (careful plaque control) | - anti virals (such as acyclovir) in immunocompromised patients

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

herpes zoster

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

thrush

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

- immunosuppressed individuals - the infant - adult who has been on antibiotic therapy for some time

predisposing conditions for thrush (acute pseudomembranous candidiasis)

antibiotics, immunosuppression, malnutrition, HIV, diabetes

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

redness of the attached gingiva; granular surface

____ candidosis shows whitish patches that can be whiped off

pseudomembranous

____ candidosis is intensely red, usually associated with pain

erythematous

treatment for oral candidiasis (thrush)

- correction of predisposing factors | - fluconazole, nystatin, amphotericin B (IV)

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

necrotizing ulcerative gingivitis (NUG)

people commonly affected by NUG

adolescents or young adults, smokers, and individuals under stress

differential diagnosis of NUG

primary herpetic gingivostomatitis

predisposing factors to NUG

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

treatment for NUG

- OHI - mechanical debridement - systemic antibiotic therapy - surgical correction of gingival destruction

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

periapical cemental dysplasis

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

hereditary gingival fibromatosis

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

TGF-b1; ECM | chromosome 2