Non-Plaque Induced Inflammatory Gingival Lesions Flashcards
T/F: Gingival inflammation, clinically presenting as gingivitis, is always due to accumulation of plaque on tooth surface
FALSE
its not always caused by plaque (but plaque is always present according to the previous lecture)
what types of gingival lesions are not caused by plaque accumulation? (theres 6 types)
1) Gingival lesions of VIRAL origin
2) Gingival lesions of FUNGAL origin
3) Gingival lesions of GENETIC origin
4) Gingival lesions of SYSTEMIC origin
5) TRAUMATIC lesions
6) Gingival lesions of specific bacterial origin
what gingival conditions are caused by specific bacteria?
Infective gingivitis and stomatitis
what are the clinical presentations of periodontitis caused by specific bacteria?
Fiery red edematous painful ulcerations
Asymptomatic chancres
Mucous patches
Atypical non-ulcerated, highly inflamed gingivitis
how is gingivitis (thats caused by specific bacterial species) diagnosed?
Biopsy
Microbiologic examination
what type of gingivitis is caused by the various herpes viruses? when are they most likely seen?
Acute herpetic gingivostomatitis
most frequently seen in infants and children younger than 6 yrs
what are the first clinical signs of acute hepatic gingivostomatitis?
Initially, it is characterized by the presence of discrete, spherical gray vesicles which may occur on the gingiva
within 24 hours, what happens to the spherical vesicles associated with acute hepatic gingivostomatitis?
vesicles rupture and form painfull small ulcers with a red, elevated, halo-like margin and a depressed yellowish or grayish white central portion
symptoms of Primary herpetic gingivostomatitis
- painful severe gingivitis with redness
- ulcerations with serofibrinous exudate
- edema accompanied by stomatitis
what are the characteristics of Primary herpetic gingivostomatitis
- Incubation period is one week.
- Formation of vesicles, which rupture, coalesce
and leave fibrin-coated ulcers. - Healing within 10 to 14 days.
________ is found in gingivitis, Necrotizing Ulcerative Diseases (NUG/NUP) and periodontitis
the herpes virus
T/F: More primary herpes infections occur at older ages in industrialized society
true
Primary herpetic gingivostomatitis may be asymptomatic in childhood, but may also give rise to ____________
severe gingivostomatitis
what is a characteristic manifestation of recurrent intraoral herpes infections?
a cluster of small painful ulcers in the attached gingiva and hard palate
Recurrent ______ infections occur, in general, more than once a year
herpes
Herpes Labialis
what are the characteristic of an infection from the Virocella-zoster virus?
- Small ulcers usually on the tongue, palatal and gingiva.
- Latent in the dorsal root ganglion.
- Unilateral lesions.
- 2nd and 3rd branch of the trigeminal ganglion
the diagnosis for _______ is usually obvious due to theunilateral occurrence of lesions associated with severe pain
Virocella-zoster virus
what are the 3 fungal infections that are most likely to effect the oral cavity?
Candidosis
Linear gingival erythema
Histoplasmosis
T/F: the fungus C.albicans is not found in the mouths of healthy patients
FALSE
found in 3-48% of healthy adults
what groups are at risk for Candidosis?
people with a reduced host defense (immunosuppressed individuals, infant and adult who has been on antibiotic therapy for some time)
________ is frequently isolated from the subgingival flora of patients with severe periodontitis
C.albicans
what are the clinical characteristics of candidosis?
Painless or slightly sensitive
Red and white lesions
Lesions can be scraped or separated from mucosa
how can candidosis be diagnosed?
A culture on Nickersons medium at room temp.
Microscopic examination of a smear of the material
scraped from the lesion and stained.
T/F: In otherwise healthy patients, oral candidosis rarely manifests in the gingiva
true
what are the different types of candidosis manifestations?
Pseudomembraneous, erythematous, plaque type, nodular
what is Linear gingival erythema?
Distinct linear erythematous band limited to the free gingiva
50% of _____ associated gingivitis sites are positive for C. albicans
HIV
the gingival manifestation of linear gingival erythema are usually seen in ___________ patients
immunosupressed
T/F: Linear gingival erythema does not respond well to improved oral hygiene or to scaling
true
what is Histoplasmosis
A granulomatous disease caused by Histoplasma capsulatum
the clinical manifestations of histoplasmosis include what?
include acute and chronic pulmonary histoplasmosis
T/F: oral histoplasmosis can be found anywhere in the mouth, but is usually found on the cheeks
FALSE- its usually found on the tongue
what is the treatment for histoplasmosis?
Systemic antifungal therapy
Type I allergic reactions (immediate Type), are mediated by ____
IgE
Type IV allergic reactions (delayed type) are mediated by what?
T-cells
what are the clinical signs of an oral allergic reaction
A diffuse fiery red edematous gingivitis sometimes with ulcerations or whitening
what are some common substances that a patient can be allergic to?
Dental restorative materials (type IV, contact allergy)
Oral hygiene products, chewing gum and food
name the 3 types of traumatic lesions
- Chemical
- Physical
- Thermal
what types of oral habits can cause traumatic ulcerative gingival lesions?
brushing and flossing techniques
what causes foreign body reactions?
Epithelial ulceration that allows entry of foreign material into gingival connective tissue
what bacterial species are involved with gingivitis due to bacteria?
Neisseria gonorrhea
Treponema pallidum
Streptococci
Mycobacterium chelonae
which type of oral Candidosis manifestation can be confused with oral leukoplakia?
plaque type
whitish plaque that cannot be removed
the Intra-oral lesions of ______ can be mistaken for aphthous ulcers
Recurrent HSV
herpes
how can you differentiate between a recurrent HSV infection and aphthous ulcers?
Aphthous ulcers do not affect keratinized mucosa
Flucanazole, Nystatin, Amphotericin B (IV) can all be used to treat what oral condition?
Thrush
Candidosis
