necrotizing perio diseases and abscesses

Question 1

what are the characteristics of both NUP and NUG?

Answer 1

Necrosis of papilla (“punched-out”)

Pain (chief complaint)

Bleeding

ATTACHMENT LOSS

Question 2

what part of the oral cavity does Necrotizing Ulcerative Stomatitis effect

Answer 2

the mucous membranes (gums, lips, or palate)

Question 3

what 2 groups are at the highest risk for necrotizing diseases?

Answer 3

young adults

Immunocompromized individuals (HIV)

Question 4

T/F: the prevalence of NUP/NUG in young adults in undeveloped areas of the world is between 2% and 7%

Answer 4

FALSE

its 2-7% in industrialized countries
much higher in undeveloped areas

Question 5

what are the clinical presentations of NUP and NUG?

Answer 5

Ulceration and necrosis of interproximal papillae
Painful gingiva
Bleeding (spontaneous, on slight provocation)

Question 6

what are the differential diagnosis of NUP and NUG?

Answer 6

Primary Herpetic Gingivostomatitis

Oral mucosal diseases

Question 7

which bacteria are associated with NUG/NUP?

Answer 7

Spirochetes (Treponema)
Fusobacterium
P. intermedia

Question 8

what host factors play a role in the development/progression of NUP and NUG?

Answer 8

Immunosuppression

Pre-existing gingivitis, poor oral hygiene, history of previous NPD

Psychological stress, lack of sleep

Smoking

Question 9

what are the acute treatments for NUP/NUG?

Answer 9

Debridement
Oral rinses (H2O2 – CHX)
Antibiotics

Question 10

________ abscesses are localized, painful, rapidly expanding lesion usually of sudden onset

Answer 10

gingival

Question 11

gingival abscesses are generally limited to the _____________ or ___________

Answer 11

marginal gingiva or interdental papillae

Question 12

what is the cause (etiology) of gingival abscesses?

Answer 12

irritation from foreign bodies forcefully embedded into previously healthy tissues

Question 13

what are periodontal abscesses?

Answer 13

localized purulent inflammation in the periodontal tissues

Question 14

periodontal abscesses extend from pocket to periodontal tissues, localized along _____________

Answer 14

lateral root surfaces

Question 15

__________ of periodontal abscesses occurs when drainage through pocket is impaired

Answer 15

localization

Question 16

when do periodontal abscesses usually occur?

Answer 16

Following trauma (root fracture) or endodontic perforation

Question 17

what are the 3 periodontal-related abscess types?

Answer 17

Exacerbation of chronic lesion

Post-therapy Abscess

Post-antibiotic Abscess

Question 18

name the 2 causes of Non-Periodontitis-related Abscesses

Answer 18

Foreign body impaction

Root morphology alterations

Question 19

what types of root morphology alterations can cause abscesses?

Answer 19

External root resorption

Cemental (root) tears

Iatrogenic (endodontic perforation)

Question 20

perio abscesses are found in ____% of patients that are being treated for periodontitis

Answer 20

27%

Question 21

where are perio abscesses most common?

Answer 21

in molar sites

Question 22

name the bacterial species associated with perio abscesses

Answer 22

Periodontitis flora

P. gingivalis

Question 23

what clinical signs are used to diagnose a periodontal abscess?

Answer 23

• Swelling/redness
• Suppuration
• Pain
• Gingival tenderness
• Associated with deep pocket
• BOP, mobility, radiographic bone loss
• Fever, malaise, lymphadenopathy

Question 24

untreated periodontal abscesses can cause ________, a condition in which bacteria enter the blood stream

Answer 24

bacteremia

Question 25

what are the differential diagnoses for perio abscesses?

Answer 25

Periapical (endodontic) abscess
Vertical root fractures
Endo-perio abscess

Question 26

what is involved in Acute lesion management? (treatment for periodontal abscesses)

Answer 26

Incision and drainage

SRP

Antibiotics

Periodontal Surgery

Question 27

what viruses have been associated with necrotizing ulcerative gingivitis?

Answer 27

Human cytomegalovirus

HIV