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DHHD 5003: Exam 2 > Jones 1 (Periodontal Pathology) > Flashcards

Jones 1 (Periodontal Pathology) Flashcards

1
Q
  • Linear band of erythema involving the free gingival margin
  • Punctate or diffuse erythema of the alveolar mucosa
  • May represent an unusual pattern of candidiasis
A

LINEAR GINGIVAL ERYTHEMA

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2
Q
  • Ulceration and necrosis of one or more interdental papillae
  • No loss of periodontal attachment
  • Gingival necrosis, bleeding, pain and halitosis
A

NECROTIZING ULCERATIVE GINGIVITIS (NUG)

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3
Q
  • Gingival ulceration and necrosis associated with rapidly progressing loss of periodontal attachment
  • Multiple isolated defects
  • Edema, severe pain, spontaneous hemorrhage
  • No deep pocketing
  • Does not respond to conventional periodontal therapy
A

NECROTIZING ULCERATIVE PERIODONTITIS (NUP)

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4
Q
  • Massive areas of tissue destruction
  • May involve soft tissue or bone
  • Results in sequestration
A

NECROTIZING STOMATITIS

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5
Q
  • “Epulis”: a generic term for any tumor of the gingiva or alveolar mucosa
  • Associated with the flange of an ill-fitting denture
  • Hyperplastic fibrous connective tissue in the alveolar vestibule
  • Usually develops on the facial alveolar ridge
  • Maxilla or mandible; F > M
A

EPULIS FISSURATUM

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6
Q
  • Reactive tissue growth that usually develops underneath a denture
  • Related to:
    1. Ill-fitting denture
    2. Poor denture hygiene
    3. Wearing the denture 24 hours a day
  • May also occur in dentate patients who are mouth breathers or have a high arched palate
  • Usually occurs on the hard palate
  • Erythematous mucosa with a pebbly or papillary surface
A

INFLAMMATORY PAPILLARY HYPERPLASIA

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7
Q
  • Represents an exuberant tissue response to local irritation or trauma
  • Smooth or lobulated mass that bleeds easily
  • 75%-85% of cases occur on the gingiva
  • MXG > MDG; anterior > posterior
  • Facial > lingual
  • Children and young adults; F > M
A

PYOGENIC GRANULOMA

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8
Q
  • Represents a reactive lesion caused by local trauma or irritation
  • Represents the soft tissue counterpart of the central giant cell granuloma
  • Only occurs on the gingiva or edentulous alveolar ridge
  • MDG > MXG
  • Any age; 52%-60% occur in females
  • Radiographic findings
    1. “Cupping” resorption of the underlying alveolar bone may occur
A

PERIPHERAL GIANT CELL GRANULOMA

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9
Q
  • Some are thought to begin as a pyogenic granuloma that has undergone fibrous maturation and subsequent calcification
  • Does not represent the soft tissue counterpart of a central ossifying fibroma
  • Occurs exclusively on the gingiva
  • MXG > MDG
  • Teens and young adults (10-19)
  • 2/3 occur in females
A

PERIPHERAL OSSIFYING FIBROMA

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10
Q
  • Histogenesis is uncertain
  • Occurs exclusively on the alveolar ridge of a newborn
  • Multiple tumors develop in 10% of cases
  • Maxillary ridge > mandibular ridge
  • 90% occur in females
A

CONGENITAL EPULIS

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11
Q
  • Autosomal recessive trait
  • Mutation and loss of function of the cathepsin C gene on the long arm of chromosome 11
  • Patients demonstrate oral and dermatologic manifestations
A

PAPILLON-LEFEVRE SYNDROME

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12
Q
  • Treatment
    1. Debridement combined with povidone-iodine irrigation
    2. Antimicrobial therapy: metronidazole, chlorhexidine, antifungals
    3. Follow-up care
    4. Long-term maintenance
A

NECROTIZING ULCERATIVE GINGIVITIS (NUG) and NECROTIZING ULCERATIVE PERIODONTITIS (NUP) Treatment

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13
Q
  • Treatment
    1. Antibiotics
    2. Debridement of necrotic tissue
A

NECROTIZING STOMATITIS Treatment

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14
Q
  • Histopathologic features
    1. Hyperplastic fibrous connective tissue
    2. Surface epithelium often demonstrates pseudoepitheliomatous hyperplasia
A

