Gingival Diseases Flashcards
What types of bacteria can cause desquamative gingivitis?
- Gonorrhea
- Pallidum
- Strep
- Myco chelonae
What is desquamative gingivitis?
Gingival lesions not caused by plaque accumulation
Could be bacterial, viral, fungal, genetic, systemic, traumatic
How do bacterial gingival lesions present clinically?
- Ulceration
- Chancres
- Mucous patches
- Atypical non-ulcerated, highly inflamed gingivitis
What are the two most common viral origins for gingivitis?
- Herpes simplex 1
2. Varicella-zoster virus
Where does the herpes virus stay latent?
Trigeminal ganglion
T/F: Viral gingivitis can be associated with Necrotizing Ulcerative Diseases.
True
What is herpes labialis?
Secondary herpes infection
Seen at vermilion border
Where are ulcers normally seen during recurrent hermetic infections?
Localized in attached gingiva and hard palate
If sampling is needed for viral lesions, aspiration from the ________ is the best way.
Vesicle
T/F: Histopathology is a good method for diagnosing herpes gingival lesions.
FALSE
Possible could use antibodies instead
What percentage of individuals with primary herpes infection will have recurrent infection?
20-40%
What is the treatment for herpes infection?
Plaque removal and antivirals
Where are ulcers usually seen in virocella-zoster infections?
Tongue, palatal, and gingival
T/F: In a varicella infection, the oral lesion is normally unilateral.
True
What viral infection is often associated with paresthesia?
Varicella
If patient has what looks like varicella lesion on left side of oral cavity, where would you expect there to be a skin lesion?
Right side of skin
What are the three main lesions that can lead to fungal infections?
- Candidosis
- Linear gingival erythema
- Histoplasmosis
What is the main candida species seen in the oral cavity?
C. Albicans
T/F: Healthy adults can be carriers for C. Albicans.
True
T/F: C. Albicans is often seen in subgingival flora of patients with severe periodontitis.
True
T/F: Candidosis can have red or white lesions.
True
What are some risk factors for candidosis?
- Long term antibiotics
- Pregnancy and contraceptives
- Diabetics
- Radiation/chemo
What medium is used to culture candidosis?
Nickerson medium at room temperature
Which type of gingival fungal infection will have a distinct erythematous band limited to the free gingiva?
Linear gingival erythema
Although it presents with red puffy free gingiva, what differentiates linear gingival erythema from normal plaque induced gingivitis?
It will not bleed
Linear gingival erythema is seen mostly in ______ patients.
HIV
___________ is a granulomatous disease caused by histoplasma capsulatum.
Histoplasmosis
What is a strong indicator of a histoplasmosis caused gingival lesion?
Immunocompromised patient or pulmonary problems
T/F: Hereditary gingival fibromatosis can interfere with or prevent tooth eruption.
True
What is the possible mechanism for hereditary gingival fibromatosis?
TGF-beta1 favor accumulation of ECM
Located on chromosome 2
What is the treatment for hereditary gingival fibromatosis?
Needs surgeries every year or so to remove gingiva
What are the most common types of oral allergic reactions?
Type IV or Type I
What is the difference between type I and type IV reactions?
Type I = immediate; IgE mediated
Type IV = delayed; T-cell mediated
What are some common allergens in the oral cavity?
- Restorative material (type IV)
- Oral hygiene products
- Chewing gum and food
T/F: Chemical lesions can be caused by various dental materials.
True
Etchant, chlorhexidine
What will the tissue response be to physical lesions?
Hyperketosis, white frictional keratosis
What is the characteristic lesion involved with lichen planus?
Wickham striae
T/F: Oral involvement alone is common in lichen planus.
True
T/F: Lichen planus is common in children.
False
What must be seen to diagnose lichen planus?
Deposits of IgM and cascade compounds in basement membrane
What is characteristic of pemphigoid?
Detachment of epithelium from connective tissue
A patient with pemphigoid will have autoantibody reactions against __________ and _________ components.
Hemidesmosome and lamina lucida
What deposits are seen to diagnose pemphigoid?
C3, IgG
What other area of the face can be affected by pemphigoid?
Eye
What is a Nicholsky sign?
Rubbing of the gingiva creates bulla formation
Associated with pemphigoid
What is a specific characteristic pemphigus vulgar is?
Formation of intraepithelial bullae in skin and mucous membranes
Also called Acantholysis
Two big terms involved with pemphigus vulgaris?
- Intraepithelial bullae
2. Acantholysis
What genetic background is most susceptible to pemphigus vulgaris?
Jewish/Mediterranean
What disease presents with swollen lips and extensive crust formation at the vermillion border?
Erythema multiforme
T/F: There is oral involvement in as much as 25-60% of erythema multiforme cases.
True
Erythema multiforme can be associated with ____________ and ___________.
Herpes; various drugs
What do the skin lesions associated with lupus erythematosus look like?
Butterfly lesions on the nose
What will be associated with the oral lesion in lupus erythematosus?
White striae with periphery of telangiectasia
Dilation of blood vessels
Increased ________ of the basement membrane is associated with lupus erythematosus.
Width
Which gastro-intestinal disease can cause mucosal problems in the mouth?
Crohn’s disease
Which hematological disorder will cause swelling, ulceration, petechia and erythema of the gingiva?
Leukemia
T/F: Periodontal tumors and cysts may have appearance of gingivitis/periodontitis.
True
List the various reactive processes of the periodontal soft tissues.
- Fibroma/focal fibrous hyperplasia
- Calcified fibroblasts granuloma
- Pyogenic granuloma
- Peripheral giant cell granuloma
List the reactive processes of the hard tissues.
- Periapical cemental dysplasia
Looks like periapical lesion but tooth is vital and asymptomatic
List the benign neoplasms of the soft tissues.
- Hamangioma
- Nevus
- Papilloma
- Verruca vulgaris
- Peripheral odontogenic tumors
Hamngiomas are _____________ but may bleed.
Asymptomatic
Where is a nevus normally seen?
Palate
A _________ can be mistaken for an amalgam tattoo.
Nevus
Where are peripheral odontogenic tumors normally found?
In soft tissue around unerupted teeth
List the benign neoplasms of hard tissues.
- Ameloblastoma
- Squamous odontogenic tumor
- Benign cementoblastoma
Where is an ameloblastoma derived from?
Odontogenic epithelium
Where is a squamous odontogenic tumor derived from?
PDL, possibly rests of Malassez
Often on lateral root surface
List the malignant neoplasms of soft tissues.
- Squamous cell carcinoma
- Metastasis to the gingiva
- Kaposi’s sarcoma
- Malignant lymphoma
Where are common spots for squamous cell carcinoma?
Mandible and posterior to premolars
T/F: Regional lymph node metastasis is common with SCC.
True
T/F: Most metastasis cases are carcinoma and not sarcoma.
True
Kaposi’s sarcoma is more prevalent in _______ patients.
AIDS
List the malignant neoplasms of the hard tissues.
- Osteosarcoma
2. Langerhans cell disease
Widening of the _______ is common with osteosarcoma.
PDL space
What is the difference between a tumor and a cyst?
Tumor: filled with growing cells
Cyst: covered in epithelium and filled with fluid
What are the five types of cysts seen in the periodontium?
- Gingival
- Lateral periodontal
- Inflammatory periodontal
- Odontogenic keratocyst
- Radicular
