Periodontal Disease

Question 1

Gingivitis

Answer 1

Inflammation limited to the soft tissues that surround teeth

Question 2

Gingivitis Clinical Features

Answer 2

Accumulation of dental plaque and calculusInflammation can be local or generalizedDiffuse, marginal gingivitis, or papillary gingivitis

Question 3

Gingivitis Signs

Answer 3

Loss of stippling and bleeding on gentle probingErythematous gingiva Severe cases may have pyogenic granulomas

Question 4

Gingivitis Epidemiology

Answer 4

Increased susceptibility during pubertyProgesterone (pregnancy) increases permeability of gingival blood vesselsRisk factors: smoking, stress, poor diet

Question 5

Gingivitis Histology

Answer 5

Inflammatory infiltrate with PMN, then lymphocytes

Question 6

Gingivitis Treatment

Answer 6

Reduce know risk factorsImprove oral hygieneRemove plaque

Question 7

Necrotizing Ulcerative Gingivitis

Answer 7

Vincent Infection, Trench MouthInfection caused byspirochetes and bacillus fusiformis in the presence of psychological stress.

Question 8

NUG Clinical Features

Answer 8

Interdental papillae are highly inflamed, edematous, and hemorrhagic.Papillae are blunted with crater-like necrosis covered by grey pseudomembrane.Can lead to loss of attachment

Question 9

NUG Epidemiology

Answer 9

Mostly seen in young and middle-aged adults and militaryCan occur in all ages

Question 10

NUG Histology

Answer 10

Non-specificInflammation, ulceration, necrotic material

Question 11

NUG Treatment

Answer 11

Debride and rinses to remove bacteriaResolves quickly

Question 12

Granulomatous Gingivitis

Answer 12

Unexplained granulomatous inflammation on gingival biopsyRule out all other possible causesMay be caused by foreign body in gingival tissue

Question 13

Granulomatous Gingivitis Clinical Features

Answer 13

Red and white macules at interdental papillaePain, sensitivity

Question 14

Granulomatous Gingivitis Epidemiology

Answer 14

Most frequently in adults

Question 15

Granulomatous Gingivitis Histology

Answer 15

Granulomas with multinucleated giant cells

Question 16

Granulomatous Gingivitis Treatment

Answer 16

Surgically excise foreign bodyIf no foreign body, evaluate for other diseases

Question 17

Desquamative Gingivitis

Answer 17

Gingival epithelium that sloughs spontaneously or with minor manipulation

Question 18

Desquamative Gingivitis Epidemiology

Answer 18

Female> 40 yo

Question 19

Desquamative Gingivitis Clinical Features

Answer 19

Gradual involvementMore facial than lingualSmooth erythemaLoss of stipplingPainfulCan have blisters

Question 20

Desquamative Gingivitis Histology

Answer 20

Lichen planus or pemphigoid

Question 21

Desquamative Gingivitis Treatment

Answer 21

Clean areaDoxycyclineImmunosupressants

Question 22

Drug Related Gingival Hyperplasia

Answer 22

Abnormal growth of gingival tissues secondary to systemic medication due to an increased production of ECM (collagen)Most common with cyclosporine and phenytoinAssociated with poor dental hygiene???

Question 23

DRGH Epidemiology

Answer 23

25 and younger

Question 24

DRGH Clinical Features

Answer 24

Enlargements start in interdental papillae and spreadDark red, bleeds easily, can ulcerateCan interfere with speech and mastication

Question 25

DRGH Histology

Answer 25

Elongated rete ridgesIncreased collagen

Question 26

DRGH Treatment

Answer 26

Discontinue medicationIf med can't be stopped - professional evaluations and home plaque controlFolic Acid

Question 27

Gingival Fibromatosis

Answer 27

Hyperplasia of gingiva

Question 28

Gingival Fibromatosis Epidemiology

Answer 28

Familial or idiopathicBegins < 20 yoMay be associated with hypertrichosis, epilepsy, and mental retardation

Question 29

Gingival Fibromatosis Clinical Features

Answer 29

Enlarged gingivaNormal colorSmooth surface

Question 30

Gingival Fibromatosis Histopathology

Answer 30

Dense hypocellularHypovascular tissueAbsent inflammation

Question 31

Gingival Fibromatosis Treatment

Answer 31

GingivectomyOral hygieneSometimes tooth extraction

Question 32

Periodontitis

Answer 32

Inflammation of gingival tissue with associated loss of bony attchment and supportRisk factors: smoking, diabetes, genetics

Question 33

Periodontitis Bacteria

Answer 33

Healthy gingiva: facultative gram postitivePeriodontisis: gram negative-A.a.-Bacteroides-Prevotella intermadiaForm biofilmRelease lipopolysaccharides, stimulate inflammation

Question 34

Chronic Periodontitis

Answer 34

Primary cause of tooth loss in pts >35 yoNo inflammationBlunting and apical positioning of the gingival marginsLoss of attachment (shown with probe)

Question 35

Necrotizing Ulcerative Periodontitis

Answer 35

Similar to NUG, with loss of attachment and alveolar boneMay occur in preexisting areas of NUG or periodontitisPts are younger

Question 36

Periodontal Abcess

Answer 36

Occurs in pre-existing periodontal lesionCan result from super infectionAppears as lateral enlargement of gingivaMay be red with edema or bleedingPain, sensitivity on palpation, foul taste, fever

Question 37

Pericoronitis

Answer 37

Develops around impacted or partially erupted teeth with debris between the gingival flap and the crownInflammationFoul tasteCan't close jaws, pain may radiate to throat, floor of mouth, or ear

Question 38

Periodontitis Histology

Answer 38

Hyperplasia of epitheliumIncreased vascularityInflammation