Gingival Overgrowths (E2,L2)

Question 1

Really Interesting Topic: Hormonal Relationship to Gingival Inflammation–_________ is an essential nutrient for P. intermedia

Answer 1

Men-a-di-one

Question 2

Really Interesting Topic: Hormonal Relationship to Gingival Inflammation– another name for Methyl-Naph-thal-ene-dione = _______

Answer 2

Men-a-di-one

Question 3

Really Interesting Topic: Hormonal Relationship to Gingival Inflammation–What is an important organic component of progesterone?

Answer 3

Naph-tho-quin-one

Question 4

Really Interesting Topic: Hormonal Relationship to Gingival Inflammation–Prevotella Intermedia can substitute is NORMAL food of Methyl-Naph-thal-ene-di-one with _________.

Answer 4

Naph-tho-quin-one (an important organic constituent of progesterone)

Question 5

Really Interesting Topic: Hormonal Relationship to Gingival Inflammation–Because of the food subsitiution, Prevotella Intermedia can thrive and cause ________’s.

Answer 5

pyogenic granuloma’s in females with high progesterone (pregnant!)

Question 6

Which gingival enlargement drug is prescribed for epilepsy, Severe Clinical Depression, Trauma induced seizures, severe cluster headaches?

Answer 6

Phen-eee-toe-in Sodium (Dilantin) (phenytoin sodium)

Question 7

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?

Answer 7

50%…begins at 1-3months…initial lesion at papillae…positive correlation with poor OH

Question 8

What do dosage, plasma levels, and duration of Dilantin treatment have to do with gingival enlargement?

Answer 8

No correlation between these variables and gingival enlargement.

Question 9

What happens to the odds of gingival overgrowth when combining Phenytoin Sodium, Carbamazepine, and Phenobarbital?

Answer 9

The odds go way up! (83%)

Question 10

What are the main 3 points as to why Dilantin causes gingival enlargement?

Answer 10

1.Suppresses MMP 2. Increases synthesis of GAG 3.Increased expression of Growth Factors

Question 11

Can gingival enlargement from Dilantin occur in edentulous mouths? Upper Pontics? Partials? What about implant fixtures?

Answer 11

Yes x 4 :)

Question 12

In dilantin gingival enlargement, Histologically there is epithelial _________ elongation.

Answer 12

rete ridge

Question 13

What happens to Type I and Type III collagen in dilantin gingival overgrowth? What about the non-collagen protein matrix?

Answer 13

Type III DOUBLES while there is LESS Type I than normal….there is a GREATER volume of non-collagen protein matrix

Question 14

What type of drug is ProCardia? What is its GENERIC name??

Answer 14

Ca2+ Channel Blocker…Ni-FED-I-PINE

Question 15

What type of drug is CARDizEM?

Answer 15

Ca2+ Channel Blocker

Question 16

What type of drug is ALdalAT?

Answer 16

Ca2+ Channel Blocker

Question 17

What type of drug is CARDene?

Answer 17

Ca2+ Channel Blocker

Question 18

What type of drug is IsopTIN?

Answer 18

Ca2+ Channel Blocker

Question 19

What are the two indications for Nifedipine (ProCardia)?

Answer 19

Angina pectoris and post-myocardial syndrome

Question 20

What is the Mechanism of Action for Nifedipine (Procardia)?

Answer 20

Blocks influx of Ca2+ into myocardial muscle cells leading to REDUCED oxygen demands

Question 21

How does Nifedipine (Procardia) induce gingival enlargement?

Answer 21

Genetic Predisposition=fibroblast phenotype will produce MORE collagen and matrix.. Also Collagenolytic activity of fibroblasts is a Ca2+ dependent event.

Question 22

What is CycloSporine (SANDimmune) prescribed for?

Answer 22

prescribed for immune suppression after major Organ Transplantation

Question 23

What is the mechanism of action for CycloSporine (SANDimmune)?

Answer 23

Suppresses some B-lymphocyes, but MORE SPECIFICALLY, CD8 Lymphocytes

Question 24

What are the 5 indications for a CycloSporine (SANDimmune) prescription? About how many people in the world are on this shiz?

Answer 24

1.Rheumatoid Arthritis 2.Sarcoidosis(immune cells forming granulomas) 3.Malaria 4.Psoriasis 5.Multiple Sclerosis….over 1 Bababababillion peeps

Question 25

What are the two main THEORIES (nothing elucidated) of why Cyclosporine (SANDimmune) causes gingival overgrowth?

Answer 25

1.Genetic disposition manifested through specific phenotypes of fibroblasts 2.Increased production of PDFG (platelet derived growth factor) that facilitates fibroblast proliferation.

Question 26

IN both Nifedipine and Cyclosporine gingival overgrowth you will see elongated epithelial _______ and ______ amount of collagen composition. There is INCREASED production of _______ by fibroblasts.

Answer 26

elongated epithelial rete ridges! and NORMAL amount of collagen composition…INCREASED production of matrix macromolecules by fibroblasts

Question 27

What are the two types of gingival enlargement assoc with Leukemia?

Answer 27

1.Acute Lymphocytic 2. Acute My-elo-cytic

Question 28

Dr. M has only seen this ONCE: Hereditary Gingival FibroMatosis….Which Chromosome is it associated with? Which gene on the chromosome??

Answer 28

Chromosome 2p21…SOS1 gene mutation

Question 29

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).

Answer 29

SOS1 gene….ras signal pathway

Question 30

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

Answer 30

ras…. apoptosis

Question 31

What is most likely a common cause for idiopathic gingival fibromatosis?

Answer 31

allergy…like in ortho. it can be surgically removed or go away on its own