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FINALS - Periodontology > Necrotizing Periodontal Disease > Flashcards

Necrotizing Periodontal Disease Flashcards

1
Q

What causes necrotizing periodontal diseases?

A

Plaque bacteria

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2
Q

What are the characteristics of NPD?

A

Rapidly destructive and debilitating shared predisposing factors - under stress opportunistic infection

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3
Q

What are the main features of NPD?

A

Painful, bleeding gums and ulceration and necrosis of interdental papilla - punched out appearance

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4
Q

What is necrotizing gingivitis?

A

When only gingival tissues infected

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5
Q

What is necrotizing periodontitis?

A

When necrosis progresses into PDL and alveolar bone leading to attachment loss

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6
Q

What is necrotizing stomatitis?

A

Necrosis progresses into deeper tissues beyond mucogingival line including lip or cheek mucosa and tongue

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7
Q

Who does necrotizing stomatitis usually occur in?

A

Malnutrition or HIV infected peopled

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8
Q

What does necrotizing stomatitis result in?

A

Denudation of bone leading to osteitis and oral antral fistula

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9
Q

What is cancrum oris?

A

Necrotizing and destructive infection of mouth and face occurring in malnourished children

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10
Q

What is Vincent’s angina?

A

Necrotising inflamation of the tonsils and pharynx, caused by NUG

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11
Q

What does the gingiva look like in necrotizing gingivitis

A

Ulcerated and necrotic papillae and gingival margin resulting in a characteristic punched out appearance

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12
Q

What are the ulcers covered with?

A

Slime made of fibrin, necrotic tissue, leucocytes, erythrocytes and mass of bacteria

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13
Q

What are the symptoms of necrotizing gingivitis?

A

Ulcerated papilla covered in slime quick developing lesions which are painful bleed if provoked first lesions interproximally in mandibular anterior region

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14
Q

What are the symptoms of necrotizing periodontitis?

A

Ulcers with deep pockets
Ulcers which develop into craters due to central necrosis
Adenopathy’s in severe cases fever
Feeling of discomfort

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15
Q

Why is diagnosis not based on bacterial tests?

A

As spirochetes and fusobacterias are not always found in the primary lesion

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16
Q

What are the differential diagnoses for a patient with suspected necrotizing periodontal disease?

A

Oral mucositis
HIV associated periodontitis
HSV
Scurvy
Gingivostomatitis
Desquamative gingivitis
Invasive fungal disease
Illicit drug related gingival disease
Agranulocytosis
Leukemias
Chronic periodontitis

17
Q

What is herpetic gingivostomatitis caused by?

A

HSV

18
Q

Who does herpetic gingivostomatitis affect?

A

Children

19
Q

What area in the mouth does herpetic gingivostomatitis affect?

A

Gingiva and entire oral mucosa

20
Q

What is the symptoms of herpetic gingivostomatitis?

A

Multiple vesicles which disrupt, leaving small round fibrin covered ulcerations

21
Q

What are the risk factors for NPD?

A

Stress, sleep deprivation, poor OH, smoking, immunosuppression malnourished children - developing countries

22
Q

What are the 2 objectives of treatment?

A

Arrest disease process and tissue destruction control patients general feeling of discomfort and pain interfering with nutrition and OH

23
Q

What is treatment of NPD?

A

Superficial debridement to remove deposits daily for as long as acute phase lasts (2-4 days)

24
Q

What should the patient not do during NPD treatment and what should they do instead?

A

No mechanical oral hygiene use chlorhexidine mouthwash instead

25
Q

Why should the patient not use mechanical oral hygiene during NPD treatment?

A

It can disrupt healing process after debridement

26
Q

What should you prescribe if patient shows unsatisfactory response to debridement or shows systemic effects?

A

Metronidazole 400mg three times daily 3 days

27
Q

Why are locally delivered antimicrobials not recommended in NPD?

A

Large numbers of bacteria present within tissues where local drug will not be able to achieve adequate concentrations

28
Q

How often should you be seeing NPD patients?

A

Every day

29
Q

What do you do once you have treated the acute phase of the disease?

A

Treat the pre-existing condition (gingivitis/periodontitis) control systemic predisposing factors

30
Q

Why should correction of gingival anatomy be considered?

A

Plaque accumulation can occur in the craters

31
Q

What are the options for corrective treatment of the disease?

A

Gingivectomy/gingivoplasty procedures periodontal flap surgery regenerative surgery

32
Q

What is the goal during supportive or maintenance phases?

A

Compliance with oral hygiene practices and control of predisposing factors

33
Q

What should the patient be screened for if they have NPD and why?

A

HIV as they might not be aware of their condition

FINALS - Periodontology (16 decks)

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