Oral Mucosa Disease

Question 1

Inflamed Gingiva

Answer 1

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

Question 2

Periodonititis

Answer 2

Loss of bone, PDL

Presence of dense inflammatory cell infiltrate

Question 3

Lymphocyte and macrophages are located in the CT and do not cross the epithelium into sulcus.

Answer 3

True

Question 4

PMNs are the only cells that get actively into the pocket

Answer 4

True

Question 5

White Pus

Green Pus

Answer 5

White –> neutrophils

Green –> myloperoxidases – BAD

Question 6

Fistula tract

Answer 6

Associated with periodontal abscess

Area where puss can travel out of tissue

Question 7

Can probe to root apex and see abscess

Can NOT probe to root apex

Answer 7

• endontic

* diabetes

Question 8

What antibody is primarily for mucosal epithelium

Answer 8

IgA

Question 9

Radiographs are used as an adjunct to diagnosis

Answer 9

True

DO NOT DIAGNOSE DIRECTLY FROM RADIOGRAPH

Question 10

Length of root tip (CEJ –> apex)

Answer 10

12 mm

Question 11

Probing bone loss

Answer 11

Use uncrowned teeth CEJ and reference point

Crowned teeth use apical aspect as reference point

Question 12

What probe is used to determine furcation bone involvement

Answer 12

Neighbors probe

Question 13

What if there is furcation invovlement

Answer 13

Test tooth’s vitality

Question 14

Inflammation of the gingiva

Answer 14

Inflammation is caused by multiple things

• underlying pathogenesis
• Gingivitis
• food
• Liver problems

Question 15

Bullous (blister forming) lesion

Answer 15

detachment of overlying epithelium tissue from underlying CT
* hemidesmosome

Question 16

Lichen Plantus

Answer 16

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

Question 17

Pemphigus vulgaris

Answer 17

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

Question 18

If you try a treatment and it doesn’t resolve what should you do?

Answer 18

Consider other types of lesions and biopsy

Question 19

Periodontal abscess

Answer 19

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

Question 20

Long standing periodontal abscess

Answer 20

will cause loss of bone

Before regenerating – make sure tooth is vital

Question 21

Lateral Periodontal Cyst

Answer 21

Epithelial lined sac

Rest cells of Mallasez

Question 22

Many lesions look the same! BIOPSY!

Answer 22

.

Question 23

Necrotizing Ulcerative Periodontal Disease

Answer 23

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

Question 24

Bisphosphonates Osteonecrosis

Answer 24

Stops the capacity of the bone to turn over