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Perio > Perio test 1 - Diseases/treatments > Flashcards

Perio test 1 - Diseases/treatments Flashcards

1
Q

Systemic conditions with ANUG sequelae (7)

A 
1&2)Nutrition and stress
3)Poor oral hygiene
4&5)Fever and Lymphadenopathy
6)Smoking
7)AIDS
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2
Q

1 standout Effect

Gingival Effects of ANUG

Acute (3)

Chronic (1)

A

*punched out papilla

Acute

  • Stench
  • PAIN
  • Bleeding

Chronic: patients may have a background of previous CHRONIC Periodontitis

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3
Q

Do papilla that are lost during ANUG regenerate?

A

Usually NO.

-There is often a mucogingival defect that may be fixed with a Gingival Graft or other surgery.

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4
Q

Can ANUG be found extragingivally?

A

Yes.
-Palate and other soft tissue

it is RARE however.

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5
Q

Ignoring the complexity of a case, what is the most ideal treatment for the patient and their own long-term care with ANUG?

A

Giving the patient oral hygiene instruction, including a PROXY Brush.

-It may be VERY painful for the patient, but it can show the patient that this very UNPLEASANT disease can be controlled BY THE PATIENT with diligent home care!

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6
Q

Take home treatments for patient with ANUG (3)

A

Proxy brush and oral hygiene

Antimicrobial rinses
-H2O2 and Chlorhexidine Rinses

Antibiotics (for systemic conditions)
-ONLY if patient presents with fever OR Lymphadenopathy.

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7
Q

Antibiotics for ANUG (3)

A

Amoxicillin, Erythromycin and Metronidazole

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8
Q

What Anatomic reasoning is there for ANUG presenting with Punched out Papilla?

A

The disease effects: constriction of blood vessels that are IN nearby Gingival tissue, and because the papilla contain TERMINAL Blood Vessels in the oral circulation, there is necrosis.

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9
Q

Why is Root planing used in the treatment of ANUG.

A

It isn’t. Boom

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10
Q

What treatments may be done in the clinic for ANUG? (2)

A

Topical anesthetic.

  • Gentle Debridement ->Removing necrotic tissue
  • Cotton Pellet and ultrasonic SCALERS.
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11
Q

What is the initial action taken by clinician in a clinical setting for ANUG?

A

1 – Get patient out of pain (Topical anesthetic?)

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12
Q

How long after initial visit of a patient with ANUG would further treatment be planned?

A

> 4 Weeks - At least a month.

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13
Q

What types of treatment AFTER the initial visit of patient with ANUG may be performed?

-Why is this treatment done?

A

Surgical correction of gingival contours.

WHY?-It will restore aesthetics and increase patients ability for oral hygiene in areas effected.

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14
Q

What is Pericoronitis?

A

Pericoronitis (from the Greek peri, “around”, Latin corona “crown” and -itis, “inflammation”) also known as operculitis, is inflammation of the soft tissues surrounding the crown of a partially erupted tooth.

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15
Q

Step 1 in case of Pericoronitis?

-Evaluate disease FOR (2):

A

Evaluate disease FOR:

1) Severity of pain and inflammation

2) Systemic complications
* Fever / Lymphadenopathy

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16
Q

Treatments for Pericoronitis? (4)

A

1-Irrigation AND
2-Debridement (possibly with local or topical anesthetic)

3- Surgical removal of flap AND/OR
4- Removal of Tooth

17
Q

Why is removal of the flap of pericoronitis not sufficient treatment?

A

Leaving behind a Pseudo-pocket!

18
Q

Complications of Pericoronitis beyond initial presenting symptoms of inflammation and pain?

A

Pseudo-pocket.

-Deep tissues holding: Bacteria and impacted food

19
Q

Healing of Pericoronitis? (2)

A

Replacement of lost Gingiva with gingiva-like fibrous tissue.

-painless

20
Q

2 types of Gingivostomatitis

A

Primary and Recurrent.

21
Q

Primary (4) vs Recurrent (4)!

A

Primary

  • Children
  • Fever
  • Full mouth affected
  • Painfully sore MOUTH (entire)

Recurrent

  • Adults
  • Fever
  • Only parts of mouth innervated by affected ganglion
  • ——Released by stress or activation of ganglion by Prophy, etc.
  • 7-10 Day course!
22
Q

Palliative treatment for Acute Herpetic Gingivostomatitis (AHG) (4)

A

1) Topical anesthetic
2) Fluid intake ^^
3) Aspirin - NOT for children (risk of Rye’s Syndrome)
4) Antibiotics for systemic complications ONLY

23
Q

Medication for AHG (NOT antibiotics nor aspirin)?

- Time frame required for effectiveness of this Medication.

A

AntiVIRAL - Acyclovir (15mg/Kg) x 5 timesAday x 7 days

-must catch within 4 days or less for effectiveness.

24
Q

Common Differential for AHG.

-Differential diagnosis points (2)

A

Consistent with the vesicle–>Ulcers of Desquamative Gingivitis!

-Can be differentiated by 1) History of Desquamation and 2) weakness of all gingiva: Sloughing of gingival tissue.

25
Q

Another AHG differential (NO sloughing of gingiva)

-point of differential

A

Aphthous ulcers

-Aphthous ulcers will appear on Mucosa! not gingiva

26
Q

Common sequelae for Pericoronitis!

A

Acute! Periodontal abscess

27
Q

Symptoms of Acute Periodontal Abscess (PD abscess) (4)

A

1) Periodontitis specific bacteria
2) Deep pocket
3) Swelling
4) Pain

28
Q

Treatment of Acute PD Abscess (3)

A

1) Local anesthetic
2) Gentle debridement –>WITH small scaler ??? CURET?
3) Drainage*

29
Q

Types of drainage for Acute PD Abscess (2)

A

Drainage through pocket

External drainage

30
Q

“Drainage through pocket” PD abscess: step(s)

A

Usually place probe into possible pocket and there will be a release of puss and 90% chance of ALSO blood.

31
Q

When is Root Planing done on acute PD abscess?

A

Not during initial treatment. During follow up appointment.

32
Q

Follow up appointment for acute PD abscess? (3)

A
  • Analgesics
  • Antibiotics
  • *Definitive PD therapy (Phase I)
  • scaling and root planing to REDUCE pocket depth and likeliness of recurrence.
33
Q

Differential for acute PD abscess (3)

A

1) Pyogenic granuloma (only if pregnant and a woman…)
2) Malignancy (check for firmness and puss)
3) Acute Endodontic Abscess (NON-VITAL)

34
Q

Gingival Abscess

  • Found:
  • Common Cause:
A

Gingival abscess:

  • Found in Marginal Gingiva ONLY
  • Commonly caused by: Foreign object
35
Q

Treatment of Gingival Abscess (3-4)

A

1) Local Anesthetic
2) Debridement
3) Incision (if needed)
[4) Follow up]

36
Q 
All of these 5 diseases:
ANUG
-Pericoronitis
-AHG
-Acute PD Abscess
-Gingival abscess

All are considered:

A

Local Diseases!

37
Q

Fetor Oris is seen in

A

ANUG

38
Q

Fast recognition and treatment of AHG includes what medication (& dosing) ?
-*What phase of the viral infection is this treatment utilized

**How can this early treatment be utilized?

A

Acyclovir 15mg/Kg x 5 times a day x 7days

PRODROMAL Stage of Viral infection

**Patients can often feel the AHG “coming on” with repeated aggravations.

Perio (5 decks)

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