necrotizing perio diseases and abscesses Flashcards
what are the characteristics of both NUP and NUG?
Necrosis of papilla (“punched-out”)
Pain (chief complaint)
Bleeding
ATTACHMENT LOSS
what part of the oral cavity does Necrotizing Ulcerative Stomatitis effect
the mucous membranes (gums, lips, or palate)
what 2 groups are at the highest risk for necrotizing diseases?
young adults
Immunocompromized individuals (HIV)
T/F: the prevalence of NUP/NUG in young adults in undeveloped areas of the world is between 2% and 7%
FALSE
its 2-7% in industrialized countries
much higher in undeveloped areas
what are the clinical presentations of NUP and NUG?
Ulceration and necrosis of interproximal papillae
Painful gingiva
Bleeding (spontaneous, on slight provocation)
what are the differential diagnosis of NUP and NUG?
Primary Herpetic Gingivostomatitis
Oral mucosal diseases
which bacteria are associated with NUG/NUP?
Spirochetes (Treponema)
Fusobacterium
P. intermedia
what host factors play a role in the development/progression of NUP and NUG?
Immunosuppression
Pre-existing gingivitis, poor oral hygiene, history of previous NPD
Psychological stress, lack of sleep
Smoking
what are the acute treatments for NUP/NUG?
Debridement
Oral rinses (H2O2 – CHX)
Antibiotics
________ abscesses are localized, painful, rapidly expanding lesion usually of sudden onset
gingival
gingival abscesses are generally limited to the _____________ or ___________
marginal gingiva or interdental papillae
what is the cause (etiology) of gingival abscesses?
irritation from foreign bodies forcefully embedded into previously healthy tissues
what are periodontal abscesses?
localized purulent inflammation in the periodontal tissues
periodontal abscesses extend from pocket to periodontal tissues, localized along _____________
lateral root surfaces
__________ of periodontal abscesses occurs when drainage through pocket is impaired
localization
when do periodontal abscesses usually occur?
Following trauma (root fracture) or endodontic perforation
what are the 3 periodontal-related abscess types?
Exacerbation of chronic lesion
Post-therapy Abscess
Post-antibiotic Abscess
name the 2 causes of Non-Periodontitis-related Abscesses
Foreign body impaction
Root morphology alterations
what types of root morphology alterations can cause abscesses?
External root resorption
Cemental (root) tears
Iatrogenic (endodontic perforation)
perio abscesses are found in ____% of patients that are being treated for periodontitis
27%
where are perio abscesses most common?
in molar sites
name the bacterial species associated with perio abscesses
Periodontitis flora
P. gingivalis
what clinical signs are used to diagnose a periodontal abscess?
- Swelling/redness
- Suppuration
- Pain
- Gingival tenderness
- Associated with deep pocket
- BOP, mobility, radiographic bone loss
- Fever, malaise, lymphadenopathy
untreated periodontal abscesses can cause ________, a condition in which bacteria enter the blood stream
bacteremia
what are the differential diagnoses for perio abscesses?
Periapical (endodontic) abscess
Vertical root fractures
Endo-perio abscess
what is involved in Acute lesion management? (treatment for periodontal abscesses)
Incision and drainage
SRP
Antibiotics
Periodontal Surgery
what viruses have been associated with necrotizing ulcerative gingivitis?
Human cytomegalovirus
HIV
