Oral Mucosa Disease Flashcards
Inflamed Gingiva
Dense inflammatory cell infiltrate – PMNs
Increased # of blood vessels
Increased vascular permeability
Disrupt epithelial cell junctions
Clinically – Tissue is red, spongy, edematous
Probing depths increase
Periodonititis
Loss of bone, PDL
Presence of dense inflammatory cell infiltrate
Lymphocyte and macrophages are located in the CT and do not cross the epithelium into sulcus.
True
PMNs are the only cells that get actively into the pocket
True
White Pus
Green Pus
White –> neutrophils
Green –> myloperoxidases – BAD
Fistula tract
Associated with periodontal abscess
Area where puss can travel out of tissue
Can probe to root apex and see abscess
Can NOT probe to root apex
- endontic
* diabetes
What antibody is primarily for mucosal epithelium
IgA
Radiographs are used as an adjunct to diagnosis
True
DO NOT DIAGNOSE DIRECTLY FROM RADIOGRAPH
Length of root tip (CEJ –> apex)
12 mm
Probing bone loss
Use uncrowned teeth CEJ and reference point
Crowned teeth use apical aspect as reference point
What probe is used to determine furcation bone involvement
Neighbors probe
What if there is furcation invovlement
Test tooth’s vitality
Inflammation of the gingiva
Inflammation is caused by multiple things
- underlying pathogenesis
- Gingivitis
- food
- Liver problems
Bullous (blister forming) lesion
detachment of overlying epithelium tissue from underlying CT
* hemidesmosome
Lichen Plantus
Cyclic schedule Localized Inflammatory infiltrate * may predispose an individual for squamos cell carcinoma Appearance of buccal mucosa -- striae
Liquefaction and loss of basement membrane
Tissue sluffs off
Pemphigus vulgaris
Antibody attacks the desmosomes between the cells
Staining – in stratum spinosum
Blistering – tissues will slough off because the cells are not attached to one another
(stratum spinosum separates from basement membrane
If you try a treatment and it doesn’t resolve what should you do?
Consider other types of lesions and biopsy
Periodontal abscess
Fistula
Painful –> pressure from swelling
Primary cells –> PMNs
Check vitality of tooth, Check pocket depth
Treatment:
IND - incision and drainage
Debridement
DO NOT root plane and scale
Won’t get loss of bone – contained in soft tissue
Long standing periodontal abscess
will cause loss of bone
Before regenerating – make sure tooth is vital
Lateral Periodontal Cyst
Epithelial lined sac
Rest cells of Mallasez
Many lesions look the same! BIOPSY!
.
Necrotizing Ulcerative Periodontal Disease
Typically HIV population
TRENCH MOUTH - smells bad
Fusoform bacteria, spirochete
Treatment: Antibiotics, irrigations (chlorahexidene)
Localized inflammation will cause bone loss acutely
* periodontium decreases in health quickly! *
Can cause a deep infection – into bone
Bisphosphonates Osteonecrosis
Stops the capacity of the bone to turn over
