Other systemic diseases that may appear on the peridontium

Question 1

how do gingivae appear in desquamative gingivitis? how does induction differ from normal gingivitis?

Answer 1

non plaque induced red gingivae glazed w/ ulceration and desquamation of the attached gingivae

a non-dental biofilm induced inflammatory condition

Question 2

what causes desquamative gingivitis? most common?

Answer 2

most common cause of desquamative gingivitis = oral lichen planus

DG can also be caused by mucous membrane pemphigoid or pemphigus vulgaris

Question 3

what is drug induced gingival enlargement? (DIGE) why do large pockets form with this condition?

Answer 3

abnormal gingival enlargement from normal therapeutic doses of drugs

the over grown tissue is not attached so large pockets form

Question 4

give 3 drugs that can cause DIGE?

Answer 4

calcium channel blockers - ipine
antiepileptic drugs - phenytoin, sodium valproate
cyclosporine - immunosuppressant

Question 5

how do drugs cause DIGE? (increasing/reducing)

Answer 5

by increasing fibroblast production of ECM and reducing collagenase

Question 6

what is required in conjunction with the drug for DIGE to occur?

Answer 6

plaque biofilm

Question 7

list 2 methods of prevention of DIGE?

Answer 7

good plaque control
folic acid supplementation - may be good for phenytoin induced DIGE

Question 8

give 2 ways DIGE can be managed

Answer 8

change the causative drug
open wound gingivectomy

Question 9

what is the most common cause of gingival enlargement?

Answer 9

plaque induced inflammation - not DIGE

Question 10

list 4 other causes for gingival enlargement

Answer 10

hormonal
leukaemia
hereditary gingival fibromatosis
wegener’s granulomatosis - rare autoimmune disease, strawb gums

Question 11

name another non-dental biofilm induced condition - how may gingnivae/mucosae present?

Answer 11

factitious injury - self harm
may have ulcerated or marginal keratosis from chronic trauma