Non-Plaque Induced Inflammatory Gingival Lesions Flashcards

1
Q

T/F: Gingival inflammation, clinically presenting as gingivitis, is always due to accumulation of plaque on tooth surface

A

FALSE

its not always caused by plaque (but plaque is always present according to the previous lecture)

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2
Q

what types of gingival lesions are not caused by plaque accumulation? (theres 6 types)

A

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

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3
Q

what gingival conditions are caused by specific bacteria?

A

Infective gingivitis and stomatitis

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4
Q

what are the clinical presentations of periodontitis caused by specific bacteria?

A

Fiery red edematous painful ulcerations

Asymptomatic chancres

Mucous patches

Atypical non-ulcerated, highly inflamed gingivitis

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5
Q

how is gingivitis (thats caused by specific bacterial species) diagnosed?

A

Biopsy

Microbiologic examination

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6
Q

what type of gingivitis is caused by the various herpes viruses? when are they most likely seen?

A

Acute herpetic gingivostomatitis

most frequently seen in infants and children younger than 6 yrs

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7
Q

what are the first clinical signs of acute hepatic gingivostomatitis?

A

Initially, it is characterized by the presence of discrete, spherical gray vesicles which may occur on the gingiva

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8
Q

within 24 hours, what happens to the spherical vesicles associated with acute hepatic gingivostomatitis?

A

vesicles rupture and form painfull small ulcers with a red, elevated, halo-like margin and a depressed yellowish or grayish white central portion

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9
Q

symptoms of Primary herpetic gingivostomatitis

A
  • painful severe gingivitis with redness
  • ulcerations with serofibrinous exudate
  • edema accompanied by stomatitis
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10
Q

what are the characteristics of Primary herpetic gingivostomatitis

A
  • Incubation period is one week.
  • Formation of vesicles, which rupture, coalesce
    and leave fibrin-coated ulcers.
  • Healing within 10 to 14 days.
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11
Q

________ is found in gingivitis, Necrotizing Ulcerative Diseases (NUG/NUP) and periodontitis

A

the herpes virus

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12
Q

T/F: More primary herpes infections occur at older ages in industrialized society

A

true

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13
Q

Primary herpetic gingivostomatitis may be asymptomatic in childhood, but may also give rise to ____________

A

severe gingivostomatitis

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14
Q

what is a characteristic manifestation of recurrent intraoral herpes infections?

A

a cluster of small painful ulcers in the attached gingiva and hard palate

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15
Q

Recurrent ______ infections occur, in general, more than once a year

A

herpes

Herpes Labialis

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16
Q

what are the characteristic of an infection from the Virocella-zoster virus?

A
  • 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
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17
Q

the diagnosis for _______ is usually obvious due to theunilateral occurrence of lesions associated with severe pain

A

Virocella-zoster virus

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18
Q

what are the 3 fungal infections that are most likely to effect the oral cavity?

A

Candidosis

Linear gingival erythema

Histoplasmosis

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19
Q

T/F: the fungus C.albicans is not found in the mouths of healthy patients

A

FALSE

found in 3-48% of healthy adults

20
Q

what groups are at risk for Candidosis?

A

people with a reduced host defense (immunosuppressed individuals, infant and adult who has been on antibiotic therapy for some time)

21
Q

________ is frequently isolated from the subgingival flora of patients with severe periodontitis

A

C.albicans

22
Q

what are the clinical characteristics of candidosis?

A

Painless or slightly sensitive

Red and white lesions

Lesions can be scraped or separated from mucosa

23
Q

how can candidosis be diagnosed?

A

A culture on Nickersons medium at room temp.

Microscopic examination of a smear of the material
scraped from the lesion and stained.

24
Q

T/F: In otherwise healthy patients, oral candidosis rarely manifests in the gingiva

A

true

25
Q

what are the different types of candidosis manifestations?

A

Pseudomembraneous, erythematous, plaque type, nodular

26
Q

what is Linear gingival erythema?

A

Distinct linear erythematous band limited to the free gingiva

27
Q

50% of _____ associated gingivitis sites are positive for C. albicans

A

HIV

28
Q

the gingival manifestation of linear gingival erythema are usually seen in ___________ patients

A

immunosupressed

29
Q

T/F: Linear gingival erythema does not respond well to improved oral hygiene or to scaling

A

true

30
Q

what is Histoplasmosis

A

A granulomatous disease caused by Histoplasma capsulatum

31
Q

the clinical manifestations of histoplasmosis include what?

A

include acute and chronic pulmonary histoplasmosis

32
Q

T/F: oral histoplasmosis can be found anywhere in the mouth, but is usually found on the cheeks

A

FALSE- its usually found on the tongue

33
Q

what is the treatment for histoplasmosis?

A

Systemic antifungal therapy

34
Q

Type I allergic reactions (immediate Type), are mediated by ____

A

IgE

35
Q

Type IV allergic reactions (delayed type) are mediated by what?

A

T-cells

36
Q

what are the clinical signs of an oral allergic reaction

A

A diffuse fiery red edematous gingivitis sometimes with ulcerations or whitening

37
Q

what are some common substances that a patient can be allergic to?

A

Dental restorative materials (type IV, contact allergy)

Oral hygiene products, chewing gum and food

38
Q

name the 3 types of traumatic lesions

A
  • Chemical
  • Physical
  • Thermal
39
Q

what types of oral habits can cause traumatic ulcerative gingival lesions?

A

brushing and flossing techniques

40
Q

what causes foreign body reactions?

A

Epithelial ulceration that allows entry of foreign material into gingival connective tissue

41
Q

what bacterial species are involved with gingivitis due to bacteria?

A

Neisseria gonorrhea
Treponema pallidum
Streptococci
Mycobacterium chelonae

42
Q

which type of oral Candidosis manifestation can be confused with oral leukoplakia?

A

plaque type

whitish plaque that cannot be removed

43
Q

the Intra-oral lesions of ______ can be mistaken for aphthous ulcers

A

Recurrent HSV

herpes

44
Q

how can you differentiate between a recurrent HSV infection and aphthous ulcers?

A

Aphthous ulcers do not affect keratinized mucosa

45
Q

Flucanazole, Nystatin, Amphotericin B (IV) can all be used to treat what oral condition?

A

Thrush

Candidosis