Other Periodontal Diseases and Conditions

Question 1

What are the two Necrotizing Periodontal Diseases (NPD)?

Answer 1

NUG (Necrotizing Ulcerative Gingivitis)

NUP (Necrotizing Ulcerative Periodontitis)

Question 2

NUG is confined to _____ and _______.

Answer 2

interdental papilla

marginal gingiva

Question 3

NUG is characterized by ____ onset of pain, _______, and bleeding.

Answer 3

rapid

necrosis of interdental gingiva

Question 4

NUG affects young adults and is associated with _____ and _____.

Answer 4

smoking

stress

Question 5

What is “pseudo membrane?”

Answer 5

ulcerations associated with NUG that are covered by a yellowish-white or grayish slough

Question 6

NUG has a _______ appearance due to necrotic interdental papilla.

Answer 6

Punched-Out

Question 7

What is the chief complaint of NUG?

Answer 7

Pain

Question 8

True or False: Swelling of regional lymph nodes may occur with Necrotizing Periodontitis.

Answer 8

True

Question 9

Which lymph nodes are usually involved with NPD?

Answer 9

usually SUBMANDIBULAR

sometimes CERVICAL also

Question 10

True or False: Fever and malaise are always associated with NPD.

Answer 10

False, not consistently found

Question 11

True or False: Increased salivation accompanies NPD.

Answer 11

True

Question 12

What is the prevalence of NPD in young adults of industrialized countries? What about young adults in developing countries? Immunocompromised individuals?

Answer 12

Industrialized: 2%-7%
Developing: much higher
HIV: 1%-28%

Question 13

Which three species of bacteria are associated with necrotizing periodontal diseases?

Answer 13

SPIROCHETES (treponema)
Fusobacterium
P. intermedia

Question 14

Which viruses are associated with NPD?

Answer 14

CMV (cytomegalovirus)

HIV

Question 15

What are four host factors that increase progression of NPD?

Answer 15

1. Immunosuppression
2. Pre-existing gingivitis, poor hygiene
3. Psychological stress, lack of sleep
4. Smoking

Question 16

In NPD, the connective tissue is ______ and the capillaries are ______.

Answer 16

hyperemic CT

engorged capillaries

Question 17

True or False: Histologically NPD is seen as necrosis of epithelium and deep layer of CT.

Answer 17

False, superficial layers of CT

Question 18

What are the four layers of NPD?

Answer 18

1. Bacterial Zone
2. Neutrophil rich Zone
3. Necrotic Zone
4. Spirocheteal Infiltration Zone

Question 19

What are two differential diagnoses of NPD?

Answer 19

1. Primary Herpetic Gingivostomatitis

2. Oral mucosal Disease

Question 20

Acute therapy for NPD involves debridement, oral rinses such as ________, and antibiotics such as ______.

Answer 20

chlorhexidine 0.12%

metronidazole

Question 21

Is NUG contagious? Is PHG?

Answer 21

NUG= no
PHG= yes (herpetic)

Question 22

What is a periodontal abscess?

Answer 22

a localized collection of pus within the tissues of the periodontium

Question 23

Periodontal abscesses are the third most common emergency condition and account for _____%

Answer 23

8%-14%

Question 24

What are the three types of abscesses in the periodontium?

Answer 24

gingival
periodontal
pericoronal

Question 25

True or False: Abscesses can be periodontis-related or non-periodontitis-related.

Answer 25

True

Question 26

A _____ abscess is irritation from foreign bodies forcefully embedded into healthy tissues.

Answer 26

gingival

Question 27

A ______ abscess is localized purulent inflammation in the periodontal tissues.

Answer 27

periodontal

Question 28

What are three situations that would result in periodontitis-related abscesses?

Answer 28

1. exacerbation of chronic lesions 2. post-therapy abscess following SRP or surgery 3. Post-antibiotic- super infection

Question 29

Non-periodontitis-related abscesses can result from _____ or ______.

Answer 29

Foreign body impaction | root morphology alterations

Question 30

What are two possible complications associated with periodontal abscess?

Answer 30

1. Tooth loss | 2. Systemic infections

Question 31

Which bacterial species is associated with Peridontal Abscesses?

Answer 31

P.gingivalis

Question 32

How are periodontal abscesses managed?

Answer 32

``` irrigation drainage debridement (if small) antibiotics (if large) OHI ```

Question 33

What is a definitive treatment plan for periodontal abscesses?

Answer 33

full mouth ScRP | Prophylaxis

Question 34

Differential diagnoses of periodontal abscesses include (4).

Answer 34

Vertical Root Fracture Endo-perio Abscess Osteomyelitis Tumors