Necrotizing Periodontal Diseases Exam 5 Flashcards
What is the relationship of necrotizing periodontal diseases and host immune system?
- (1) In chronically, severely compromised patients and may constitute a severe or even life‐threating
condition: AIDS patients, severe malnourishment, extreme living conditions, or severe infections) - (2) in temporarily and/or moderately compromised patients health: Smokers or psycho‐socially stressed adult patients
Necrotizing Gingivitis
Necrotizing Periodontitis
Necrotizing Stomatitis
Are similar how?
- Insufficient evidence they are separate disease entities
- Different presentation or stages of same infection
- Related to diminished systemic resistance to infection
What is the previous names for necrotizing periodontal diseases?
Necrotizing Ulcerative Gingivitis/Periodontitis (NUG/NUP)
What is necrotizing gingivitis and what is its cause?
- Type of necrotizing periodontal disease limited to gingival tissues
- Caused by fusiform bacillus and spirochetes: Borrelia vincentii, Vincent’s infection
What are the predisposing factors of necrotizing periodontal disease?
- Bacteria
- Emotional stress: Trench mouth
- Smoking
- Decreased nutrition
- Systemic conditions with decreased resistance to infection: HIV/ AIDS
What are the clinical features for necrotizing gingivitis ?
- Red inflamed gingiva
▪ Extremely painful
▪ Spontaneous gingival bleeding
▪ Necrosis and ulceration of papillae and/or gingival
margin: Punched out or cratered lesions
▪ Heavy plaque - Pseudomembrane may be present
▪ Lymphadenopathy
▪ Fever
▪ Fetid odor
▪ Metallic taste
▪ Rapid onset
▪ Untreated can spread to periodontium and become necrotizing periodontitis
Diagnosis is based on what for Necrotizing gingivitis?
- signs and symptoms
- Resolves woth debridement and oral home care
What antibiotics are given with necrotizing gingivitis?
- With systemic symptoms of fever and malaise
- Penicillin and metronidazole
What is the difference between necrotizing gingivitis and mucositis ?
▪ Necrotizing gingivitis can involve adjacent soft
tissue beyond gingiva
Necrotizing Mucositis
▪ Type of necrotizing periodontal disease limited to
mucosal tissues
▪ Areas not continuous with gingiva
What is necrotizing periodontitis?
Individuals with systemic conditions including but not
limited to
▪ HIV infection
▪ Severe malnutrition
▪ Immunosuppression
What are the previous names for necrotizing periodontitis?
- HIV periodontitis
- Necrotizing Ulcerative Periodontitis
What are the clinical features for necrotizing periodontitis?
▪ Extensive necrosis of gingival tissues
▪ Rapid bone loss: Exposure and destruction of underlying bone
▪ Extremely painful
▪ Halitosis
▪ Gingival bleeding
▪ Pseudomembrane formation
▪ Ulceration and necrosis destroys marginal epithelium
which results in recession
▪ Lacks pocketing
▪ Deep crater-like osseous lesions
What is the cause for NUP?
Similar flora Periodontitis and Necrotizing Gingivitis
▪ Treponema species
▪ Selenomonas species
▪ Fusobacterium species
▪ Prevotella intermedia
▪ Variable level of spirochetes
What is Necrotizing stomatitis clinical features?
▪ Bone often exposed
▪ Necrosis
▪ Osteitis-Bone inflammation
▪ Sequestration- Dead bone / separation
▪ Untreated Necrotizing Periodontitis can spread into
adjacent maxilla and mandible- May develop without prior appearance of necrotizing gingivitis/periodontitis lesions
What are the predisposing factors for Necrotizing stomatitis?
▪ Poor hygiene
▪ Alcohol use
▪ Emotional stress
▪ Fatigue
▪ Recent illness
▪ Malnutrition or dehydration
▪ Smoking
▪ Systemic disease (immunocompromised)
