Gingival Overgrowths (E2,L2) Flashcards
Really Interesting Topic: Hormonal Relationship to Gingival Inflammation–_________ is an essential nutrient for P. intermedia
Men-a-di-one
Really Interesting Topic: Hormonal Relationship to Gingival Inflammation– another name for Methyl-Naph-thal-ene-dione = _______
Men-a-di-one
Really Interesting Topic: Hormonal Relationship to Gingival Inflammation–What is an important organic component of progesterone?
Naph-tho-quin-one
Really Interesting Topic: Hormonal Relationship to Gingival Inflammation–Prevotella Intermedia can substitute is NORMAL food of Methyl-Naph-thal-ene-di-one with _________.
Naph-tho-quin-one (an important organic constituent of progesterone)
Really Interesting Topic: Hormonal Relationship to Gingival Inflammation–Because of the food subsitiution, Prevotella Intermedia can thrive and cause ________’s.
pyogenic granuloma’s in females with high progesterone (pregnant!)
Which gingival enlargement drug is prescribed for epilepsy, Severe Clinical Depression, Trauma induced seizures, severe cluster headaches?
Phen-eee-toe-in Sodium (Dilantin) (phenytoin sodium)
What % of Dilantin patients show gingival enlargement? When does it begin? Where is the initial lesion? Does oral hygiene have anything to do with it?
50%…begins at 1-3months…initial lesion at papillae…positive correlation with poor OH
What do dosage, plasma levels, and duration of Dilantin treatment have to do with gingival enlargement?
No correlation between these variables and gingival enlargement.
What happens to the odds of gingival overgrowth when combining Phenytoin Sodium, Carbamazepine, and Phenobarbital?
The odds go way up! (83%)
What are the main 3 points as to why Dilantin causes gingival enlargement?
1.Suppresses MMP 2. Increases synthesis of GAG 3.Increased expression of Growth Factors
Can gingival enlargement from Dilantin occur in edentulous mouths? Upper Pontics? Partials? What about implant fixtures?
Yes x 4 :)
In dilantin gingival enlargement, Histologically there is epithelial _________ elongation.
rete ridge
What happens to Type I and Type III collagen in dilantin gingival overgrowth? What about the non-collagen protein matrix?
Type III DOUBLES while there is LESS Type I than normal….there is a GREATER volume of non-collagen protein matrix
What type of drug is ProCardia? What is its GENERIC name??
Ca2+ Channel Blocker…Ni-FED-I-PINE
What type of drug is CARDizEM?
Ca2+ Channel Blocker
What type of drug is ALdalAT?
Ca2+ Channel Blocker
What type of drug is CARDene?
Ca2+ Channel Blocker
What type of drug is IsopTIN?
Ca2+ Channel Blocker
What are the two indications for Nifedipine (ProCardia)?
Angina pectoris and post-myocardial syndrome
What is the Mechanism of Action for Nifedipine (Procardia)?
Blocks influx of Ca2+ into myocardial muscle cells leading to REDUCED oxygen demands
How does Nifedipine (Procardia) induce gingival enlargement?
Genetic Predisposition=fibroblast phenotype will produce MORE collagen and matrix.. Also Collagenolytic activity of fibroblasts is a Ca2+ dependent event.
What is CycloSporine (SANDimmune) prescribed for?
prescribed for immune suppression after major Organ Transplantation
What is the mechanism of action for CycloSporine (SANDimmune)?
Suppresses some B-lymphocyes, but MORE SPECIFICALLY, CD8 Lymphocytes
What are the 5 indications for a CycloSporine (SANDimmune) prescription? About how many people in the world are on this shiz?
1.Rheumatoid Arthritis 2.Sarcoidosis(immune cells forming granulomas) 3.Malaria 4.Psoriasis 5.Multiple Sclerosis….over 1 Bababababillion peeps
What are the two main THEORIES (nothing elucidated) of why Cyclosporine (SANDimmune) causes gingival overgrowth?
1.Genetic disposition manifested through specific phenotypes of fibroblasts 2.Increased production of PDFG (platelet derived growth factor) that facilitates fibroblast proliferation.
IN both Nifedipine and Cyclosporine gingival overgrowth you will see elongated epithelial _______ and ______ amount of collagen composition. There is INCREASED production of _______ by fibroblasts.
elongated epithelial rete ridges! and NORMAL amount of collagen composition…INCREASED production of matrix macromolecules by fibroblasts
What are the two types of gingival enlargement assoc with Leukemia?
1.Acute Lymphocytic 2. Acute My-elo-cytic
Dr. M has only seen this ONCE: Hereditary Gingival FibroMatosis….Which Chromosome is it associated with? Which gene on the chromosome??
Chromosome 2p21…SOS1 gene mutation
Dr. M has only seen this ONCE: Hereditary Gingival FibroMatosis….Activation of the _____ gene results in overproduction of its protein which, in turn, complexes with other cellular molecules to activate the ____ signal pathway (a much-studied topic in cancer research).
SOS1 gene….ras signal pathway
Dr. M has only seen this ONCE: Hereditary Gingival FibroMatosis….The ____ signal pathway, once activated, can prompt cells to grow, differentiate, or even commit _______, all tasks that are essential to life
ras…. apoptosis
What is most likely a common cause for idiopathic gingival fibromatosis?
allergy…like in ortho. it can be surgically removed or go away on its own