EPULIS FISSURATUM Histopathologic features

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15
Q
  • Treatment and prognosis
    1. Surgical excision
    2. Ill-fitting denture should be remade or relined
A

EPULIS FISSURATUM Treatment and prognosis

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16
Q
  • Histopathologic features
    1. Mucosa exhibits numerous papillary growths
    2. May demonstrate pseudoepitheliomatous hyperplasia
    3. May be associated with Candida
A

INFLAMMATORY PAPILLARY HYPERPLASIA Histopathologic features

17
Q
  • Treatment and prognosis
    1. Early lesions
      • Remove the denture
      • Topical or systemic antifungal therapy
    2. Advanced lesions
      • Excision of the hyperplastic tissue
      • Reline or remake the dentures
A

INFLAMMATORY PAPILLARY HYPERPLASIA Treatment and prognosis

18
Q
  • Histopathologic features
    1. Highly vascularized granulation tissue
    2. Often associated with surface ulceration
A

PYOGENIC GRANULOMA Histopathologic features

19
Q
  • Treatment and prognosis
    1. Conservative surgical excision
    2. Gingival lesions often recur if adjacent teeth are not thoroughly scaled to remove irritation
    3. 3%-15% recurrence rate
A

PYOGENIC GRANULOMA Treatment and prognosis

20
Q
  • May arise in pregnant women: pregnancy gingivitis
    1. 1st trimester to the 7th month
    2. Related to an increase in estrogen and progesterone levels as pregnancy progresses
A

PYOGENIC GRANULOMA Variation

21
Q
  • Histopathologic features
    1. Proliferation of multinucleated giant cells set in a vascularized fibrous connective tissue stroma
    2. Hemorrhage and hemosiderin
    3. Surface ulceration in 50% of cases
A

PERIPHERAL GIANT CELL GRANULOMA Histopathologic features

22
Q
  • Treatment and prognosis
    1. Local surgical excision
    2. Scale adjacent teeth
    3. 10%-18% of lesions recur
    4. May be associated with primary hyperparathyroidism
A

PERIPHERAL GIANT CELL GRANULOMA Treatment and prognosis

23
Q
  • Histopathologic features

1. Fibrous proliferation with the formation of a mineralized product: cementum, bone, or dystrophic calcification

A

PERIPHERAL OSSIFYING FIBROMA Histopathologic features

24
Q
  • Treatment and prognosis
    1. Local surgical excision
    2. Scale adjacent teeth
    3. 8%-16% recurrence rate
A

PERIPHERAL OSSIFYING FIBROMA Treatment and prognosis

25
Q
  • Histopathologic features
    1. Large, rounded cells with abundant granular, eosinophilic cytoplasm
    2. No pseudoepitheliomatous hyperplasia
    3. Cells do not stain with s-100 protein
A

CONGENITAL EPULIS Histopathologic features

26
Q
  • Treatment and prognosis
    1. Surgical excision
    2. No recurrence
    3. Complete regression without treatment has been reported
A

CONGENITAL EPULIS Treatment and prognosis

27
Q
  • Dermatologic manifestations
    1. First become evident by age 3
    2. Diffuse keratosis on the palms, soles, dorsa of hands and feet, elbows, knees
    3. White, yellow, or brown plaques that develop crusts, cracks, and fissures
A

PAPILLON-LEFEVRE SYNDROME Dermatologic manifestations

28
Q
  • Oral manifestations
    1. Advanced periodontitis of the primary and secondary dentitions
    2. Hyperplastic and hemorrhagic gingivitis
    3. Loss of bone support leading to teeth floating in space
    4. Exfoliation of all primary teeth by age 4 or 5
    5. Once edentulous the gingiva returns to normal until the permanent teeth erupt and the cycle starts over
    6. Exfoliation of all permanent teeth by age 15
    7. Periodontal destruction linked to infection with Aggregatibacter actinomycetemcomitans
A

PAPILLON-LEFEVRE SYNDROME Oral manifestations

29
Q
  • Treatment
    1. Skin: retinoids
    2. Oral
      • Difficult: disease often progresses until all teeth are lost
      • Antibiotic regimen: amoxicillin and metronidazole
      • Rigorous oral hygiene, prophylaxis, chlorhexidine mouth rinses
A

PAPILLON-LEFEVRE SYNDROME Treatment

DHHD 5003: Exam 2 (2 decks)

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