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perio exam 2: ging diseases 1 Flashcards

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1
Q

is ging infmm always from an accumulation of pq around tooth surface?

A

NO!

desquamative gingivitis also

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2
Q

desquamative gingivitis (i think this implies ging from stuff not pq) 6 ex’s are…

A
  1. sp B origin
  2. viral origin
  3. fungal origin
  4. genetic origin
  5. systemic origin
  6. trauma
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3
Q
  1. sp B origin-general info
A

infective ging and stomatitis (what’s diff? latter=wiki says mouth and lips)

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4
Q

desquamative gingivitis

A

wiki “Unlike plaque-induced inflammation of the gums (normal marginal gingivitis), desquamative gingivitis extends beyond the marginal gingiva, involving the full width of the gingiva and sometimes the alveolar mucosa.[3]”

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5
Q

bacteria involved with sp B origin ging

A

Neisseria ginorrhea, Treponema pallidum, streps, mycobacterium chelonae

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6
Q

with sp B origin ging, lesions are accompanied by lesions elsewhere in the body. t/f

A

with sp B origin ging, lesions may or may not be accompanied by lesions elsewhere in the body

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7
Q

sp B origin ging: clinical presentation

A

variations:
fiery red edematous painful ulcerations
asymptomatic chancres, mucous patches, atypical non-ulcerated, highly inflamed ging

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8
Q

sp B origin ging: diagnosis

A

biopsy or microiological exam

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9
Q

viral origin

A

herpes simplex 1* &2 or varicella zoster

*most often 1

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10
Q

how does primary hepatic gingvostomatitis occur?

A

the virus penetrates the oral mucosal epi and neural ending and travels to the trigeminal ganglion

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11
Q

primary hepatic gingvostomatitis symptoms

A

painful, severe redness, ulcerations w/serofibrinous exudate, edema accompinied by stomatitis

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12
Q

viral origin ging characteristics (3)

A
  1. 1 wk incubation
  2. forms vesicles–>rupture–>coalesce–>leave fibrin coated ulcers
  3. healing 10-14 days
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13
Q

how long can the herpes virus stay latent in the trigeminal gang?

A

years!

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14
Q

is herpes virus found in periodontitis, ging, or NUD (NUG/NUP)

A

any

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15
Q

more primary infections of herpes occur at younger ages in industrialized countries t/f

A

f-older ages

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16
Q

percentage of ppl w/ primary hepatic gingvostomatitis who get recurring lesions?

A

20-40%

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17
Q

recurrent herpatic infections-herpes labialis more or less than 1/yr and where?

A

more (vermillion border and skin adjacent)

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18
Q

recurrent herpatic infections-triggers

A

stress, menstruation, uv, fever

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19
Q

recurrent herpatic infections: diagnosis

A

aphtous ulceration, ulcers attached to ging and hard palate

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20
Q

ging lesions of viral origin: can they be life threatening?

A

yes in immunocompromised pt’s

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21
Q

what’s the best way to collect and same from ging lesions of viral origin?

A

aspiration from vesicles

wiki: “Fine-needle aspiration biopsy (FNAB, FNA or NAB), or fine-needle aspiration cytology (FNAC), is a diagnostic procedure used to investigate superficial (just under the skin) lumps or masses. In this technique, a thin, hollow needle is inserted into the mass for sampling of cells that, after being stained, will be examined under a microscope. “

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22
Q

blood samples can determine an increased what with regard to the virus?

A

increased antibody titer

histopathology is not specific

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23
Q

tx of ging lesions of viral origin (2)

A
  1. careful pq removal to limit bacterial superinfection of the ulcerations
  2. systemic uptake of antivirals like aciclovir
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24
Q

ging lesions of viral origin (herpes zoster) are latent where?

A

the dorsal root ganglion (then later it just has 2nd and 3rd trigeminal gang branches…)

