Nectrotising Periodonal Disease Flashcards
What is necrotising gingivitis?
Only gingival tissues affected
‘Note necrotisation of papilla’
What is necrotising periodontitis?
Necrosis progresses into the periodontal ligament and alveolar bone, leading to loss of attachment
What is necrotising stomatitis?
Necrosis progresses to deeper tissues beyond mucogingival line - including lip or cheek
Can lead to OAF
What are characteristics/symptoms of ‘necrotising disease’?
Rapidly destructive and develop quickly
Due to shared factors in population e.g. students during exams
Very Painful,
bleeding gums
ulceration and necrosis of the papilla ‘punched out appearance’ - covered ion yellow/white slain ‘pseudomembrane’
Deep pockets and attachment loss
‘Opportunistic infection’
Why can’t diagnosis be based on testing?
Biopsy - histopathology is not characteristic for NPD
Microbiology - not characteristic either
What are some risk factors of NPD?
Young adult with predisposing factors such as:
- psychological stress
- sleep deprivation
- poor oral hygiene
- smoking
- immunosuppression e.g. HIV or leukaemia
What are the aims of treating the acute phase of NPD?
Arrest the disease process and tissue destruction
Control patients feeling of discomfort and pain interfering with nutrition and oral hygiene
What treatment should occur for NPD?
Start with careful superficial debridement - removes soft mineralised deposits (daily)
during this period patient should avoid brushing their teeth and use chlorhexadine twice daily
What treatment should follow if response to debridement is unsatisfactory?
Prescribe anti microbial
Metronidazole 400mg TID 3 days
Followed by daily visits
Following the patients improvement of NPD, what treatment should occur?
Treatment of the pre-existing condition that the NPD occurred over.
Most likely chronic gingivitis or periodontal disease
Management of left over gingival craters from NPD, this can involve gingival surgery
What follows all treatment??
Maintenance and supportive care, maintain oral hygiene
