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Perio I > Gingival Enlargement > Flashcards

Gingival Enlargement Flashcards

1
Q

Hypertrophy is an increase in number of cells. Hypertrophy and hyperplasia usually occur simultaneously.
a. both statements are true
b. both statements are false
c. first statement true. second statement false
d. first statement false. second statement true

A

d. first statement false. second statement true

hyperplasia is an increase in number of cells while hypertrophy refers to increased cell size.
they usually both occur at the same time

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2
Q

What did gingival enlargement used to be termed?

A

hypertrophic gingivitis or gingival hyperplasia

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3
Q

Why do false enlargements usually occur?

A

increase in size (hypertrophy) of underlying osseous/dental tissues

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4
Q

Which grade has gingival enlargement confined to interdental papilla?

A

Grade I

Grade 0= no signs
Grade I= enlargement confined to interdental papilla
Grade II= enlargement involves papilla and marginal gingiva
Grade III= enlargement covers 3/4 or more of crown

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5
Q

T/F: inflammatory enlargement only occurs in chronic gingivitis.

A

False.

can also happen in acute

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6
Q

T/F: Gingival Overgrowth associated with systemic condition and system diseases are the same thing.

A

False.

they are separate things

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7
Q

What is the first indicator to differentiate between acute and chronic inflammatory enlargement?

A

In acute, it is painful and tender while chronic is coming & going pain because they’re used to it

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8
Q

Where is the location of both acute and chronic inflammatory enlargement?

A

acute= generally limited to marginal gingiva and interdental papilla
chronic= increase until it covers part of the crowns

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9
Q

What is the usual cause of acute inflammatory enlargement?

A

trauma

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10
Q

Which can be generalized and which is rapidly expanding: acute and chronic inflammatory enlargement?

A

chronic inflammatory enlargement is generalized and progresses slowly and painlessly

acute chronic inflammatory is rapidly expanding and painful

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11
Q

What type of cells are seen in histopath of inflammatory enlargement?

A

inflammatory cells with lots of capillaries

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12
Q

T/F: Lesions that are pink and firm will have lots of fibroblasts and collagen fibers but less capillaries.

A

True

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13
Q

What are the drugs that can induce gingival enlargement?

A

Anticonvulsants
Immunosuppressants
Calcium Channel Blockers

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14
Q

Which drug is associated with anticonvulsants and what is the prevelance of gingival overgrowth?

A

Phenytoin
50%

phenobarbital and valproic acid are seen less often than phenytoin

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15
Q

What is the clinical onset of anticonvulsant and when does the severity show?

A

clinical onset= 1 month
increasing severity= 12-18 months

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16
Q

Where is the frequent site of lesion from anticonvulsants?

A

anterior buccal maxilla and mandible gingiva

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17
Q

Where/which class does the enlargement from anticonvulsants arise from?

A

Class I- interdental papilla

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18
Q

What is the prevalence of calcium channel blocker for gingival overgrowth?

A

6-83%
HIGHLY variable

19
Q

Which drug is involved in gingival overgrowth from immunosuppressants?

A

Cyclosporin A
(used to prevent rejection in transplants and autoimmune conditions)

20
Q

What is the prevalence of immunosuppressants for gingival overgrowth?

A

30% but much higher in pediatric population

21
Q

What is key in being able to tell immunosuppressant causes of GO rather than calcium channel blockers or anticonvulsants?

A

Immunosuppressants have MANY inflammatory cells and very red and bleeds regularly (increased vascularization)

22
Q

Which is involved in fibrosis and has stratified squamous epithelium with long, thin rate pegs extending deep into connective tissue?
a. phenytoin-induced GO
b. calcium channel blocker induced GO
c. cyclosporin A induced GO

A

a. phenytoin-induced GO

calcium channel blockers are also similar in having stratified squamous epithelium with long, thin rate pegs extending deep into connective tissue

23
Q

What is the mechanism of action for phenytoin-induced GO?

A

elevated levels of collagen synthesis

24
Q

What is the mechanism of action for calcium channel blocker induced GO?

A

decreased calcium levels in fibroblasts and T cells.
nifedipine- induced GO have defective collagen production due to decreased levels of collagenase activity

25
Q

What is the mechanism of action cyclosporin A induced GO?

A

cyclosporin A directly impairs collagen synthesis of fibroblasts which increase levels of type I collagen.
It also decreases expression of matrix metalloproteinase (MMPs) which degrades extracellular matrix

26
Q

T/F: drug induced gingival overgrowth cannot be prevented

A

True.
but it can be reduced by eliminating local factors, plaque control, and regular periodontal maintenance

27
Q

What are some ways to treat drug induced gingival overgrowth?

A

eliminate local factors, plaque control, regular periodontal maintenance, surgical elimination via gingivectomy or gingivoplasty

the most effective treatment is withdrawn or substitution of the medication

28
Q

T/F: Recurrence rate is high for treating drug induced gingival overgrowth.

A

True

29
Q

What are the three types of conditioned gingival enlargements?

A

Hormonal, Nutritional, and Allergic

30
Q

Plaque is necessary for initiation of conditioned enlargements. It is the sole determinant of the clinical feature.
a. both statements are true
b. both statements are false
c. first statement true. second statement false
d. first statement false. second statement true

A

c. first statement true. second statement false

31
Q

What are other gingival overgrowths seen often in clinic?

A

pregnancy, puberty, and vitamin c deficiency

32
Q

What is the most helpful way to manage gingival overgrowth?

A

reducing plaque

33
Q

Where does Wegener Granulomatosis usually stem from?

A

respiratory tract

34
Q

Which systemic GO usually begins with eruption of primary/secondary dentition and can sometimes regress after extraction?

A

Idiopathic gingival enlargement

Cause is unknown but thought that teeth were the initiating factor

35
Q

What is the most common neoplastic enlargement?

A

Fibroma

36
Q

Where do fibromas arise from?

A

gingival c.t. or PDL

37
Q

What does a Fibroma/neoplastic enlargement look like?

A

same color as gingiva and can be painful or painless or firm or soft

38
Q

What neoplastic enlargement is associated with human papilloma virus?

A

Papilloma

Appear as solitary, cauliflower/wart like protuberances
HPV 6 and 11 are isolated

39
Q

Which human papilloma virus is usually associated?

A

HPV 6 and 11

40
Q

Which side does Peripheral giant cell granuloma arise from?

A

labial/buccal

41
Q

In Peripheral giant cell granuloma, if it has a stock is it:
a. sessile
b. pedunculated

A

b. pedunculated

if it has no stock= sessile

42
Q

Where can malignant tumors of gingiva arise from?
a. carcinoma
b. sarcoma
c. malignant melanoma
d. metastasis
e. all of the above

A

e. all of the above

43
Q

Are false enlargements soft or hard?

A

Hard because it’s overgrown bone underneath gingiva

Perio I (5 decks)

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