Unit 9 - Other Conditions Affecting the Periodontium Flashcards
What are the six other conditions affecting the periodontium?
- Necrotizing periodontal diseases
- Mucogingival deformaties and conditions around the teeth
- Tooth and prosthesis related predisposing factors
- Periodontal abscesses and endodontic-periodontal lesions
- Traumatic occlusal forces
- Local risk factors
What is necrosis?
Tissue death
What is included in necrotizing periodontal disease?
Necrotizing gingivitis
Necrotizing periodontitis
Necrotizing stomatitis
All necrotizing periodontal diseases have three clinical freatures including:
Tissue necrosis
Spontaneous bleeding
Pain
True or False: necrotizing periodontal diseases are associated with impairment of the host immune system and found in clients who are severely immunocompromised.
True
Is necrotizing periodontal disease painful?
Yes, very painful
Clients with necrotizing periodontal disease will present with ulcerated, necrotic papillae and gingival marings with some areas being covered by a whitish/grayish slough which is called:
A pseudo membrane
What will it look like under the pseuo membrane with necrotizing periodontal disease?
Very red, shiny tissue that can bleed spontaneously
What are other signs of necrotizing periodontal disease?
Swollen lymph nodes
Fever
Malaise
What are the necrotizing periodontal disease predisposing factors?
Severe biofilm related condition
Impaired immune response
Associated with immunosuppression in conditions such as HIV infection/AIDS
Highest prevalance between ages 20-30
Malnutrition/poor nutrition, fatigue, alchohol/drug abuse, smoking
What is necrotizing gingivitis?
Tissue necrosis confined to the gingival tissues
What are the signs and symptoms of necrotizing gingivitis?
Ulcerations or necrosis of the interdental papillae
Gingival bleeding
Pain
What is necrotizing periodontitis?
Tissue necrosis of the gingival tissues and loss of attachment and alveolar bone
What are the signs and symptoms of necrotizing periodontitis?
Necrosis of the gingiva, PDL and bone that can happen very rapidly and is very painful
What is necrotizing stomatitis?
The most severe condition with severe tissue necrosis that extends beyond the gingival tissues in the cheeks, tongue and palate along with bone destruction and osteitis (inflammation of the bone).
What is the treatment for necrotizing gingivitis?
Anti-inflammatory for pain
Chlorhexidine or hydrogen peroxide rinse
Removal of pseudo membrane
Debridement
Avoid alcohol, drugs, smoking
OHI and nutrition counselling
Antibiotics may be prescribed
Treatment for necrotizing periodontitis
Referral to peridontist
Treatment for necrotizing stomatitis
Immediate referral to an oral pathologist and/or oral surgeon
What are examples of systemic diseases affecting the periodontium?
Rare disorders (down symdrome)
Oral cancer
Diabetes
Osetoporosis
What are the mucogingival deformaties and conditions around the teeth?
Gingival recession
Lack of keratinized gingiva
Decreased vestibular depth
Absent frenum/muscle position
Gingival excess
Abnormal colour
What is the most common of the mucoingival deformaties and conditions around the teeth?
Gingival recession
What was the most commonly used classification system for recession of the margin but has recently been replaced?
Miller Classifcation System for Recession of Gingival Margin
What is the current classification system for recession?
Cairo Classification System for Recession of Gingival Margin
How does the Cairo classification system for recession work?
It is based on CAL measurements at buccal and interproximal sites
What is RT1?
Gingival recession with no loss of interproximal attachment
What is RT2?
Gingival recession associated with interproximal attachment loss (interproximal loss is less than or equal to the buccal loss). Periodontitis horizontal bone loss.
What is RT3?
Gingival recession associated with interproximal attachment loss (interproximal loss is greater than buccal loss). Periodontitis infrabony defect.
What are the localized dental prosetheses-related factors?
Partial denture
Crown/bridge
What is the space occupied by the JE and CT attachment fibers?
Supracrestal Tissue Attachement (Biological Width)
Impingement on the supracrestal tissues attachment will cause
Chronic gingival inflammation and bone loss
A crown placement of ___mm coronal to alveolar crest is paramount in maintaining gingival health.
2mm
What can happen if the crown margin is closer than 2mm to the alveolar crest?
Bone resorption
What occurs if margins of restorations encroach upon the zone of soft tissue occupied by the JE and conntective tissue attachment fibers?
Supracrestal tissue attachment violation
What is a localized accumulation of pus in a peridontal pocket?
A periodontal abscess
What can trigger an endo-periodontal lesion?
Carious or traumatic lesion that affects both the pulp and periodontium
What is traumatic occlusal force or excessive occlusal trauma?
Force that exceeds that adaptive capacity of the periodontium or teeth
True or False: Local risk factors can be either acquired or anatomical
True
What are some aquired local risk factors?
Calculus
Restoration overhangs
Poorly contoured restorations
What are some anatomical local risk factors?
Malpositioned teeth
Root grooves
Concavities
Furcations