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25
ging lesions of viral origin (herpes zoster) are bilateral ulcerations?
false. unilateral
26
ging lesions of viral origin (herpes zoster) clinical presentation
sm ulcerations on the tongue, palate, and ging may or may not have skin lesions also initial symptoms-pain and paresthesia
27
ging lesions of viral origin (herpes zoster): diagnosis
unilateral and super painful characteristic make it mostly "obvious"
28
ging lesions of viral origin (herpes zoster): tx
soft diet, rest, atraumatic pq removal, diluted chlorohexidine rinses. can be supplemented with antiviral thpy
29
ging from fungus-which three?
1. candidosis 2. linear ging erythema 3. histoplasmosis
30
ging from fungus-candidosis albicans; who, when is there disease?
carry this routinely also (3-48% of healthy ppl); reduced host defenses-immunocomp or longer term antibiotics
31
ging from fungus-candidosis albicans is frequently isolated from who?
severe perio pts' subgingival flora
32
ging from fungus-candidosis albicans-symptoms 3?
1. painless or slightly sensitive 2. red and white lesions 3. lesions can be scraped or separated from the mucous
33
ging from fungus-candidosis albicans risks?
cancer pts w/ radiation, several anti B's over several wks or months, diabetic pts, women, pregnancy and use of contraceptive
34
ging from fungus-candidosis albicans:diagnosis
culture on Nickerson's medium @ room temp | microscopic exam of the smear material scraped from the lesion and stained
35
ging from fungus-candidosis albicans: tx
antimycotic/antifungal agents | ex. nystatin given as mouth rinse systemically
36
ging from fungus-candidosis albicans: characteristics are pseudomembranous or erythematous?
trick question! both! characteristics can be pseudomembranous or erythematous
37
ging from fungus-candidosis albicans: typical clinical appearance: redness of ? gingiva often associated with a ? surface
attached; granular
38
ging from fungus-candidosis albicans: different types or oral mucosa manifestations: (4) which is associated with pain? which needs to be differentiated from leukoplakia? which has elevations that are slightly elevated? which have white patches that can be wiped off vs. type that something can't be removed?
pseudomembranous - whitish patches can be wiped off erythematous-red associated with pain pq type-whitish pq that can't be removed, need to differentiate from lekoplakia nodular has elevated nodes of white or reddish color
39
ging from fungus-candidosis albicans: linear erythematous band limited to the free gingiva
linear ging erythema
40
ging from fungus-candidosis albicans: linear ging erythema type-does it bleed? positive cutures for: % of HIV associated ging sites? % of unaffected sites of HIV seropositive pt's? % of healthy sites of HIV neg pt's?
NO! 50% hiv ging sites 26% healthy sites of hiv pts 3% healthy ppl healthy sites
41
ging from fungus-candidosis albicans: linear ging erythema: | does it response well to improved oral hygiene? to scaling?
no
42
ging from fungus-candidosis albicans: linear ging erythema: | is the infmm response proportional to the pq accumulation?
no.
43
ging from fungus-candidosis albicans: linear ging erythema: tx
conventional thpy + cholorhexidine .12% rinse antimycotic therapy if candida is detected (if the heading is fungi origin-why are there cases it isn't detected? other fungi?)
44
ging from fungus-histoplasmosis | will the pt know she/he has it?
yes-it affects the lungs 1st (my notes)
45
ging from fungus-histoplasmosis-where on pt?
acute or chronic pulmonary histo and a disseminated form in immunocompromised pts it can be on any area of the oral mucosa but mainly the tongue nodular or papillary and later may become ulcerative type of lesions with pain
46
ging from fungus-histoplasmosis: diagnosis is from?
clinical view and histopathology, systemic manifestations
47
ging from fungus-histoplasmosis: tx
systemic antifungal therapy
48
ging lesions of genetic origin: give an ex.
hereditary gingival fibromatosis
49
ging lesions of genetic origin: hereditary gingival fibromatosis: describe
diffuse gingival enlargement, diseae entity or part of a syndrome ex. hypertrichosis, mental or growth retardation, epilepsy, hearing loss, abnormalities of the extremities can interfere w/or prevent tooth eruption
50
ging lesions of genetic origin: hereditary gingival fibromatosis: possible mechanisms
TGF-B1 fairs the accumulation of the dcm might be located in chr 2 deletion of son of sevenless-1 gene on chr 2p21 (SOS)
51
ging lesions of systemic origin
allergic and traumatic reactions other ging manifestations mucocutaneous disorders
52
ging lesions of systemic origin: allergies are due to which two types of rxns?
type 1 or type 4 rxns
53
ging lesions of systemic origin: allergies with immediate type response are due to which type of rxns?
type 1 (type 4 is delayed (12-48 hrs post exposure)
54
ging lesions of systemic origin: allergies with IgE mediated type response are due to which type of rxns?
type 1
55
ging lesions of systemic origin: allergies can be due to what? give ex's
dental restorative materials (mercury, palladium, nickel, gold, zinc, chromium, acrylics and more) oral hygiene products, chewing gum or food (generally flavor additives or preservatives)
56
ging lesions of systemic origin: allergies can look like...
a diffuse fiery red edematus gingivitis. sometimes has ulcerations or whitenings
57
what can cause traumatic lesions?
chm, physical, or thermal
58
chm traumatic lesions
surface etching from chm w/toxic properties ex's: chlorohexidine-induced mucosal desquamation, acetylsalicylic acid burn, cocaine burn incorrect use of caustics by the dentist
59
physical traumatic lesions
1. hyperkeratsis-a white leukoplakia*-like frictional keratosis 2. ging lacerations 3. traumatic ulcerative ging lesion ex. brushing/flossing *wiki "Leukoplakia in the mouth (oral leukoplakia), is defined as "a predominantly white lesion of the oral mucosa that cannot be characterized as any other definable lesion".[6] However, this definition is inconsistently applied, and some refer to any oral white patch as "leukoplakia".[3] Leukoplakia and is a descriptive clinical term that is only correctly used once all other possible causes have been ruled out (a diagnosis of exclusion).[3] As such, leukoplakia is not a specific disease entity, and the clinical and histologic appearance are variable, i.e. the term has no specific histologic implications.[7]"
60
trauma: thermal injury
hot beverages, mostly on palatal ad labial mucosa | painful erythematous lesions, vesicles may develop
61
trauma: foreign body reactions
epi ulceration allows foreign bodies to enter ging ct. this can usually be detected on the x-ray ex. amalgam tattoos, abrasives, toothpicks
62
ging lesions of systemic origin
1. lichen planus 2. pemphigoid 3. pemphigus ? 4. erythematus multiform 5. lupus erythematosus 6. drug induced mucocutaneous disorders

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